The evaluation of multiple gated acquisition (MUGA) scan in breast cancer patients with left breast expander artifact. Description, challenges and solutions

Learning Objectives 1. The purpose for this study is to evaluate the frequency, appearance, location, effect, challenges and solutions of the left breast expander artifact in MUGA scans in patients with left breast expander device. The solution includes limited but certain adjustments of acquisition protocols in order to avoid the artifact caused by the breast expander. 2. To show: 1) Normal anatomy and appearance of MUGA scans. 2) Description of the device artifact appearance in MUGA scans. 3) The different locations of this artifact, the frequency and the limitations of each location. 4) How to evaluate the difference in the ejection fraction caused by this artifact. 5) How to avoid this artifact, challenges and solutions. 6) If the artifact is unavoidable, how to deal with it. 7) Different examples of each location and appearance. 8) How to perform subsequent imaging in the same patient

Summary: The breast expander artifact may or may not affect the MUGA scan results. It depends on the location, size and appearance of this artifact. Evaluation of this artifact requires meticulous observation and slight but certain adjustments of the imaging protocols in order to improve the results. Detailed documentation of all the data is required as a future reference for the following exams in the same patient. Understanding the examples provided for each location and situation is important.