MPI in Women

Clinical Utility

Single-photon emission computed tomography (SPECT) MPI is the most commonly performed cardiac imaging procedure in the US⁷ and has demonstrated utility in defining risk and clinical decision making in women.^9,10 Exercise or pharmacologic stress MPI with SPECT has demonstrated diagnostic and risk-stratification value in the assessment of CAD in women.^9,10,153 SPECT MPI adds substantial incremental diagnostic and risk stratification value in women.⁹ Stratification was more effective in women than in men.¹⁰

Recommendations for MPI in Women

The revised ACC/AHA/ASNC Guidelines for the Clinical Use of Cardiac Radionuclide Imaging recognized the gender-related limitations of exercise ECG and the potential additive benefits of stress perfusion imaging in women.⁶⁵ A recent AHA scientific statement focusing on noninvasive cardiac testing in women indicated that nuclear MPI has value in assessing risk for cardiac death or myocardial infarction, or the need for revascularization.⁷ According to an ASNC consensus statement, ECG-gated SPECT MPI is the cornerstone of noninvasive evaluation of women with an intermediate pretest likelihood of CAD.⁹