**Northern Lincolnshire and Goole NHS Foundation Trust - Nuclear Medicine** 

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SELECT sop AS "SOP Code",title AS "Title",reviewdate AS "Review Date" FROM sops WHERE sop='REF002'|0]] 
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^  Authorised By  ^  Authorising Role  ^  Authorisation Signature \\  (only on master paper copy)  ^  Date Authorised  |
|  Dr M Balerdi    |  ARSAC Licence Holder  |    |  2025-01-07  |

====== REF002 - Radionuclide Ventriculography ======
See [[referral_criteria:ref000-how_to_refer_to_nlagnm|REF000 - Referring to Nuclear Medicine (NLAG)]] for details on how to refer. 

=====  Description  =====
Radionuclide ventriculography (sometime referred to as a MUGA scan) is a reproducible technique for assessing left ventricular function and left ventricular ejection fraction. It is performed by in-vivo labelling of red cells with a radioactive tracer followed by acquiring ECG gated images on a gamma camera. 

[[sqlite:unused:unused:unused:/home/heynmorg/public_html/wikifarm/nlag/data/meta/arsac/database2019.db|SELECT fullname AS "ARSAC Licence Holders" FROM practitionerlicences INNER JOIN practitioners,procedurecodes,praclicproc,nuclides,chemicalforms ON practitionerlicences.practitioner=practitioners.id AND praclicproc.plicid=practitionerlicences.id AND praclicproc.procid=procedurecodes.id AND procedurecodes.nuclide_id=nuclides.id AND procedurecodes.chemicalform_id=chemicalforms.id AND practitionerlicences.certificateactive='Y' WHERE procedure_code='99mTc-48-10'  AND date('now')<=expirydate  ORDER BY expirydate|0]]
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[[sqlite:unused:unused:unused:/home/heynmorg/public_html/wikifarm/nlag/data/meta/employers_procedures/drl_database.db|
SELECT nuclide AS Nuclide, pharmaceutical_form AS "Pharmaceutical Form",  
local_drl AS "Local DRL (MBq)" FROM drls INNER JOIN nuclides ON drls.nuclide_id=nuclides.id 
WHERE drls.id=7|0]]
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^Typical Radiation Dose (mSv)  |2.8mSv for 400MBq  | 

===== Staff Entitled to Refer =====
  * All UK registered medical practitioners

===== Supplementary Drugs =====
  * Sodium chloride for parenteral use (0.9% w/v).
  * Stannous Agent/Sodium pyrophosphate.


===== Contraindications =====
  * Pregnancy.
  * Significant disturbance of cardiac rhythm, e.g. atrial fibrillation, and hence a highly variable RR interval, means gated imaging is unlikely to be reliable.


===== Clinical Indications =====
|Assessment of global left ventricular function[([[https://cdn.ymaws.com/www.bnms.org.uk/resource/resmgr/guidelines/planar_radionuclide_cardiac_.pdf|Nicol, A et al. Procedure Guideline for Planar Radionuclide Cardiac Ventriculogram for the Assessment of Left Ventricular Systolic Function. Version 2 2016. British Nuclear Medicine Society]])][([[https://www.acr.org/-/media/ACR/Files/Practice-Parameters/CardiacScint.pdf|ACR–NASCI–SNMMI–SPR–STR Practice Parameter For The Performance of Cardiac Scintigraphy (Amended 2023)]])] | 
|Assessment of regional left ventricular function/wall motion abnormalities[(#2)]  |
|Assessment of diastolic function[(#2)]  |
|Serial measurement of left ventricular ejection fraction to assess left ventricular function following administration of chemotherapeutic or other cardiotoxic agents (e.g.Herceptin) [(#1)][(#2)]  |
|Suspected heart failure (e.g. selection of patients for ACE inhibitor) [(#1)] |
|Assessment of ventricular function in patients with valvular heart disease [(#1)] |
|Assessment of left ventricular function prior to major surgery  |
|Assessment of left ventricular function prior to cardiac transplantation  |
|Assessment of left-to-right cardiac shunts (via first pass imaging) [(#2)]  |
|Assessment of right ventricular function (via first pass imaging) [(#2)]  |