Copyright ©2012 Baishideng Publishing Group Co.
World J Radiol. Oct 28, 2012; 4(10): 421-430
Published online Oct 28, 2012. doi: 10.4329/wjr.v4.i10.421
Table 1 Older and recent applications of multigated acquisition
Older applications
Recent applications
Evolving applications for routine use
Commonly employed modality in current practice
Chamber orientation++/--Echocardiogram
Chamber size++/--Echocardiogram
Rhythm abnormalities+--Electrophysiologic studies
Global EF++++Contrast angiogram, 2D echocardiogram
Regional EF++++MUGA
Wall motion abnormalities+++/--Gated myocardial perfusion scans
Diastolic function evaluation-+++Echo-Doppler with E/A measurements
Assessment of synchrony--++Speckle tracking echocardiogram
Table 2 Guidelines to perform multigated acquisition in adult patients on doxorubicin[14]
Baseline MUGA (before starting of chemotherapy or before 100 mg/m2 doseIf LVEF is ≤ 30% - no doxorubicin
If baseline LVEF is > 30% and < 50%MUGA to perform before each dose
If baseline LVEF is ≥ 50%MUGA to perform at the dose of 250-300 mg/m2, 400-450 mg/m2 and thereafter before each higher dose
If the fall of LVEF from previous study is ≥ 10% or if LVEF is ≤ 30%Discontinue doxorubicin
Table 3 Guidelines for serial monitoring of left ventricular ejection fraction in pediatric patients receiving anthracyclines and mediastinal irradiation[15]
If mediastinal irradiation is < 1000 cGyPerform echocardiogram every alternate dose of doxorubicin when dose is < 300 mg/m2 and perform echocardiogram before each dose if the dose of chemotherapeutic agent is ≥ 300 mg/m2
If mediastinal irradiation is > 1000 cGyPerform echocardiogram before each dose
When the cumulative dose of chemotherapy crosses 400 mg/m2Perform MUGA before any additional dose
Discontinue doxorubicinIf the fall of LVEF is ≥ 10% from previous study or LVEF is < 55%
Follow upMUGA at 1st year of completion of therapy and then echocardiogram yearly till next 3 years and a repeat MUGA at 5th year along with electrocardiogram yearly