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A system is described for tomographic myocardial perfusion imaging which has proven superior to planar imaging. This approach utilizes a multi-pinhole plate to project 7 simultaneous views of the heart as separate images. The heart is positioned 13 cm from the pinhole plate, and 750,000 count images are accumulated. The digitized data is processed into 12 tomographic planes spaced 6 cm to 24 cm from the pinhole plate. Reconstruction is accomplished by the Simultaneous Multiple Angle Reconstruction Technique (SMART) which computes 12 tomographic images in less than 2 minutes. Iterative techniques are used to perform attenuation correction and refocusing of the data. Point source resolution 13 cm from the collimator was measured to be 10 mm FWHM parallel to the detector and 15 mm perpendicular. The probability of detection in patients with coronary artery disease was improved from .75 to .95 by the tomographic method.