SPECT imaging performed after stress reveals the distribution of the radiopharmaceutical, and therefore the relative blood flow to the different regions of the myocardium. Diagnosis is made by comparing stress images to a further set of images obtained at rest. As the radionuclide redistributes slowly, it is not usually possible to perform both sets of images on the same day, hence a second attendance is required 1–7 days later (although, with a Tl-201 myocardial perfusion study with dipyridamole, rest images can be acquired as little as two-hours post stress). However, if stress imaging is normal, it is unnecessary to perform rest imaging, as it too will be normal – thus stress imaging is normally performed first.
