Myocardial perfusion scintigraphy and cost effectiveness of diagnosis and management of coronary heart disease.

M yocardial perfusion scintigraphy (MPS) is a well validated, non-invasive imaging technique that has a valuable role in the diagnosis, management, and assessment of prognosis of coronary heart disease (CHD). The diagnostic accuracy of MPS allows reliable risk stratification and guides the selection of patients for further interventions, such as revascularisation. MPS also has particular advantages over alternative techniques in the management of a number of patient subgroups, including women, the elderly, and those with diabetes. Increased use of MPS will improve patient outcomes and be associated with greater cost effectiveness of treatment, in terms of life-years saved, particularly in these special patient groups. Currently, however, access to MPS in the UK is limited, with inappropriately long waiting times, and MPS activity levels fall short of estimated need.