MUGA clinical LVEFs were lower than CMR reference LVEFs by a mean of 1.5% (p=0.17) with wide limits of agreement (-19.4% to 16.5%), misclassifying 35% and 20% of patients at 50% and 55% thresholds.
Cross-Sectional (n=75)
Single-blind
No
Does MUGA accurately assess LVEF compared to CMR in patients with cancer?
MUGA LVEF assessments in cancer patients show wide limits of agreement and significant misclassification rates compared to CMR, suggesting limited accuracy for clinical decision-making.
Mean Difference: -1.5
Tasa de eventos absoluta: 48.5% vs 50%
valor p: p=0.17
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. In 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%. Compared 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. MUGA 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.
Huang et al. (Thu,) conducted a cross-sectional in Cancer (n=75). Multiple gated acquisition scanning (MUGA) vs. Cardiovascular magnetic resonance (CMR) was evaluated on Mean Left Ventricular Ejection Fraction (LVEF) (MD -1.5%, p=0.17). MUGA clinical LVEFs were lower than CMR reference LVEFs by a mean of 1.5% (p=0.17) with wide limits of agreement (-19.4% to 16.5%), misclassifying 35% and 20% of patients at 50% and 55% thresholds.
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