Nuclear cardiology · UK
Myocardial perfusion imaging, read by a cardiologist.
SPECT, PET or stress cardiac MRI - chosen for the clinical question, ordered by a consultant cardiologist, and interpreted the same way. Not a slot in a list.
Indicative pricing
What private myocardial perfusion imaging costs in the UK.
Indicative ranges across our partner nuclear cardiology and CMR units.
In short
£800–£1,400, with the cardiology consultation to translate it arranged the same week.
| Test | Indicative range | Typical duration | Report turnaround |
|---|---|---|---|
| SPECT MPI (rest + stress, 2-day) | £900–£1,400 | 2 × 3–4 h | 3–5 days |
| SPECT MPI (1-day protocol) | £800–£1,300 | 6–8 h | 3–5 days |
| PET MPI (Rb-82 or 13N-ammonia) | £1,200–£2,200 | 2–3 h | 3–5 days |
| Stress cardiac MRI (CMR perfusion) | £900–£1,600 | 60–75 min | 3–7 days |
| CT coronary angiogram (alternative) | £700–£1,400 | 30–45 min | 2–5 days |
| Cardiology consultation (report review) | £250–£450 | 30–45 min | Same visit |
Prices vary by centre, by which technique and tracer are used, by whether stress is exercise or pharmacological, and by whether a cardiology consultation is bundled in.
The problem
The right test, in the right order, for the right patient.
NICE CG95 now recommends CT coronary angiography first for many patients with stable chest pain - with MPI or stress CMR reserved for when a functional answer is needed. Ordering MPI in the wrong sequence wastes time, tracer and radiation.
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Chest pain, no clear diagnosis?
CT-CA is usually first per NICE CG95. MPI or stress CMR follows when the anatomy is ambiguous or disease is already known.
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Known CAD, new symptoms?
Functional imaging shows whether narrowings are actually limiting flow - the question that drives revascularisation decisions.
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Worried about radiation?
Stress cardiac MRI uses no ionising radiation and is increasingly first-line where available. We say when it fits.
When it helps
When myocardial perfusion imaging is the right step.
The situations where MPI genuinely changes management, plus the one red flag that means an ambulance rather than an appointment.
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Chest pain - typical or atypical angina
Where CT coronary angiogram is inconclusive or already shows disease that needs functional assessment.
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Post-MI risk stratification
After a heart attack, to map ischaemic burden and viable myocardium before planning revascularisation.
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Pre-operative cardiac risk
Before major non-cardiac surgery in patients with known CAD or significant cardiovascular risk factors.
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After PCI or CABG
Assessing completeness of revascularisation, graft patency, and any recurrent ischaemia in stented or bypassed territories.
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Known CAD with new symptoms
When established disease seems to be progressing - has flow become limiting, and where?
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Athlete cardiac evaluation
For symptomatic or high-risk athletes where a functional assessment adds to structural imaging.
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Cardiomyopathy workup
Ischaemic versus non-ischaemic cause - perfusion imaging (often CMR) helps make the distinction.
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Red flag: acute chest pain
Crushing central chest pain, breathlessness, sweating or radiation to arm or jaw is an emergency - call 999, not a clinic.
Techniques
SPECT, PET or CMR - and which stress with it.
What each modality and stress protocol actually involves - and which fits which patient.
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SPECT MPI
Most widely used UK test. Technetium-99m sestamibi or tetrofosmin (occasionally thallium-201), stress plus rest, gated for LVEF and wall motion.
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PET MPI
Rubidium-82 or 13N-ammonia. Superior spatial resolution and quantitative myocardial blood flow reserve. Fewer UK centres, higher cost.
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Stress cardiac MRI (CMR)
Gadolinium-based perfusion imaging. Increasingly first-line per NICE CG95 update. No ionising radiation and excellent resolution.
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Exercise stress
Treadmill Bruce or Modified Bruce, or cycle. Preferred where exercise capacity is intact and beta-blockers are not blocking target heart rate.
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Adenosine / regadenoson
Coronary vasodilators for patients who cannot exercise. Regadenoson is quicker and better tolerated; both wear off in minutes.
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Dipyridamole
An older vasodilator, still used in some UK centres. Similar principle to adenosine, longer half-life.
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Dobutamine stress
An inotrope for patients who cannot have vasodilators - for example, severe reactive airways disease.
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Consultation only
An honest discussion of whether MPI is the right next test, or whether CT-CA, CMR or invasive angiography fits better.
Safety and preparation
What to expect on the day - honestly.
Myocardial perfusion imaging is a well-established, low-risk investigation. The things worth planning are the caffeine pause, your medications, and knowing what pharmacological stress feels like.
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Ionising radiation (SPECT/PET)
SPECT MPI delivers roughly 10–14 mSv, PET 4–8 mSv - comparable to a CT abdomen. CMR perfusion uses no ionising radiation.
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Pharmacological stress side effects
Transient chest tightness, breathlessness, headache or flushing with adenosine or regadenoson - usually gone in under two minutes.
