Myocardial Perfusion Imaging (MPI) Testing Market By Imaging Modality (SPECT, PET); By Tracer Type (Technetium-99m, Thallium-201, Rubidium-82, N-13 Ammonia); By Application (Coronary Artery Disease Diagnosis, Therapy Monitoring, Pre-Surgical Risk Assessment); By End User (Hospitals, Outpatient Imaging Centers, Private Cardiology Clinics, Academic Institutions); By Geography, Segment Revenue Estimation, Forecast, 2024–2030

Introduction And Strategic Context

The Global Myocardial Perfusion Imaging (MPI) Testing Market is on track for sustained growth, registering a steady CAGR of 6.8%, with an estimated valuation of USD 2.7 billion in 2024, and projected to reach nearly USD 4.1 billion by 2030, according to Strategic Market Research.

 

At its core, myocardial perfusion imaging is used to evaluate blood flow to the heart muscle, often during stress and rest conditions. It plays a central role in diagnosing coronary artery disease (CAD), assessing myocardial viability, and guiding revascularization strategies. As global cardiovascular disease rates continue to rise — especially among aging populations in both developed and emerging markets — the strategic relevance of MPI testing is growing sharper with each passing year.

 

Several macro forces are converging to shape the market between 2024 and 2030. First, there’s been a noticeable shift in cardiac diagnostics from invasive to non-invasive modalities. This aligns with global health systems’ push toward value-based care and risk reduction. Nuclear cardiology, particularly single-photon emission computed tomography (SPECT) and positron emission tomography (PET), remains central to this shift — thanks to its ability to provide actionable, image-based insights without catheterization.

 

Second, reimbursement frameworks are evolving. In the U.S., Centers for Medicare & Medicaid Services (CMS) has expanded payment models that favor diagnostic precision. In Europe, digital health integration is enabling MPI data to be shared and interpreted across facilities, improving throughput and collaboration. This is raising the bar for imaging equipment and software — and increasing demand for advanced tracer agents that offer sharper contrast and faster decay.

 

Third, we’re seeing a spike in hybrid imaging adoption. SPECT/CT and PET/CT systems are becoming more prevalent in tertiary hospitals and cardiology centers. These machines offer anatomical and functional insights in a single scan, supporting faster diagnoses and reducing the need for follow-ups. At the same time, software enhancements — including artificial intelligence for image reconstruction and automated perfusion analysis — are transforming how clinicians interpret MPI results.

 

The stakeholder mix is also shifting. Original equipment manufacturers are bundling MPI hardware with clinical decision-support tools. Radiopharmaceutical companies are investing in next-generation tracers. Hospitals are upgrading their nuclear cardiology departments as part of broader heart disease programs. Meanwhile, cardiologists and imaging specialists are leaning heavily on MPI as a decision-making tool — not just a screening method.

 

Market Segmentation And Forecast Scope

The myocardial perfusion imaging (MPI) testing market can be segmented across four main dimensions: by imaging modality, by tracer type, by application, and by end user. Each layer reveals how healthcare systems, imaging centers, and cardiologists are evolving their approach to ischemic heart disease diagnosis — balancing cost, clarity, and clinical confidence.

By Imaging Modality

The MPI testing market is split between SPECT and PET technologies.

• SPECT continues to dominate in terms of installed base and procedure volume, especially in community hospitals and diagnostic centers. It offers broad accessibility and lower upfront costs.

• PET-based MPI is gaining traction due to superior resolution, shorter acquisition times, and more accurate quantification of myocardial blood flow.

In 2024, SPECT still accounts for over 70% of MPI test volume globally — but PET is the faster-growing modality. Hybrid systems (like SPECT/CT or PET/CT) are now being viewed not just as upgrades but as standard investments by high-volume cardiac centers.

What’s pushing PET forward? The wider availability of rubidium-82 generators and FDA approvals for new PET tracers are key catalysts. Also, the emergence of AI-enabled PET workflow software is lowering the expertise barrier for adoption.

 

By Tracer Type

Radiopharmaceuticals used in MPI include Technetium-99m (Tc-99m) agents, Thallium-201, and PET tracers like Rubidium-82 and N-13 ammonia.

• Tc-99m remains the backbone of SPECT imaging — with agents like sestamibi and tetrofosmin offering reliable diagnostic quality.

• PET tracers, while more expensive and logistically demanding, deliver faster results and better specificity.

