<s>
Radionuclide	O
angiography	O
is	O
an	O
area	O
of	O
nuclear	O
medicine	O
which	O
specialises	O
in	O
imaging	O
to	O
show	O
the	O
functionality	B-Algorithm
of	O
the	O
right	O
and	O
left	O
ventricles	O
of	O
the	O
heart	O
,	O
thus	O
allowing	O
informed	O
diagnostic	O
intervention	O
in	O
heart	O
failure	O
.	O
</s>
<s>
It	O
involves	O
use	O
of	O
a	O
radiopharmaceutical	B-Algorithm
,	O
injected	O
into	O
a	O
patient	O
,	O
and	O
a	O
gamma	O
camera	O
for	O
acquisition	O
.	O
</s>
<s>
MUGA	O
scanning	O
is	O
also	O
called	O
equilibrium	O
radionuclide	O
angiocardiography	O
,	O
radionuclide	B-Algorithm
ventriculography	I-Algorithm
(	O
RNVG	O
)	O
,	O
or	O
gated	O
blood	O
pool	O
imaging	O
,	O
as	O
well	O
as	O
SYMA	O
scanning	O
(	O
synchronized	O
multigated	O
acquisition	O
scanning	O
)	O
.	O
</s>
<s>
MUGA/Cine	O
scanning	O
represents	O
a	O
robust	O
adjunct	O
to	O
the	O
now	O
more	O
common	O
echocardiogram	B-Application
.	O
</s>
<s>
The	O
advantage	O
of	O
a	O
MUGA	O
scan	O
over	O
an	O
echocardiogram	B-Application
or	O
an	O
angiogram	O
is	O
its	O
accuracy	O
.	O
</s>
<s>
An	O
echocardiogram	B-Application
measures	O
the	O
shortening	O
fraction	O
of	O
the	O
ventricle	O
and	O
is	O
limited	O
by	O
the	O
user	O
's	O
ability	O
.	O
</s>
<s>
Radionuclide	B-Algorithm
ventriculography	I-Algorithm
is	O
done	O
to	O
evaluate	O
coronary	O
artery	O
disease	O
(	O
CAD	O
)	O
,	O
valvular	O
heart	O
disease	O
,	O
congenital	O
heart	O
diseases	O
,	O
cardiomyopathy	O
,	O
and	O
other	O
cardiac	O
disorders	O
.	O
</s>
<s>
Radionuclide	B-Algorithm
ventriculography	I-Algorithm
gives	O
a	O
much	O
more	O
precise	O
measurement	O
of	O
left	O
ventricular	O
ejection	O
fraction	O
(	O
LVEF	O
)	O
than	O
a	O
transthoracic	O
echocardiogram	B-Application
(	O
TTE	O
)	O
.	O
</s>
<s>
Transthoracic	O
echocardiogram	B-Application
is	O
highly	O
operator	O
dependant	O
,	O
therefore	O
radionuclide	B-Algorithm
ventriculography	I-Algorithm
is	O
a	O
more	O
reproducible	O
measurement	O
of	O
LVEF	O
.	O
</s>
<s>
In	O
this	O
setting	O
,	O
a	O
much	O
more	O
accurate	O
measurement	O
of	O
ejection	O
fraction	O
,	O
than	O
a	O
transthoracic	O
echocardiogram	B-Application
can	O
provide	O
,	O
is	O
necessary	O
.	O
</s>
<s>
The	O
MUGA	O
scan	O
is	O
performed	O
by	O
labeling	O
the	O
patient	O
's	O
red	O
blood	O
pool	O
with	O
a	O
radioactive	O
tracer	O
,	O
technetium-99m-pertechnetate	O
(	O
Tc-99m	O
)	O
,	O
and	O
measuring	O
radioactivity	O
over	O
the	O
anterior	O
chest	O
as	O
the	O
radioactive	O
blood	O
flows	O
through	O
the	O
large	O
vessels	O
and	O
the	O
heart	O
chambers	O
.	O
</s>
<s>
In	O
the	O
in	O
vivo	O
method	O
,	O
stannous	O
(	O
tin	B-Protocol
)	O
ions	O
are	O
injected	O
into	O
the	O
patient	O
's	O
bloodstream	O
.	O
</s>
<s>
A	O
subsequent	O
intravenous	O
injection	O
of	O
the	O
radioactive	O
substance	O
,	O
technetium-99m-pertechnetate	O
,	O
labels	O
the	O
red	O
blood	O
cells	O
in	O
vivo	O
.	O
</s>
<s>
The	O
technetium	B-Algorithm
is	O
subsequently	O
added	O
to	O
the	O
mixture	O
as	O
in	O
the	O
in	O
vivo	O
method	O
.	O
</s>
<s>
In	O
both	O
cases	O
,	O
the	O
stannous	O
chloride	O
reduces	O
the	O
technetium	B-Algorithm
ion	O
and	O
prevents	O
it	O
from	O
leaking	O
out	O
of	O
the	O
red	O
blood	O
cells	O
during	O
the	O
procedure	O
.	O
</s>
<s>
The	O
patient	O
is	O
placed	O
under	O
a	O
gamma	O
camera	O
,	O
which	O
detects	O
the	O
low-level	O
140	O
keV	O
gamma	O
radiation	O
being	O
given	O
off	O
by	O
Technetium-99m	O
(	O
99mTc	O
)	O
.	O
</s>
<s>
Radionuclide	B-Algorithm
ventriculography	I-Algorithm
has	O
largely	O
been	O
replaced	O
by	O
echocardiography	B-Application
,	O
which	O
is	O
less	O
expensive	O
,	O
and	O
does	O
not	O
require	O
radiation	O
exposure	O
.	O
</s>
<s>
An	O
uneven	O
distribution	O
of	O
technetium	B-Algorithm
in	O
the	O
heart	O
indicates	O
that	O
the	O
patient	O
has	O
coronary	O
artery	O
disease	O
,	O
a	O
cardiomyopathy	O
,	O
or	O
blood	O
shunting	O
within	O
the	O
heart	O
.	O
</s>
