echo vs muga

[rinaina]

Before starting chemo, A/C, I had a muga and my score was 61%. Then I had another muga prior to Herceptin and it was 64%. I just had an echo and will get the results tomorrow. My onc wanted me to get an echo this time because he felt it gave more info than a muga as well as it being more accurate than a muga. Does anyone have any opinions on this or know of any documentation supporting one over the other? Thanks for your help once again.

[Bev]

Hi Rinaina,

I switched from muga to echo because the muga was making me claustrophobic and I saw others on board were doing echos.

I know my echo tech did complain that it was really hard to get a good view of my heart between my closely spaced ribs. I would guess bones are transparent to mugas.

I go in this week for another echo. I do find echos easier and less time consuming. I'll see if the tech knows what the difference is.

I'm curious too. BB

[tousled1]

I have been getting echocardiograms to monitor my LVEF since starting Herceptin. With the MUGA I believe that some sort of dye is inserted into your vein. As far as I know both tests give good results.

[rinaina]

yes tousled, with the muga they have to take your blood and then mix it with some radioactive material and it has to sit and mix for a bit in the lab and then they re-inject it into you before doing the muga so it is a process and the muga definitely takes longer. supposedly the echo gives more info such as how the blood is flowing.

[cathy34]

Hi,
Initially when all this started I got MUGA's and they were too much of a hassel. I had really small, rolling veins and I used to leave there looking like a pin cushion.
I told my onc. and she said she preferred ECHO's over MUGA's anyway. She said they are show more.
I think an ECHO is the way to go.
Good luck!!!!

[rinaina]

Thanks Cathy and I agree with the muga's being a hassle. They take longer and why keep getting that radioactive junk injected into us, we have enough problems to deal with as it is. I did have to get an IV though for my echo in order for them to get good contrast but that was no big deal. Thanks for your input. I value the experience of the forum members.

[Ruth]

Just a quick note...had a "false" low reading on MUGA (didn't know this could happen) & was on weekly Herceptin. Onc. insisted on ECHO (felt MUGA test was wrong) & didn't want my Herceptin interupted...had Echo, heart looked awesome and no MUGA's following only ECHO's. I was not in the HERA trial so he had freedom to do this. Personally LOVED the Echo; hated the MUGA and the sticking!

Ruth

[Chelee]

rinaina, I know I have always wondered which one actually is more accurate? The two oncologist I have had order ECHO's for me. When I first started it seemed more women on the boards were getting MUGA's. Its a toss up to me as to which might be better?

However one thing I like about getting an ECHO is no radioactive dye is being used. I get enough of that during PET/CT scans.

Let us know what the results of your first ECHO is when you find out. Good luck to you.

Chelee

[rinaina]

I agree with you Chelee about echo over muga simply because of the radioactive dye alone. It did seem like more people on here were getting mugas and that is one reason why I asked the question muga vs echo.

I got my echo results and my EF was 60% so I can continue on with herceptin knowing my heart is doing okay. Everything else was perfect too they said.

[Bev]

Tech had limited English so I didn't ask. It did occur to me that if you recently had surgery on the left side, you would not want them pressing the ECHO transducer into your surgical site. So perhaps once they start with MUGAs they stick with them. Hmm.

[Chelee]

rinaina, Thats great to hear your ECHO was up enough to continue on herceptin. Its always nice to get good news. At least no inturruptions this way. I think Bev might be on to something when it comes to the MUGA's. Many women have bilat mastectomys or at least a left side mastectomy...so that would make it almost impossible to use a ECHO. She might be right as to why most oncologist seem to do MUGA's.

If your reading this Bev...that makes sense. I think you just might be right on the money here. :)

Chelee

[tousled1]

Chelee,

I had a bilateral mastectomy and my oncologist has always ordered echocardograms. I have no problem with getting the echo since my surgery. I had my surgery in June and had echos in July and October. I had large breasts (D cup) and now I think it's easier since they don't get in the way. I still think it's just a personal preference for the doctor as to whether you get a MUGA or echo.

[newgg]

The best thing about the ECHO.....is no sticks ! Also had a bilateral and it has not been a problem getting accurate ECHO. Sometime have to change position ... inhale and hold or exhale and hold. The ECHO is NO sticks and faster from start to finish.
Hugs, Bonnie

[atdec05]

For some reason, my hospital will give a MUGA, unless you request an echo. The cynic in me thinks this is related to billing/insurance. My onc. was going to give me MUGAs, but thanks to this and other boards, I knew to ask for echos.

