1. Treadmill exercise is the most widely used stress modality. Several treadmill exercise protocols are described which differ in the speed and grade of treadmill inclination and may be more appropriate for specific patient populations. The Bruce and modified Bruce protocosls are the most widely used exercise protocols. 2. Upright bicycle exercise is commonly used in Europe. This is preferable if dynamic first-pass imaging is planned during exercise. Supine or semisupine exercise is relatively suboptimal and should only be used while performing exercise radionuclide angiocardiography.

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers