MUGA (Radionuclide Ventriculography) Report

Patient: [name, MRN, DOB/age, sex]

Study Date: [date of acquisition]

Study: Gated Equilibrium Radionuclide Angiography (MUGA/ERNA) — [planar / SPECT]

Ordering Clinician: [name/service]

Interpreting Physician: [name, credentials]

Clinical Context

[Indication phrased as a clinical question] (If not provided, state "Indication not provided on requisition.")

[Pertinent history affecting interpretation] (Include only items that modify interpretation: cancer therapy agent class and baseline vs surveillance status, known cardiac disease, or rhythm considerations. Omit if none relevant.)

Comparison: [Most relevant prior LVEF study with modality, date, and LVEF value] (For cardiotoxicity monitoring, include baseline study if different from most recent prior. If no prior exists, state "No prior study available for comparison.")

Technique

• Radiopharmaceutical: [radiopharmaceutical identity] — [activity with units] IV; RBC labeling: [in vivo / in vitro / modified in vitro] (State "not documented" for any element missing from source data.)
• Acquisition: [planar / SPECT] ERNA; position: [supine / semi-upright]; views: [views obtained or tomographic parameters]
• ECG gating: rhythm: [sinus / atrial fibrillation / paced / frequent ectopy]; [number] frames per R–R; arrhythmia rejection: [yes with threshold / no / not documented]
• Quantification: [count-based ROI / volumetric]; contouring: [automated / manual / semi-automated]
• Technical limitations: [motion artifact / gating errors / frequent ectopy / chamber overlap / dose infiltration / no significant technical limitations] (Omit this line if no limitations.)

Findings

• LV Size: [normal / mildly enlarged / moderately enlarged / severely enlarged] (If SPECT volumes available: EDV [value] mL, ESV [value] mL.)
• LVEF: [value]% (LLN [value]%); [normal / mildly reduced / moderately reduced / severely reduced] LV systolic function
• Regional Wall Motion: [normal / abnormal — severity and location] (If abnormal, specify mild/moderate/severe hypokinesis, akinesis, or dyskinesis with anatomic location. If not reliably assessed, state reason.)
• Right Ventricle: [qualitative size and function assessment] (Include RVEF only if validated SPECT RV quantification available. May omit for planar studies.)

Impression

• LVEF [value]% (LLN [value]%); [normal / mildly reduced / moderately reduced / severely reduced] LV systolic function.
• [Regional wall motion summary] (State "Normal regional wall motion" or specify regions and severity of abnormalities.)
• [Comparison statement with absolute delta] (Example: "Compared with [modality] [date], LVEF [increased / decreased / stable] from [value]% to [value]% ([+/−value] EF units)." Note cross-modality comparability limitations if applicable.)
• [Clinical correlation] (For cardiotoxicity monitoring with LVEF below LLN or decline ≥5 EF units: state findings are "concerning for" LV systolic dysfunction and recommend clinical/oncology correlation. For heart failure: emphasize severity category and global vs regional pattern.)
• [Critical results communication] (If applicable, document recipient, method, and time per institutional policy. Omit if not applicable.)

Electronically signed by: [interpreting physician name, credentials]

Finalized: [date and time]