Choosing the Appropriate Stress Test for Myocardial Perfusion Imaging

  • Michael Chetrit
  • Beni R Verma
  • Bo XuEmail author
Cardiac Nuclear Imaging (A Cuocolo and M Petretta, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Cardiac Nuclear Imaging


Purpose of Review

Choosing the most appropriate test or protocol to ensure patient safety along with accurate and informative results can be challenging. The aim of this article is to review important considerations when choosing a nuclear stress perfusion study.

Recent Findings

Single-photon emission computed tomography (SPECT) has a sensitivity of 70% and a specificity of 78% for the diagnosis of coronary artery disease (CAD), and positron emission tomography (PET) has a sensitivity of 90% and specificity of 88%. The addition of either SPECT or PET to cardiac-gated computed tomography (CCTA) confers an increase in specificity when compared to CCTA alone, at the cost of a lower sensitivity.


SPECT sets itself aside because of its relative low cost and easy accessibility. PET has a superior diagnostic performance and lower radiation exposure, but is less available and relatively more expensive for most clinicians. When ordering a nuclear stress perfusion test, the type of protocol and radiotracers used should be tailored to achieve the best overall accuracy and prognostic assessment with the lowest radiation dose achievable.


Myocardial perfusion imaging Nuclear perfusion imaging SPECT PET Hybrid CT Radiation 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. 1.Section of Cardiovascular Imaging, Heart and Vascular InstituteCleveland ClinicClevelandUSA
  2. 2.Department of Hospital MedicineCleveland ClinicClevelandUSA
  3. 3.Department of Cardiovascular MedicineCleveland ClinicClevelandUSA

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