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Ehime University School of Medicine, based in the north-west of Japan’s Shikoku Island, is a world leader in cardiac imaging, with expertise in SPECT, PET, CT, and MR. Research into EKG-gated SPECT began in 1983 using a single head-rotating gamma camera and radioisotope Thallium-201, a world first. Now, the radiology team is able to provide excellent myocardial blood flow (MBF) quantification with a semi-conductor-detector SPECT – used for both MBF and myocardial flow reserve (MFR) or coronary flow reserve (CFR). They have extensive experience using FDG-PET for cardiac sarcoidosis, clinical NH3-PET (MBF/CFR), as well as NH3-PET and coronary CT-angiography. The Ehime Radiology team also began working on cardiac imaging using CT in 1996, using a single-detector helical CT for coronary CT angiography and 4D CT. Now they are working on whole heart stress perfusion CT and MBF quantification, evaluating the advantage of compressed sensed cardiac MR, with applications in cine-CT, coronary angiography, perfusion, and 3D late gadolinium enhancement (LDG). With these innovations, as well as world-class expertise across the modalities in cardiac imaging, Ehime University is making a major impact on the possibilities provided to radiologists around the world.