My understanding is that a MUGA gives you a precise number for the LEVF rate, whereas the echo is based on the technician's assessment, so it can be given as a range, e.g., 60-65.

For 4 of my echos, the technicians could get a rate, even though my ribs are close together. At my last echo, the technician wanted to inject some dye to get a better reading. Luckily, I'm at a small hospital and insisted I run upstairs to get my port accessed so they could use it.

- Anna

[Hopeful]

I just had my first MUGA since I started Herceptin (aprox. 3 months in) and the onc was disturbed that the LVEF dropped from 74 to 64. He wants yet ANTOHER MUGA, and, like most of you, I am tired of being stuck. I am going to call and see if we can get an ECHO instead. Thanks for bringing this issue to everyone's attention.

Hopeful

[rinaina]

Wow, an EF of 74 was really high to begin with, not that that is bad. A 64 EF is still considered to be very good. I was told that if it falls below 50 that is reason for concern. Mine was just 60% and I was told that is great so I wouldn't be too concerned. Perhaps the 74 was an error to begin with. Maybe repeat with an echo for clarification. Echo gives a lot more info than a muga as well. I don't think you have anything to worry about but then again, I am not a doctor.

[Hopeful]

Rinaina,

The onc did comment that 74 was high. I had both tests done at the same facility. I talked to the technician at length during the second test, and she explained to me that different sites use different computer programs to calculate the LVEF, so that if you have your tests done at different sites, there could be some inconsistent results. She said that with the program they use, the fields are set by the computer, but the operator has the opportunity to "correct" something that doesn't look right. I really know nothing about this equipment and how it works, so she lost me after a bit. I like the idea that the ECHO gives more information and does not involve nuclear medicine. I am defintely going to discuss with the doc. At this point I am not worried, just growing impatient with all these doctor visits and tests!

Hopeful

[rinaina]

Hopeful, I can relate when you say you are tired of it all. Hang in there though because you want to do whatever you can to help yourself fight this horrible disease. All the tests and doctors and treatments are for our own good, as frustrating as it can get sometimes. We just need to stay informed so we can be our own best advocate. That's why this forum and other sites are so helpful.

[Hopeful]

Rinaina,

Thanks for the support; I am just a little overwhelmed with seasonal stuff, work, and now one more thing to add to the "to do" list. Most of the time, I feel very fortunate, grateful (and a little guilty) that I have access to the care that I do and insurance to help pay for it.

Have a great day!

Hopeful

[rinaina]

Don't feel guilty, just be thankful you do have the resources. I know I am. Have a great holiday season.

[Donna]

Hi Rinaina,

I talked to my oncologist about his today and here's her answer:
the MUGA is not subject to human interpretation as the ECHO is and so it is more reliable. A cardiologist interprets the ECHO and each cardiologist may interpret it differently, whereas the MUGA is a machinated process measuring the muscle that is the problematic reason for the test in the first place. She said there are ways to make the ECHO work, but that the best test in her opinion is the MUGA.

I am scheduled for my third MUGA on the 29th so I was interested to know and I am so glad you brought it up so I could ask about it.

Best to You,

Donna

[rinaina]

Thanks for the input on muga vs. echo. I think I remember reading things along those lines as well about the mugs. I suppose either way, it's close enough to what they are concerned about hopefully. Good luck on your next muga.

[Chelee]

Donna, Thank you so much for explaining the difference between MUGA & ECHO. I for one appreciate it. I have always gotten ECHO's. I have really questioned my latest one? That day the lady that did my ECHO had a brand new machine to learn. So someone was teaching her how to use it while doing my ECHO. Right in the middle of my ECHO a total power outage! Then they had back-up generators kick on. They mentioned losing SOME of my results during the blackout. (Again, NEW machine.)

So they finished up and when I recieved my last ECHO it states my EF rate at 70%. Thats exactly what my FIRST ECHO was BEFORE the start of chemo/herceptin. (I also over heard the two women saying that the parameters had NOT been set for this machine yet and they were going to have to WAIT till the doctors did that, and agreed on what they would be.)
I'm hoping the doctors got this right because I really find it hard to believe my EF is exactly the same as the day I started herceptin 10 months ago? But if it is...sounds great to me. http://www.her2support.org/vbulletin/images/smilies/smile.gif

But it sounds like a MUGA might be more accurate although its more invasive due to the radioactive dye. I might ask if I could have at least one MUGA to compare to my EHCO's.

Chelee