The read stuff, and the option stuff in general, is based on the ability to read certain defenders instead of blocking them. You could still run the zone stuff, both inside and outside, but I don't know that you could have the same playbook. You could do some same-side reads (think Paul Johnson's offense at GT), but personally if I was going to do that type of option, I would prefer it under center. It hits so much quicker...
As was mentioned above, however, it would give a better opportunity for bootleg type plays, where you set up a play one way and get the flow moving, then pull it out and boot the QB around. The disadvantage is that from the pistol, unless you align your RB REALLY deep, the play fake occurs really early and the flow doesn't get as much of a chance to get moving, thus tends to be a little less effective (given an equal amount of selling/faking by the offense).
At least that's my take on it...when Nevada had the right tools, however, they certainly didn't have any problems running option out of the pistol. So it boils down to whatever you can coach effectively and what system best fits what your players can do. Sometimes it's not the X's and the O's, but the Jimmy's and the Joe's...
/Captain Obvious