Liver 131I Scan
Norm of Liver 131I Scan
Normal size, shape, and position of liver.
Usage of Liver 131I Scan
Cirrhosis, diffuse infiltrating processes affecting the liver (such as amyloidosis, sarcoidosis), granulomas, hepatomas, hepatic abscesses or cysts, jaundice, tuberculosis, and tumors. Also used as confirmatory test after other findings have been obtained.
Description of Liver 131I Scan
A nuclear medicine scan in which radioactive iodine is used to determine the uptake in the liver to outline and detect structural changes in the liver.
Professional Considerations of Liver 131I Scan
Consent form IS required.
Risks
Allergic reaction to dye (itching, hives, rash, tight feeling in the throat, shortness of breath, bronchospasm, anaphylaxis, death).
Contraindications
Previous allergy to iodine, shellfish, or radiographic contrast medium; renal insufficiency; during pregnancy (because of radioactive iodine crossing the blood-placental barrier) or breast-feeding.
Preparation
- Have emergency equipment readily available.
- Just before beginning the procedure, take a “time out” to verify the correct client, procedure, and site.
Procedure
- The client is transported to the nuclear medicine department. For inpatients, a nuclear medicine technologist may administer the radionuclide at the bedside.
- The client is injected intravenously with radioactive iodine-131.
- A gamma-ray detector is placed over the right upper quadrant of the client's abdomen 30 minutes after the client has been injected.
- The client is placed in lateral, prone, and supine positions, so that all the surfaces of the liver may be visualized.
- Scans are taken of the liver at intervals.
- The radionuclide image of the distribution of radioactive particles in the liver is recorded on either x-ray or Polaroid film.
Postprocedure Care
- Assess vital signs every 15 minutes × 2.
- Observe the client carefully for up to 60 minutes after the study for a possible (anaphylactic) reaction to the radionuclide.
- For 24 hours wear rubber gloves when discarding urine after the procedure. Wash the gloved hands with soap and water before removing the gloves. Wash the ungloved hands after the gloves have been removed.
Client and Family Teaching
- No fasting or premedication is required.
- The IV injection of the radionuclide is the only discomfort associated with this procedure.
- You will not be exposed to large amounts of radiation, because only tracer doses of 131I are used.
- This procedure is performed by a trained technologist in approximately 1 hour. A physician trained in nuclear medicine interprets the results.
- Meticulously wash your hands with soap and water after each void for 24 hours after procedure.
- Family members must wear rubber gloves when discarding the client's urine for 24 hours after procedure, if family will be providing this care.
- Follow-up diagnostic tests (such as ultrasonography, CT scan, or biopsy) are needed to confirm the diagnosis.
Factors That Affect Results
- Barium in the GI tract overlying the liver or spleen will produce defects on the scan, which may be mistaken for masses.
- False-negative results may occur in clients with space-occupying lesions (such as tumors, cysts, abscesses) smaller than 2 cm because the scan can demonstrate only filling defects greater than 2 cm in diameter.
- False-positive results may occur in clients with cirrhosis. Because of the distortion of the client's liver parenchyma, the scan may be incorrectly interpreted as positive for filling defects.
Other Data
- 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.
- If “cold spots” (areas that do not take up the radionuclide) appear, then cysts, abscesses, and tumors may be suspected.
- The half-life of iodine-131 is 8 days.
- See also Hepatobiliary scan.