There’s growing interest in PET tracers among private cardiology chains and large academic hospitals. In fact, several are forming direct partnerships with radiopharma companies to ensure consistent tracer supply — especially for rubidium-based imaging.

 

By Application

The dominant application for MPI remains coronary artery disease (CAD) diagnosis. However, its role is expanding into risk stratification, treatment monitoring, and pre-surgical cardiac assessments for high-risk patients.

While CAD testing accounts for the majority of procedures in 2024, the fastest-growing use case is therapy monitoring — particularly in patients with known ischemia or undergoing medical therapy for chronic angina. As payers demand more proof of treatment efficacy, repeat MPI scans are becoming part of cardiology care pathways.

 

By End User

Key end users include:

• Hospitals and Cardiac Centers: These dominate the market, especially in high-acuity cases requiring hybrid imaging systems.

• Outpatient Imaging Facilities: Rising in relevance as insurers push diagnostics into lower-cost settings.

• Standalone Cardiology Clinics: In regions like North America and parts of Europe, private cardiology practices are investing directly in compact SPECT systems or entering tracer-sharing networks.

• Academic Institutions: Often early adopters of PET MPI, especially in research around myocardial flow reserve and microvascular dysfunction.

What’s interesting? Cardiac care is becoming more decentralized. A decade ago, most MPI tests happened in tertiary hospitals. Now, outpatient imaging centers with same-day scheduling are capturing more routine MPI demand — especially in urban and suburban areas.

 

By Region

While a full breakdown follows in Section 5, it’s worth noting here that North America leads in procedure volume, Europe leads in regulatory standardization, and Asia Pacific is growing fastest due to new investments in cardiovascular diagnostic infrastructure. Meanwhile, PET-based MPI is still largely limited to North America, Japan, and a handful of EU countries — though that's starting to shift.

 

Market Trends And Innovation Landscape

There’s a quiet transformation happening in myocardial perfusion imaging — one driven not by flashy product launches, but by subtle shifts in how technology, workflow, and software are coming together to redefine cardiac diagnostics.

The biggest trend right now is the push toward AI-powered automation in MPI interpretation. Vendors are embedding machine learning models into image reconstruction workflows to cut interpretation time, improve lesion detection accuracy, and reduce inter-reader variability. Some cardiologists report that AI-assisted analysis now flags perfusion defects that might’ve been overlooked in conventional reads — especially in borderline ischemia cases.

 

Next up is hardware miniaturization and portability, especially in the SPECT segment. Compact cardiac SPECT systems — which used to be confined to academic labs — are now being deployed in private cardiology offices and mid-sized community hospitals. These systems, often mounted on wheels and designed for quick-turnaround stress testing, are enabling MPI to expand into more decentralized settings.

 

Then there’s quantitative perfusion measurement, which is quickly becoming a clinical differentiator. PET MPI allows for absolute quantification of myocardial blood flow and myocardial flow reserve. That means cardiologists no longer have to rely solely on visual or semi-quantitative reads. It’s changing how borderline lesions are managed and whether patients go to stents or stick with medical therapy.

 

On the software side, cloud-based MPI post-processing is emerging fast. Some vendors now offer full remote analysis suites — physicians can upload raw scan data, run it through cloud-based reconstruction engines, and receive structured perfusion reports within minutes. That’s particularly helpful for outpatient imaging facilities without in-house nuclear cardiology expertise.

 

Meanwhile, radiopharmaceutical innovation is heating up quietly but meaningfully. Developers are refining existing tracers to improve washout rates and reduce radiation exposure. There’s also a wave of clinical research on new-generation PET tracers that could enable even sharper perfusion imaging — with fewer logistical constraints. Expect more progress here by the end of the decade, particularly if reimbursement opens up for novel compounds.

 

One overlooked but important trend is the rise of MPI in pre-operative risk stratification — especially in high-risk, non-cardiac surgeries. More hospitals are adopting it as a go-to tool before orthopedic, vascular, and oncology-related surgeries. The logic is simple: MPI gives a fast, non-invasive read on ischemic risk that can dramatically alter surgical planning.

 

On the M&A and partnerships front, there’s been a flurry of activity:

• Imaging OEMs are acquiring AI startups to embed MPI intelligence into scanners natively.

• Radiopharma manufacturers are collaborating with health systems to guarantee stable tracer supply.

• Workflow software firms are partnering with PACS vendors to integrate perfusion results directly into cardiologists’ reporting templates.

