Advantages of different radiopharmaceutical and protocol options
| Thallium-201 | Technetium-99m-based agent |
| Huge literature and familiarity | 99mTc available “24/7” from generator |
| Better perfusion tracer physiologically | Lower radiation exposure to patient |
| ? better viability tracer | Stress imaging can be delayed and repeated (e.g. for patient movement) |
| Need not be delivered daily (long half-life) | Better images, particularly in the obese |
| No preparation required | Gating practical |
| 99mTc-sestamibi | 99mTc-tetrofosmin |
| Large literature | No boiling required in preparation |
| ? better perfusion tracer physiologically | Faster gut clearance for good imaging |
| Two day 99mTc protocol | One day 99mTc protocol |
| Optimal quality images for stress and rest | More convenient for many patients |
| Second acquisition unaffected by first injection | |
| Gating of both acquisitions possible | |
| One day stress–rest order | One day rest–stress order |
| Rest study avoidable if stress study normal | No delay required between injections |