We read with great interest the recent article by Zhang et al. regarding the prognostic value of CZT SPECT myocardial blood flow (MBF) quantification. They studied a population of 118 patients with ischemia and no obstructive coronary artery disease (INOCA), all of whom underwent dynamic CZT SPECT imaging on a D-SPECT camera. During a median follow-up of 15 months, 19 major adverse cardiovascular events (MACEs) occurred. Both stress MBF and coronary flow reserve (CFR) were significantly lower in the MACE group. Compared with CFR, stress MBF provided a better prognostic model and remained a robust predictor of MACEs. Several studies previously confirmed feasibility, reproducibility, and good agreement in the calculation of MBF between CZT SPECT and PET-CT. Stress and rest MBF values obtained by CZT-SPECT are different than those measured by PET imaging and are usually higher, especially in the case of no attenuation correction (NAC) data. There can also be an influence of a flow model used for quantification of MBF on CZT SPECT. In the discussion, Zhang et al. mentioned a matter up for debate concerning which parameter (stress MBF or CFR) is better [1]. Results of their study suggest that stress MBF is superior to CFR. However, both stress MBF and CFR can be considered, at least if the values are assessed by means of CZT SPECT.