Cardiac blood pool scan

Last revised by Subhan Iqbal on 27 Oct 2021

A multi-gated (MUGA) cardiac blood pool scan (sometimes just called a MUGA scan) is a common study performed in patients who are receiving potentially cardiotoxic chemotherapy. 

  • patient in normal sinus rhythm
  • IV administration of Tc-99m-labeled RBCs
  • ECG gated – with R wave gating
  • minimum of 16 frames/cardiac cycle
  • at rest and exercise

This is obtained by injecting a compact bolus of suitable radiopharmaceutical intravenously. This stage is favorable for intracardiac shunts and ejection fraction calculation 2.

  • major advantage: data collected rapidly over very few cardiac cycles allows measurement of ventricular function at peak stress during exercise ventriculography
  • major disadvantage: counting statistics are low and only a limited number of views are possible
  • qualitative analysis
  • quantitative analysis
  • functional parameters
    • wall motion assessment (regional and global)
    • end-diastolic (ED) and end-systolic (ES) ventricular volumes
    • stroke volume
    • cardiac output
    • ejection fraction (LV and RV)
    • regurgitant fraction (stroke index ratio)
    • ventricular filling and emptying rates
    • cardiac shunt quantitation
      • left to right shunts: evaluated using the first transit technique (not equilibrium)
      • right to left shunts: evaluated using Tc-99m labeled macro aggregated albumin and comparing the ratio of tracer in the lung to tracer gaining access to the systemic circulation

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