Here’s what all this means long term: MPI testing is slowly shedding its “supporting cast” image and stepping into a more central diagnostic role. With AI, hybrid hardware, and smart software maturing in parallel, myocardial perfusion imaging is set to become a strategic pillar of precision cardiology — not just a test, but a data-generating decision engine.

 

Competitive Intelligence And Benchmarking

Competition in the myocardial perfusion imaging (MPI) testing market is centered on a few critical battlegrounds — hardware innovation, tracer availability, software integration, and downstream service contracts. Unlike in other imaging markets, differentiation here often comes down to operational efficiency and diagnostic precision rather than just image quality alone.

GE HealthCare continues to be a dominant force, especially in the SPECT space. Its cardiac-specific gamma cameras have a wide installed base globally, particularly in community hospitals and outpatient imaging centers. The company has also invested heavily in hybrid systems that combine SPECT with CT, offering fused anatomical-functional diagnostics in a single workflow.

 

Siemens Healthineers holds a strong position in the PET MPI segment. Its systems are known for speed and clarity, particularly in busy cardiac departments handling high patient throughput. Siemens has also been ahead in integrating AI algorithms for motion correction and automatic perfusion mapping — two features that are becoming table stakes in high-end MPI imaging.

 

Philips Healthcare is pushing aggressively into software-driven MPI. Their IntelliSpace platform offers modular AI interpretation tools, remote post-processing, and automated reporting — helping mid-sized hospitals and imaging chains scale MPI without adding nuclear cardiology staff. For sites prioritizing turnaround time and report consistency, that software layer is becoming a make-or-break factor.

 

Spectrum Dynamics is carving out a niche with its CZT-based SPECT systems. These compact, high-sensitivity cameras are optimized specifically for cardiac imaging, offering sharper scans at lower radiation doses. Adoption is rising, especially in outpatient cardiology offices where floor space and speed matter more than multi-specialty versatility.

 

Bracco Imaging plays a critical role on the radiopharmaceutical side. It provides a range of tracer agents and has built partnerships with imaging networks to streamline supply logistics. In North America, Bracco's distribution agreements with PET tracer facilities give it strong leverage in the growing rubidium-82 market.

 

CardioNavix and INVIA Medical Imaging Solutions, while smaller, are gaining attention with their specialized MPI interpretation software. These companies offer AI-powered workflow solutions that layer onto existing imaging hardware — effectively turning older SPECT units into smart diagnostic platforms. This retrofit approach is catching on with budget-constrained hospitals.

 

From a benchmarking standpoint, the competitive edge increasingly lies in integration rather than standalone innovation. Players that offer end-to-end MPI ecosystems — from tracer to scanner to interpretation software — are winning long-term deals, especially with regional hospital networks and cardiac-focused outpatient chains.

 

Also, there’s a rising trend of vendor-managed services. Some OEMs are now bundling scanner leases, tracer logistics, and software licenses into a single monthly payment model. This shifts capital expenses to operating budgets, making MPI upgrades more palatable for CFOs — and giving vendors deeper control over the entire diagnostic workflow.

 

Regional Landscape And Adoption Outlook

Adoption of myocardial perfusion imaging (MPI) varies widely across regions — driven not just by technology access but by reimbursement policies, clinical training, and the structure of cardiac care delivery. What works in a suburban U.S. outpatient center may not apply in a public hospital in South Asia. That makes the regional dynamics of this market particularly important for vendors and investors.

North America remains the most mature and procedure-dense region for MPI testing. The U.S. alone accounts for a large share of global scan volume, fueled by a mix of aging populations, high cardiovascular disease burden, and well-developed insurance coverage. SPECT is still dominant, but PET MPI is growing fast — especially in private cardiology practices and academic health systems that prioritize speed and quantification. PET tracers like rubidium-82 are widely accessible through generator-based supply chains, and radiopharma infrastructure is strong across the U.S. and Canada.

What’s helping adoption here is a clear reimbursement path and standardized MPI protocols. Many practices follow American Society of Nuclear Cardiology (ASNC) guidelines, which promotes consistent testing patterns and technology upgrades. Plus, hybrid systems like SPECT/CT and PET/CT are often covered by Medicare and private payers when clinically justified.

 

Europe takes a more conservative but structured approach. Germany, the UK, and the Netherlands lead in terms of MPI volume, but the modality mix still favors SPECT. That said, PET MPI is making slow but steady inroads — mostly in research hospitals and university-affiliated heart centers. Reimbursement policies vary, but some EU nations are beginning to support PET MPI under pilot schemes or bundled payments for cardiac care.

