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Gallium Scan of Liver

Norm of Gallium Scan of Liver

Symmetric patterns of liver gallium uptake. Requires interpretation.

 

Usage of Gallium Scan of Liver

Detection of hepatomas, abscesses, biopsy sites, and alcoholic cirrhoses and evaluation of recurrent lymphomas or tumors after chemotherapy and radiation therapy.

 

Description of Gallium Scan of Liver

Nuclear medicine scan of the liver using gallium-67 citrate radiopharmaceutical. Normal liver tissue will absorb gallium in a symmetric fashion. Abscesses appear as a “rim sign,” heavily concentrated areas of gallium uptake surrounding a cold center. The cold center is an area where no inflammation exists. Abscesses are rich with lactoferrin in the neutrophils, and gallium appears to bind to the lactoferrin, making the abscess visible. Tumors appear as heavily concentrated areas of gallium with normal symmetric gallium uptake in the surrounding liver tissue.

 

Professional Considerations of Gallium Scan of Liver

Consent form IS required.

Risks
Allergic reaction to radiopharmaceutical (itching, hives, rash, tight feeling in the throat, shortness of breath, bronchospasm, anaphylaxis, death), infection.
Contraindications
Previous allergic reaction to a radiopharmaceutical. This procedure is usually contraindicated during pregnancy and breast-feeding.

 

Preparation

  1. The client is injected with a gallium-67 citrate radiopharmaceutical intravenously 48–72 hours before the scan.
  2. See Client and Family Teaching.
  3. Just before beginning the procedure, take a “time out” to verify the correct client, procedure, and site.

 

Procedure

  1. The client is positioned either erect or recumbent under a gamma (Anger) camera or rectilinear scanner in the nuclear medicine department.
  2. Serial images are obtained anteriorly and posteriorly, and occasionally lateral views may be required.
  3. The client must lie motionless during the scan.

 

Postprocedure Care

  1. See Client and Family Teaching.

 

Client and Family Teaching

  1. Increase oral intake of fluids, where not contraindicated, 24 hours before the scan.
  2. A clear-liquid diet may be prescribed for the day before the test.
  3. Cleansing enemas may be prescribed the morning before the test.
  4. The camera will make clicking noises during the scan.
  5. The scan takes 30–60 minutes to perform.
  6. Drink 6–8 glasses of water and other fluids per day for 2 days (where not contraindicated) after the scan.

 

Factors That Affect Results

  1. Normal hepatic gallium uptake may obscure the detection of abnormal para-aortic nodes in Hodgkin's disease, resulting in a false-negative scan.
  2. Localization of neutrophils labeled with gallium into fresh operative sites and inflamed peritoneum limits this test's usefulness in clients who have recently undergone surgery.

 

Other Data

  1. Gallium is excreted by the kidney and colon in 24–48 hours.
  2. Gallium scanning does not differentiate malignant from benign tumors.
  3. Health care professionals working in a nuclear medicine area must follow federal standards set by the Nuclear Regulatory Commission. These standards include precautions for handling the radioactive material and monitoring of potential radiation exposure.