Stress only myocardial perfusion imaging: Is it time for a change?

Stress single photon emission computed tomographic (SPECT) myocardial perfusion imaging has enjoyed great success over the past several decades as the modality of choice for accurately diagnosing and risk stratifying patients with suspected or known coronary artery disease. Same-day low-dose rest/high-dose stress imaging protocols have generally been widely adopted for this purpose. However, recent studies indicate that rest imaging may be unnecessary in patients with a normal initial stress SPECT. Elimination of the additional imaging would decrease costs, streamline patient evaluations, and reduce radiation exposure. SPECT imaging guidelines should be revised to reflect this new information.