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Protocols and Procedures

Protocols and Procedures

Patient-Centered MPI Protocols

Various protocols exist for MPI, and each protocol has its advantages and disadvantages.1 ASNC Imaging Guidelines recommend that nuclear cardiology laboratories implement patient-centered imaging by choosing the proper imaging procedure for each individual patient.2

Exercise Stress Testing

  • Preferred over pharmacologic stress when patients are able to exercise to ≥85% of the MPHR1

Pharmacologic Stress Testing

  • Testing with a pharmacologic stress agent may be appropriate for MPI procedures for patients who experience symptoms such as moderate-to-severe chest pain, excessive shortness of breath, or fatigue during exercise stress prior to achieving adequate exercise2

1-day Protocol

  • May have advantages over 2-day procedures for some patients1,2

2-day Protocol

  • May be preferred for large patients (>250 lb)1

Protocol Choice

  • Allow for stress-only imaging when the stress test is normal and therefore may be preferable to rest/stress protocols1
  • Protocols that limit radiation exposure and provide interpretable image quality are preferred, according to the ASNC Imaging Guidelines2

Staying up-to-date and adhering to these guidelines can help providers offer safe, high-quality patient care.

Find additional information about safety guidelines at The Joint Commission and US Pharmacopeial Convention websites.


1. DePuey EG, Mahmarian JJ, Miller TD, et al. Patient-centered imaging. J Nucl Cardiol 2012;19(2):185-215. Erratum in: J Nucl Cardiol 2012:19(3):633. 2. Henzlova MJ, Duvall WL, Einstein AJ, Travin MI, Verberne HJ. ASNC imaging guidelines for SPECT nuclear cardiology procedures: stress, protocols, and tracers. J Nucl Cardiol 2016;23(3):606-39. Erratum in: J Nucl Cardiol 2016;23(3):640-2.