ROC curves generated using summed stress scores (n=393 males, 235 females). The diagnostic accuracy of stress perfusion CMR was significantly greater than SPECT in both single-vessel disease (SVD) and multi-vessel disease (MVD) - for both sexes (all p values <0.05). In SVD (A, B), the diagnostic accuracy was similar between males and females for both stress perfusion CMR (AUC, M: 0.86 vs. F: 0.89; p=0.420) and SPECT (AUC, M: 0.72 vs. F: 0.71; p=0.941). In MVD (C,D), stress perfusion CMR maintained a similar diagnostic accuracy between sexes (AUC, M: 0.92 vs. F: 0.89; p=0.635) but SPECT had a significantly lower diagnostic accuracy in females (AUC, M: 0.80 vs. F: 0.64; p=0.045). AUC = area under the curve. CMR = cardiovascular magnetic. SPECT= single-photon emission computed tomography.