Improving Efficiency in the Nuclear Cardiology Laboratory: The Role of Stress-Only Imaging Coupled with Faster Acquisition Protocols and New Stressor Agents

Laboratory efficiency is an important benchmark to achieve whether imaging is hospital-based or in the private practice setting. The stressor and imaging protocols used and the camera systems available for imaging all play a pivotal role toward this end. A same-day low-dose rest/high-dose stress imaging protocol has been widely adopted in nuclear cardiology laboratories. However, recent studies indicate that rest imaging may be unnecessary in patients with a normal initial stress single photon emission CT (SPECT) study. Appropriate elimination of rest imaging would decrease costs, streamline patient evaluations, and significantly reduce radiation exposure. Several recent studies have validated the safety of stress-only imaging in patients who have an initially normal perfusion study. Combined with new pharmacologic stressor agents and camera systems that can complete imaging within minutes, laboratory efficiency and patient satisfaction should improve considerably. The following article will review these currently available advances in SPECT imaging.