The serotonin 4 receptor (5-HT 4 receptor) is known to be involved in learning and memory. We evaluated for the first time the quantification of a novel 5-HT 4 receptor radioligand, 11 C-SB207145, for in vivo brain imaging with PET in humans. Methods: For evaluation of reproducibility, 6 subjects were scanned twice with 11 C-SB207145 on the same day. A further 2 subjects were scanned before and after blocking with the selective 5-HT 4 receptor inverse agonist piboserod (SB207266). Arterial blood samples were drawn for the calculation of metabolite-corrected arterial input functions. Regions of interest were delineated automatically on the individual's MR images coregistered to the PET images, and regional time-activity curves were extracted. Quantitative tracer kinetic modeling was investigated with 1-and 2-tissue-compartment models using plasma input functions and the simplified reference tissue model (SRTM). Results: 11 C-SB207145 readily entered the brain and showed a distribution consistent with the known localization of the 5-HT 4 receptor. Using plasma input models, the time-activity data were well described by the 2-tissue-compartment model in all regions and allowed for the estimate of binding potentials relative to the reference region (BP ND : striatum, 3.38 6 0.72; hippocampus, 0.82 6 0.19; parietal cortex, 0.30 6 0.08). Quantification with the 1-tissue-compartment model, 2-tissue-compartment model, and SRTM were associated with good test-retest reproducibility and time stability. However, the SRTM-generated BP ND values in the striatum were underestimated by 20%243% in comparison to the 2-tissue-compartment model. The blocking study with piboserod confirmed that the radioligand was selective for the 5-HT 4 receptor, that the cerebellum was a suitable reference region devoid of specific binding, and that nonspecific binding was constant across brain regions. Conclusion: In vivo imaging of cerebral 5-HT 4 receptors can be determined reliably using 11 C-207145 PET with arterial input in humans. SRTM showed high reproducibility and reliability but bias in the striatum, and therefore, the use of SRTM should be considered carefully for individual applications.