A recent clinical study performed in 322 patients  was the first randomized comparison of the clinical effectiveness of pharmacologic stress PET with rubidium-82 or SPECT with technetium-99m in symptomatic patients undergoing risk stratification for coronary artery disease.
It was found that a higher proportion of patients with high-risk findings on PET imaging underwent coronary revascularization on follow-up than those undergoing SPECT and that a lower proportion of patients with low-risk findings on PET underwent follow-up catheterization than on SPECT. This suggests that PET supports better risk assessment than SPECT resulting in improved downstream use.
Patel KK et al., Randomized Comparison of Clinical Effectiveness of Pharmacologic SPECT and PET MPI in Symptomatic CAD Patients, J Am Coll Cardiol Img 2019 ;12 :1821-1831