2026 ASNC guideline for stress testing in single-photon emission computed tomography (SPECT) and positron emission tomography (PET) myocardial perfusion imaging.

TL;DR

Updated 2026 ASNC guideline provides comprehensive practice standards for cardiac stress testing with SPECT and PET myocardial perfusion imaging. Covers patient selection, stress protocols, safety, and interpretation to support standardized, patient-centric nuclear imaging across diverse clinical settings.

Key findings

• Updated standards since 2016 ASNC guideline to reflect evolving clinical experience and diagnostic imaging advances
• Encompasses complete workflow: patient selection/preparation, stress modalities/protocols, safety considerations, and result interpretation
• Addresses both SPECT and PET imaging in conjunction with various stress test modalities
• Provides practical guidance supporting individualized risk assessment and protocol adaptation based on patient characteristics and site-specific factors

Why this matters at the bedside

Guideline documents establish clinical practice standards for one of the most frequently performed cardiac diagnostic procedures; direct application to stress testing protocols in both outpatient and inpatient nuclear cardiology settings to optimize diagnostic accuracy and patient safety.