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Bronchospasm risk
Adenosine, regadenoson and dipyridamole are avoided in significant asthma or reactive airways disease. Dobutamine is offered instead.
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Heart block and arrhythmia
Vasodilators are avoided in high-grade AV block. Serious arrhythmia, MI or stroke during testing is very rare (<0.1%).
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Caffeine and medication pause
No caffeine for 24 hours before pharmacological stress. Some anti-anginals may be paused - never stop medication without advice.
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Fasting
Usually 4–6 hours nothing to eat before stress imaging. Sips of water and essential medications with a small drink are generally fine.
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Tracer or contrast reaction
Radiopharmaceutical reactions are very rare. Gadolinium for CMR carries a small allergy risk and is used with care in advanced kidney disease.
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Cumulative radiation exposure
A small excess lifetime cancer risk from repeated nuclear studies - one reason CMR is now often preferred where available.
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Red flags
Persistent chest pain, breathlessness or arrhythmia after the test are not normal - call the clinic, GP or A&E the same day.
Reading your MPI report
Your MPI report in four parts. Read the last one first.
Whichever technique was used, the report the cardiologist sends you keeps to the same shape.
A quiet reminder
Nuclear cardiology language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the report before your consultant review, just ask.
- 01 Header
Indication, stressor and tracer
Why the test was done, whether stress was exercise or pharmacological, and which tracer or contrast agent was used.
- 02 Technique
Protocol and image quality
1-day or 2-day protocol, target heart rate reached, blood pressure response, and any technical limitations of the images.
- 03 Findings
Perfusion, LVEF and wall motion
Summed stress and rest scores, reversible or fixed defects by coronary territory, ejection fraction and regional wall motion.
- 04 Impression
Ischaemia, scar and next step
Read this first: is there flow-limiting ischaemia, prior infarct, or a normal study - and does it warrant angiography or medical therapy.
Recognised by major UK insurers
Cover for myocardial perfusion imaging varies by insurer and indication - usually funded when a cardiologist has ordered it for symptom evaluation or risk stratification.
Frequently asked
Everything we get asked about myocardial perfusion imaging.
Quick answers on techniques, radiation, cost, preparation, and what your report actually means.
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What is myocardial perfusion imaging and what does it show?
MPI is a non-invasive test that maps blood flow to the heart muscle at rest and under stress. A radioactive tracer (SPECT/PET) or gadolinium contrast (CMR) highlights areas that are underperfused - showing ischaemia from flow-limiting coronary disease, scar from a prior heart attack, or a normal, low-risk study.
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How is MPI different from a CT coronary angiogram?
CT coronary angiogram (CT-CA) shows the anatomy of the coronary arteries - the plaque and narrowings. MPI shows whether those narrowings are actually limiting blood flow to the muscle. NICE CG95 now recommends CT-CA first for many patients with stable chest pain; MPI or CMR perfusion follows when CT-CA is inconclusive or shows disease that needs functional assessment.
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Which technique is best - SPECT, PET or CMR perfusion?
SPECT is the most widely available UK test and adequate for most patients. PET has better resolution and quantifies blood flow, but is offered by fewer centres. CMR perfusion has excellent resolution and no ionising radiation, and is increasingly first-line where available. Your cardiologist chooses based on the clinical question and local expertise.
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How much does private myocardial perfusion imaging cost in the UK?
Roughly £800–£1,400 for SPECT MPI, £1,200–£2,200 for PET MPI, and £900–£1,600 for stress cardiac MRI. CT coronary angiogram - often the first-line alternative - is £700–£1,400. A cardiology consultation to translate the report is £250–£450.
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Is the radiation dose from MPI dangerous?
SPECT MPI delivers about 10–14 mSv and PET 4–8 mSv - comparable to a CT abdomen and roughly 3–5 years of natural background radiation. The excess lifetime cancer risk from a single study is very small, and the clinical benefit almost always outweighs it. CMR perfusion uses no ionising radiation at all.
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What happens during pharmacological stress?
You are given adenosine, regadenoson or dipyridamole through a cannula - these dilate coronary arteries and mimic the effect of exercise. Regadenoson is a single small injection; adenosine runs for several minutes. Most people feel brief chest tightness, breathlessness, flushing or headache that settles in under two minutes. Dobutamine is used if vasodilators are not suitable.
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How should I prepare?
No caffeine for 24 hours before pharmacological stress - that includes coffee, tea, chocolate and decaffeinated products. Fast for 4–6 hours. Some anti-anginal medications may be paused, but only on your cardiologist’s advice - never stop tablets on your own. Bring a list of current medications.
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What does a "reversible defect" on my report mean?
It means an area of heart muscle is well perfused at rest but underperfused during stress - the hallmark of flow-limiting coronary disease (ischaemia). A fixed defect (reduced at both rest and stress) usually means prior infarct or scar. Partially reversible means a mix of ischaemia and scar. Your cardiologist decides whether to add angiography or manage medically.