Type of test Nuclear scan

Normal findings

Diffuse, low level of gallium uptake, especially in the liver and spleen

No increased gallium uptake within the body

Test explanation and related physiology

A gallium scan of the total body may be performed 24, 48, and 72 hours after an IV injection of radioactive gallium. Most commonly, a single scan is performed 2 to 4 days after the gallium injection. Gallium is a radionuclide that is concentrated by areas of inflammation and infection, abscesses, and benign and malignant tumors. However, not all types of tumors will concentrate gallium. Lymphomas are particularly gallium avid. Other tumors that can be detected by a gallium scan include sarcomas, hepatomas, and carcinomas of the gastrointestinal (GI) tract, kidney, uterus, stomach, and testicle.

This test is useful in detecting metastatic tumor. However, to a large degree, positron emission tomography (PET) scans (p. 716) have replaced gallium scans for the identification of malignancy. The gallium scan is useful in demonstrating a source of infection in patients with a fever of unknown origin. Gallium can be used to identify noninfectious inflammation within the body in patients who have an elevated sedimentation rate. PET scans are more commonly used to identify areas of acute infection.

Another method of scanning is called single-photon emission computed tomography (SPECT) imaging. This provides a more detailed image.

Contraindications

• Patients who are pregnant unless benefits outweigh risks Interfering factors

• Recent barium studies will interfere with visualization of gallium within the abdomen.

 Procedure and patient care

Before

* Explain the procedure to the patient. See p. xviii for radiation exposure and risks.

• If ordered, administer a cathartic or enema to the patient to minimize increased gallium uptake in the bowel.

During

• Note the following procedural steps:

1. The unsedated patient is injected with gallium.

2. A total-body scan may be performed 4 to 6 hours later by slowly passing a radionuclide detector over the body.

 3. Additional scans are usually taken 24, 48, and 72 hours later.

4. During the scanning process, the patient is placed in the supine position and occasionally in the lateral position.

• Note that a nuclear medicine technologist performs each scan in approximately 30 to 60 minutes. Repeated scanning is required. Repeated injections are not necessary.

* Inform the patient that test results are interpreted by a physician trained in nuclear medicine and are usually available 72 hours after the injection.

After

* Assure the patient that only tracer doses of radioisotopes have been used and that no precautions against radioactive expo sure to others are necessary.

 Abnormal findings

- Tumor

- Noninfectious inflammation

- Infection

- Abscess

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