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MUGA / Equilibrium Radionuclide Angiography (Tc-99m Labeled RBC)

NM+ ContrastCardiac

Indications

Accurate, reproducible LV ejection fraction measurement
Monitoring cardiotoxic chemotherapy (e.g., anthracyclines, trastuzumab)
Assessment of LV/RV function in heart failure
Pre/post cardiac surgery functional assessment

Patient prep

No specific fasting required
Place ECG leads for gating (regular rhythm needed for best results)
IV access for in vitro/in vivo RBC labeling

Contrast

AgentTc-99m labeled autologous red blood cells (in vitro modified labeling preferred)

RouteIV

Dose15-25 mCi (555-925 MBq)

TimingImaging begins after equilibrium of labeled RBCs in blood pool (~few minutes)

Technique

LEHR collimator, 140 keV, ECG-gated equilibrium acquisition (16-24 frames/cardiac cycle)
Best-septal LAO view to separate ventricles for LVEF; also anterior and LPO
Counts-based LVEF = (end-diastolic counts - end-systolic counts)/(EDC - background)

Series / Sequences

#	Series / Sequence	Plane	Notes
1	Best septal LAO	LAO (40-45 deg)	Primary view for LVEF calculation
2	Anterior	Anterior	Wall motion assessment
3	LPO / left lateral	Oblique/lateral	Inferior/posterior wall motion

Key points

MUGA provides highly reproducible LVEF, valued for serial chemotherapy monitoring
Best-septal LAO view critical for accurate ventricular separation
Arrhythmias (atrial fibrillation, frequent ectopy) degrade gating accuracy
Good RBC labeling efficiency essential; free pertechnetate degrades blood-pool images

References

• SNMMI Procedure Guideline for Gated Equilibrium Radionuclide Ventriculography
• ASNC guidance on radionuclide ventriculography
• Radiopaedia: MUGA scan link

Source: Researched — verify against your institution

‹ PreviousCardiac MRI - Function and Viability With Contrast Next ›Myocardial Perfusion SPECT (Rest/Stress Tc-99m Sestamibi)

Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.