The Stress / Rest , or Rest / Stress models are considered compatible with respect to diagnostic performance. Local preference and logistics usually determine which one is used.

The Stress / Rest model has a clear advantage. If the stress study is normal, the rest study can be avoided because the rest study can not become more normal, than normal.

This approach will miss some patients with reverse changes (reverse redistribution with Tl-201). This phenomen is rare (< 5% in general population, and somewhat higher in patients who have had thrombolysis), and it is a good sign -- indicating patent artery or well developed collaterals to an area with myocardial injury.

If the clinical question specifically probe the possibility of a prior MI, then both the stress and rest study must be obtained.