Equilibrium radionuclide angiocardiography: Its usefulness in current practice and potential future applications

Table 3 Guidelines for serial monitoring of left ventricular ejection fraction in pediatric patients receiving anthracyclines and mediastinal irradiation[15]

If mediastinal irradiation is < 1000 cGy	Perform echocardiogram every alternate dose of doxorubicin when dose is < 300 mg/m2 and perform echocardiogram before each dose if the dose of chemotherapeutic agent is ≥ 300 mg/m2
If mediastinal irradiation is > 1000 cGy	Perform echocardiogram before each dose
When the cumulative dose of chemotherapy crosses 400 mg/m2	Perform MUGA before any additional dose
Discontinue doxorubicin	If the fall of LVEF is ≥ 10% from previous study or LVEF is < 55%
Follow up	MUGA at 1st year of completion of therapy and then echocardiogram yearly till next 3 years and a repeat MUGA at 5th year along with electrocardiogram yearly

MUGA: Multigated acquisition; LVEF: Left ventricular ejection fraction.