Radiation-induced cardiac disease has been observed in patients who have been irradiated to the mediastinum. A 68-year-old man who had been treated with chemoradiotherapy for esophageal cancer showed high FDG-uptake in his myocardium six months after the radiotherapy. The area of high FDG-uptake closely matched the irradiation field. This area also showed low 123I-BMIPP-uptake and delayed enhancement on Gd-MRI. These findings suggested the likelihood of radiation cardiomyopathy. There have been several studies on the detection of radiation cardiomyopathy by perfusion imaging, but few on detection by metabolic imaging or MRI. Early visualization and quantification of the degree of radiation cardiomyopathy might be possible by FDG-PET and 123I-BMIPP Gd-MRI.