2 Finally, several figures and new sections on myocardial blood flow with SPECT, stress-first/stress-only imaging, and patient centered MPI are added to this update. The section on reporting of SPECT MPI has been removed and is now included in the new American Society of Nuclear Cardiology (ASNC) reporting guideline document. The interpretation section now includes guidance on interpretation of MPI from dedicated cardiac cameras. New information was added on reduced count density reconstruction techniques and reconstruction for solid state cameras. The processing section now has expanded coverage of iterative reconstruction and attenuation correction (AC). Acquisition protocols for MPI on existing cameras were updated and new protocols added for MPI with semiconductor detector cameras. The instrumentation quality assurance and performance section was updated with advances in novel detectors, novel cameras, and hybrid SPECT/computed tomography (CT) equipment. The current update includes the latest knowledge on SPECT MPI incorporated into existing and new sections of the document. Hence, the imaging guidelines described in this publication should be applied clinically only after review and approval by qualified local institutional physicians and technologists.

We recognize that SPECT technology is evolving rapidly and that these recommendations may need further revision in the near future. While the information supplied in this document has been carefully reviewed by experts in the field, the document should not be considered as medical advice or a professional service.

This publication is designed to provide MPI guidelines for conventional and novel SPECT for qualified medical professionals engaged in the practice of nuclear cardiology.

Myocardial perfusion imaging (MPI) can now be personalized and tailored to the individual patient and the clinical question.

Recent advances in Single Photon Emission Computed Tomography (SPECT) have fundamentally changed acquisition, processing, and interpretation of myocardial perfusion images using new technology. The purpose of this document is to update the “ASNC Imaging Guidelines for Nuclear Cardiology Procedures: Single photon-emission computed tomography” 1 in several areas in which novel evidence has emerged since its publication.

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