The contribution of PET viability studies to the understanding of recoverable ischemic left ventricular dysfunction cannot be overemphasized. However, it is uncertain whether FDG used with PET will continue to play a pivotal role in the clinical evaluation of all patients with poor function. Several competitive approaches became available over the recent years, perhaps equally effective. Currently, no data from appropriate prospective studies comparing cost, effectiveness and impact on patient prognosis of the different approaches are available.