Recent advances in nuclear cardiology instrumentation have enabled myocardial perfusion imaging (MPI) with improved image quality and fast scan times. These developments also can be exploited to reduce the effective radiation dose to the patient. In this review, we discuss these technologies including new single photon emission computed tomography (SPECT) and positron emission tomography (PET) scanners, as well as novel reconstruction software with regard to their potential for the reduction of the patient radiation dose. New advances in nuclear cardiology instrumentation will allow routine rest/stress MPI imaging with low radiation doses (< 5 mSv) and fast imaging times, even by the software-only solutions. It is possible to further reduce the MPI radiation dose to less than 2 to 3 mSv range with standard acquisition times. PET perfusion imaging also can be performed with very low doses especially by the three-dimensional scanners allowing hybrid PET/computed tomographic angiography (CTA) imaging with low overall dose. In addition, stress-only protocols can be utilized to further reduce the radiation dose and the overall test time.
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