We compared the influences of reconstruction methods using 180¡Æor 360¡Ædata upon contrasts and discriminating capability and diagnostic accuracy in Tc-99m-MIBI stress/rest myocardial SPECT, We reviewed SPECT images reconstructed only with 180¡Æprojection data or with 360¡Ædata in 18 patients and in 11 normal subjects. To compare counts of surface structures and deep structures, we measured apex/posterior wall ratios in 11 normal subjects. To compare the contrasts of images, we measured apex/ventricle ratios. To compare contrasts between normal and diseased myocardial segments, we measured count ratios of defect and normal segments in 4 patients who had single coronary artery diseases. To compare diagnostic accuracy, we scored SPECT images made with 180¡Æand 360¡Æata segmentally. Sensitivity and specificity for the diagnosis of coronary artery disease and for the diseased arteries with both 180¡Æand 360¡ÆSPECT images. If involvled coronary arteries had more narrowing than 50% in coronary angiogram, we considered them as diseased arteries. Apex/posterior wall ratios were not different significantly in normal subjects. Apex/ventricle ratios in normal subjects were different, significantly between 180¡Æand 360¡ÆSPECT images. Defect/normal ratios were different significantly between 180¡Æand 360¡ÆSPECT images in single vessel disease patients. The overall diagnostic accurracy was the same between 180¡Æand 360¡Ædata collection. Sensitivity was 94% and specificity was 91% for both types of data collection in this sample population. Sensitivity and specificity of each coronary artery territory were not significantly different between the images made with 180¡Æand 360¡Æ data. The images made with 180¡Ædata had better contrast between ventricle and myocardium and between hypoperfused and normal myocardium, though no difference was found between the ratios of the myocardial counts of surface and deep structures. However, diagnostic sensitivities of diseased artery territories were not different significantly and so were overall diagnostic accuracy between both methods of making images with 180¡Æand 360¡Ædata