How accurate is stress radionuclide imaging for diagnosis of CAD?

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Stress radionuclide testing is a moderately accurate test compared with coronary angiography for the diagnosis of coronary artery disease (CAD) in intermediate-risk individuals. Variations in technique of imaging (planar or single-photon emission computed tomography [SPECT]) and stress (exercise or pharmacologic) do not significantly alter the accuracy of this test, although there is some evidence for decreased accuracy in women (strength of recommendation [SOR]: A, based on multiple meta-analyses). Abnormal stress radionuclide screening in vascular surgical candidates also predicts an increased rate of perioperative cardiac events (SOR: A, based on meta-analysis).

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