Abstract: Cell apoptosis, or programmed cell death, is an important form of cell death, which extensively exists in the physiological and pathological processes of the formation and progression of many diseases. The ubiquitous presence of externalized phosphatidylethanolamine (PE) on apoptosis cells makes it an attractive target for in vivo molecular imaging of apoptosis. Apoptosis imaging provides a noninvasive and dynamic approach to monitor the therapy induced cellular changes in tumor, thus it is valuable in the evaluation of early tumor response to anticancer therapy, and may serve as a helpful tool for individualized treatment in clinical practice. Duramycin is a peptide that binds to PE with high affinity in the nanomolar range. Preclinical studies had shown the potential of radiolabeled duramycin for imaging of cell apoptosis associated with PE exposure. In this review, principles of apoptosis detection, preparation, purification and biodistribution characteristics of radiolabeled duramycin were summarized. Preclinical applications of 99mTc-HYNIC-Duramycin for the non-invasive imaging of cell apoptosis in response evaluation of tumors at early stage were specifically emphasized.