EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology B. Hesse 1 , K. Ta ¨gil 2 , A. Cuocolo 3 , C. Anagnostopoulos 4 , M. Bardie ´s 5 , J. Bax 6 , F. Bengel 7 , E. Busemann Sokole 8 , G. Davies 9 , M. Dondi 10 , L. Edenbrandt 2 , P. Franken 11 , A. Kjaer 1 , J. Knuuti 12 , M. Lassmann 13 , M. Ljungberg 14 , C. Marcassa 15 , P. Y. Marie 16 , F. McKiddie 17 , M. O’Connor 18 , E. Prvulovich 19 , R. Underwood 20 , B. van Eck-Smit 8 1 Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark 2 Department of Clinical Physiology, Malmo ¨ University Hospital, Malmo ¨ , Sweden 3 Department of Biomorphological and Functional Sciences, University Federico II, Naples, Italy 4 Imperial College School of Medicine (NHLI), London, UK 5 INSERM U601, Nantes, France 6 Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands 7 Nuklearmedizinische Klinik der TU, Munich, Germany 8 Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands 9 Department of Medical Physics, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK 10 Nuclear Medicine Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria 11 Nuclear Medicine, AZ VUB, Brussels, Belgium 12 Turku PET Centre, Turku University Central Hospital, Turku, Finland 13 Klinik fu ¨ r Nuklearmedizin, Universita ¨t Wu ¨ rzburg, Wu ¨ rzburg, Germany 14 Department of Medical Radiation Physics, The Jubileum Institute, Lund, Sweden 15 Fondazione Maugeri, IRCCS, Verona, Italy 16 Service de Me ´ decine Nucle ´aire, Ho ˆ pital de Brabois, Vandoeuvre, France 17 Nuclear Medicine Department, Aberdeen Royal Infirmary, Foresterhill Scotland, UK 18 Section of Nuclear Medicine, Mayo Clinic, Rochester MN, US 19 Institute of Nuclear Medicine, Middlesex Hospital, London, UK 20 Department of Nuclear Medicine, Royal Brompton Hospital, London, UK Published online: 21 May 2005 © Springer-Verlag 2005 Abstract. The European procedural guidelines for radio- nuclide imaging of myocardial perfusion and viability are presented in 13 sections covering patient information, radio- pharmaceuticals, injected activities and dosimetry, stress tests, imaging protocols and acquisition, quality control and reconstruction methods, gated studies and attenuation- scatter compensation, data analysis, reports and image dis- play, and positron emission tomography. If the specific recommendations given could not be based on evidence from original, scientific studies, we tried to express this state-of-art. The guidelines are designed to assist in the practice of performing, interpreting and reporting myocar- dial perfusion SPET. The guidelines do not discuss clinical indications, benefits or drawbacks of radionuclide myocar- dial imaging compared to non-nuclear techniques, nor do they cover cost benefit or cost effectiveness. Abbreviations AC: Attenuation compensation (attenuation correction) . ALS: Advanced life support . COR: Centre of rotation . DRL: Diagnostic reference levels . EF: Ejection fraction . FBP: Filtered back-projection . FDG: Fluorodeoxyglucose . FWHM: Full-width at half-maximum . LEAP: Low-energy, all-purpose (collimator) . LEGP: Low-energy general- purpose (collimator) . LEHR: Low-energy high- resolution (collimator) . LV: Left ventricular . LVEF: Left ventricular ejection fraction . MLEM: Maximum likelihood expectation maximisation . NEMA: National Electrical Manufacturers Association . OSEM: Ordered subsets expectation maximisation . PVC: Premature ventricular contractions . QC: Quality control . SA block: Sinoatrial block . SDS: Summed difference score . SRS: Summed rest score . SSS: Summed stress score . Eur J Nucl Med Mol Imaging (2005) 32:855–897 DOI 10.1007/s00259-005-1779-y Guidelines B. Hesse (*) . Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark e-mail: bhesse@rh.hosp.dk European Journal of Nuclear Medicine and Molecular Imaging Vol. 32, No. 7, July 2005