There’s also a growing push for standardized MPI protocols across the continent. Regulatory bodies like the European Association of Nuclear Medicine (EANM) are aligning with radiology societies to streamline patient prep, tracer usage, and follow-up care. The result is more clinical trust in MPI, even if funding remains a bottleneck in many public systems.

 

Asia Pacific is the fastest-growing region — not necessarily in procedure volume, but in infrastructure investments. Countries like China, India, South Korea, and Japan are expanding nuclear cardiology capacity as part of broader efforts to reduce cardiac mortality. Japan already has a mature MPI ecosystem, with high PET MPI penetration. South Korea is investing in AI-enabled SPECT labs. Meanwhile, in China and India, the focus is on scaling SPECT access across secondary and tertiary hospitals.

Interesting to note: some private health networks in India are leapfrogging straight to hybrid systems, bypassing older standalone SPECT models entirely. That creates a mixed landscape — world-class MPI in metros, limited access in rural belts. Over the next 5–7 years, AI-powered remote interpretation and mobile tracer logistics could help bridge that gap.

 

Latin America and Middle East & Africa (MEA) remain underdeveloped but emerging markets. Brazil and Mexico are seeing slow growth in cardiac imaging, driven by urban private hospitals and growing insurance penetration. In MEA, access to MPI is mostly limited to major cities like Riyadh, Dubai, and Johannesburg. Infrastructure, not demand, is the main limiter here.

Still, governments in both regions are signaling more support. Some are exploring public-private partnerships to deploy nuclear imaging in underserved areas. If those programs gain traction, these regions could see a late-decade acceleration in MPI volume — particularly for CAD risk stratification and pre-surgical assessment.

 

Across all regions, one theme stands out: hybrid MPI systems are increasingly the baseline, not the upgrade. Whether SPECT/CT or PET/CT, clinicians are looking for tools that do more with less — fewer false positives, shorter exam times, and clearer treatment signals. The vendors who can deliver that — and scale it across geographies with very different needs — are the ones best positioned to lead the next wave of growth.

 

End-User Dynamics And Use Case

Myocardial perfusion imaging (MPI) is a highly procedure-centric field — and who conducts those procedures matters just as much as how. The end-user landscape for MPI spans hospitals, specialized cardiac centers, imaging chains, and outpatient clinics. Each has different priorities, risk tolerances, and workflows, which shape how MPI systems and tracer logistics are bought, deployed, and optimized.

Hospitals and Cardiology Departments are the largest and most influential end-user segment. These facilities handle both acute and elective cardiac imaging. Most have in-house nuclear medicine teams and are equipped with full SPECT or PET MPI suites — often hybrid systems (SPECT/CT or PET/CT). In large urban hospitals, MPI is part of the standard ischemic workup for patients presenting with chest pain or pre-operative cardiac clearance needs.

What sets them apart? Scale and staffing. Hospitals perform high volumes of MPI scans daily, and many are adding AI-based reconstruction software to speed up reporting. Because most hospital cardiac programs are tied to interventional cardiology or surgical pathways, MPI results feed directly into treatment decisions — bypass surgery, stents, or medication adjustments.

 

Outpatient Imaging Centers are growing fast as payers push more diagnostic services into lower-cost settings. These centers tend to favor compact SPECT systems due to lower capital costs and simpler tracer logistics. Many are now working with third-party radiopharmaceutical networks to ensure just-in-time delivery of Tc-99m agents.

Workflow efficiency is the big driver here. Centers that can schedule same-day stress/rest imaging with fast turnaround reports are capturing more referrals from general practitioners and cardiologists. Some are also embedding MPI into broader cardiac panels that include ECG, echocardiography, and calcium scoring — offering bundled diagnostics in a single visit.

 

Private Cardiology Clinics represent a strategic but unevenly distributed segment. In North America, especially the U.S., a growing number of cardiologists now own and operate their own MPI equipment — typically compact SPECT units designed for in-office use. In other regions like Europe and Asia Pacific, private ownership is less common, but partnerships with imaging labs are on the rise.

What’s changing is how these clinics manage data and reporting. Cloud-based MPI software allows even solo practitioners to run high-quality perfusion analysis without needing in-house nuclear specialists. That’s unlocking adoption in suburban areas where access to imaging expertise is limited.

