TY - JOUR
T1 - LVEF by Multigated Acquisition Scan Compared to Other Imaging Modalities in Cardio-Oncology
T2 - a Systematic Review
AU - Printezi, Markella I
AU - Yousif, Laura I E
AU - Kamphuis, Janine A M
AU - van Laake, Linda W
AU - Cramer, Maarten J
AU - Hobbelink, Monique G G
AU - Asselbergs, Folkert W
AU - Teske, Arco J
N1 - Funding Information: L. W. L. is supported by the Netherlands Heart Foundation, Dekker Senior Clinical Scientist 2019, grant agreement no. 2019T056. F. W. A. is supported by UCL Hospitals NIHR Biomedical Research Centre. Publisher Copyright: © 2022, The Author(s).
PY - 2022/6
Y1 - 2022/6
N2 - Purpose of Review: The prevalence of cancer therapy-related cardiac dysfunction (CTRCD) is increasing due to improved cancer survival. Serial monitoring of cardiac function is essential to detect CTRCD, guiding timely intervention strategies. Multigated radionuclide angiography (MUGA) has been the main screening tool using left ventricular ejection fraction (LVEF) to monitor cardiac dysfunction. However, transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR) may be more suitable for serial assessment. We aimed to assess the concordance between different non-radiating imaging modalities with MUGA to determine whether they can be used interchangeably. Recent Findings: In order to identify relevant studies, a PubMed search was performed. We included cross-sectional studies comparing MUGA LVEF to that of 2D TTE, 3D TTE, and CMR. From 470 articles, 22 were selected, comprising 1017 patients in total. Among others, this included three 3D TTE, seven 2D harmonic TTE + contrast (2DHC), and seven CMR comparisons. The correlations and Bland-Altman limits of agreement varied for CMR but were stronger for 3D TTE and 2DHC. Summary: Our findings suggest that MUGA and CMR should not be used interchangeably whereas 3D TTE and 2DHC are appropriate alternatives following an initial MUGA scan. We propose a multimodality diagnostic imaging strategy for LVEF monitoring in patients undergoing cancer treatment.
AB - Purpose of Review: The prevalence of cancer therapy-related cardiac dysfunction (CTRCD) is increasing due to improved cancer survival. Serial monitoring of cardiac function is essential to detect CTRCD, guiding timely intervention strategies. Multigated radionuclide angiography (MUGA) has been the main screening tool using left ventricular ejection fraction (LVEF) to monitor cardiac dysfunction. However, transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR) may be more suitable for serial assessment. We aimed to assess the concordance between different non-radiating imaging modalities with MUGA to determine whether they can be used interchangeably. Recent Findings: In order to identify relevant studies, a PubMed search was performed. We included cross-sectional studies comparing MUGA LVEF to that of 2D TTE, 3D TTE, and CMR. From 470 articles, 22 were selected, comprising 1017 patients in total. Among others, this included three 3D TTE, seven 2D harmonic TTE + contrast (2DHC), and seven CMR comparisons. The correlations and Bland-Altman limits of agreement varied for CMR but were stronger for 3D TTE and 2DHC. Summary: Our findings suggest that MUGA and CMR should not be used interchangeably whereas 3D TTE and 2DHC are appropriate alternatives following an initial MUGA scan. We propose a multimodality diagnostic imaging strategy for LVEF monitoring in patients undergoing cancer treatment.
KW - Cardiac magnetic resonance imaging
KW - Cardio-oncology
KW - Cardiotoxicity
KW - Echocardiography
KW - Left ventricular ejection fraction
KW - Multigated acquisition scan
UR - http://www.scopus.com/inward/record.url?scp=85127375091&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s11897-022-00544-3
DO - https://doi.org/10.1007/s11897-022-00544-3
M3 - Review article
C2 - 35355205
SN - 1546-9530
VL - 19
SP - 136
EP - 145
JO - Current Heart Failure Reports
JF - Current Heart Failure Reports
IS - 3
ER -