Abstract
BackgroundMultiple gated acquisition scanning (MUGA) is a common imaging modality for baseline and serial assessment of left ventricular ejection fraction (LVEF) for cardiotoxicity risk assessment prior to, surveillance during, and surveillance after administration of potentially cardiotoxic cancer treatment. The objective of this study was to compare the accuracy of left ventricular ejection fractions (LVEF) obtained by contemporary clinical multiple gated acquisition scans (MUGA) with reference LVEFs from cardiovascular magnetic resonance (CMR) in consecutive patients with cancer.MethodsIn a cross-sectional study, we compared MUGA clinical and CMR reference LVEFs in 75 patients with cancer who had both studies within 30 days. Misclassification was assessed using the two most common thresholds of LVEF used in cardiotoxicity clinical studies and practice: 50 and 55%.ResultsCompared to CMR reference LVEFs, MUGA clinical LVEFs were only lower by a mean of 1.5% (48.5% vs. 50.0%, p = 0.17). However, the limits of agreement between MUGA clinical and CMR reference LVEFs were wide at −19.4 to 16.5%. At LVEF thresholds of 50 and 55%, there was misclassification of 35 and 20% of cancer patients, respectively.ConclusionsMUGA clinical LVEFs are only modestly accurate when compared with CMR reference LVEFs. These data have significant implications on clinical research and patient care of a population with, or at risk for, cardiotoxicity.
Highlights
Multiple gated acquisition scanning (MUGA) is a common imaging modality for baseline and serial assessment of left ventricular ejection fraction (LVEF) for cardiotoxicity risk assessment prior to, surveillance during, and surveillance after administration of potentially cardiotoxic cancer treatment
Common cancer treatments such as anthracyclines and trastuzumab are associated with an increased risk of cardiotoxicity, which is responsible for significant mortality and morbidity in cancer survivors [1, 2]
The objective of this study was to compare the accuracy of LVEFs obtained by contemporary clinical MUGA in consecutive patients with cancer with reference LVEFs from cardiovascular magnetic resonance (CMR), the gold standard technique for assessment of left ventricular volumes and LVEF [5]
Summary
Multiple gated acquisition scanning (MUGA) is a common imaging modality for baseline and serial assessment of left ventricular ejection fraction (LVEF) for cardiotoxicity risk assessment prior to, surveillance during, and surveillance after administration of potentially cardiotoxic cancer treatment. The objective of this study was to compare the accuracy of left ventricular ejection fractions (LVEF) obtained by contemporary clinical multiple gated acquisition scans (MUGA) with reference LVEFs from cardiovascular magnetic resonance (CMR) in consecutive patients with cancer Common cancer treatments such as anthracyclines and trastuzumab are associated with an increased risk of cardiotoxicity, which is responsible for significant mortality and morbidity in cancer survivors [1, 2]. The objective of this study was to compare the accuracy of LVEFs obtained by contemporary clinical MUGA in consecutive patients with cancer with reference LVEFs from cardiovascular magnetic resonance (CMR), the gold standard technique for assessment of left ventricular volumes and LVEF [5]
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