 

Academic and Research Institutions play a smaller volume role but are critical for innovation. These centers are usually early adopters of advanced PET MPI protocols, quantitative perfusion techniques, and investigational tracers. Many are also conducting research into how MPI can be used to assess microvascular dysfunction, which could broaden its application scope beyond coronary artery disease.

 

Use Case Highlight: Real-World Scenario

A tertiary hospital in South Korea integrated AI-based MPI post-processing software into its SPECT/CT workflow. Prior to implementation, image reconstruction and report generation took an average of 30 minutes per scan. After adopting the new system, the same process was cut to under 10 minutes — while maintaining diagnostic accuracy and reducing reader fatigue.

This time savings allowed the hospital to increase its daily scan volume by 40%, reduce patient wait times, and offer same-day MPI appointments for outpatient referrals. It also enabled cross-coverage by general radiologists, lowering the dependency on nuclear medicine specialists and easing staffing pressures.

 

Recent Developments + Opportunities & Restraints

Recent Developments (Past 2 Years)

• GE HealthCare launched MyoSPECT AI in 2023, a deep learning-based solution for cardiac SPECT imaging. It automates perfusion quantification and reconstruction, reducing interpretation time by up to 50%. Early deployments in U.S. cardiology clinics reported improved diagnostic consistency.

• Siemens Healthineers introduced Biograph Vision Quadra PET/CT, designed for ultra-fast, whole-body imaging. Though broader than cardiology, this platform enables dynamic cardiac PET studies with higher sensitivity — accelerating adoption of myocardial blood flow quantification.

• Bracco Imaging expanded Rubidium-82 generator distribution across Europe, responding to the growing interest in PET MPI outside North America. The company also announced partnerships with major radiopharmacies in Germany and France to ensure tracer availability.

• INVIA Medical Imaging released Corridor4DM v2024, featuring updated AI-enabled software modules for MPI interpretation. New features include ischemia burden quantification and integrated coronary flow reserve estimates, aimed at reducing false negatives.

• Nuclear medicine units in India and Brazil initiated public-private partnerships with international OEMs to expand access to hybrid SPECT/CT systems, especially in urban heart centers. These collaborations include bundled training programs and tracer supply chains.

 

Opportunities

• PET MPI expansion in Asia Pacific and Latin America: Emerging economies are scaling up nuclear cardiology infrastructure. Hybrid PET/CT systems are being piloted in both public and private hospitals, opening new demand for rubidium-based perfusion imaging.

• AI-driven interpretation software integration: Vendors that offer cloud-based post-processing or workstation-integrated AI modules are gaining traction — especially in imaging chains seeking faster throughput with fewer specialists.

• Mobile radiopharmaceutical delivery networks: Tracer supply is a key bottleneck. New logistics models, including mobile PET tracer cyclotrons and shared- radiopharmacy models, could unlock MPI access in mid-tier cities and underserved regions.

 

Restraints

• High capital investment and long ROI cycles: MPI systems — especially hybrid PET/CT — involve significant upfront costs. In many healthcare systems, these investments are difficult to justify without bundled reimbursement or guaranteed referral volumes.

• Shortage of trained nuclear medicine professionals: Many regions lack adequate personnel to operate MPI systems, interpret scans, or manage tracer protocols. This limits adoption in smaller hospitals and rural areas.

 

7.1. Report Coverage Table

Report Attribute	Details
Forecast Period	2024 – 2030
Market Size Value in 2024	USD 2.7 Billion
Revenue Forecast in 2030	USD 4.1 Billion
Overall Growth Rate	CAGR of 6.8% (2024 – 2030)
Base Year for Estimation	2024
Historical Data	2019 – 2023
Unit	USD Million, CAGR (2024 – 2030)
Segmentation	By Imaging Modality, By Tracer Type, By Application, By End User, By Geography
By Imaging Modality	SPECT, PET
By Tracer Type	Technetium-99m, Thallium-201, Rubidium-82, N-13 Ammonia
By Application	Coronary Artery Disease Diagnosis, Therapy Monitoring, Pre-Surgical Risk Assessment
By End User	Hospitals, Outpatient Imaging Centers, Private Cardiology Clinics, Academic Institutions
By Region	North America, Europe, Asia Pacific, Latin America, Middle East & Africa
Country Scope	U.S., Canada, Germany, U.K., France, China, India, Japan, Brazil, South Korea, Saudi Arabia, South Africa
Market Drivers	- Shift toward non-invasive cardiac diagnostics - Growth in AI-enhanced image analysis - Expansion of hybrid imaging systems across emerging markets
Customization Option	Available upon request