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Gallium Scan

Test Overview

A gallium scan is a nuclear medicine test. A nuclear medicine test uses a special camera to take pictures of specific tissues in the body after a radioactive tracer (radionuclide or radioisotope) makes them visible. Each type of tissue that may be scanned (including bones, organs, glands, and blood vessels) uses a different radioactive compound as a tracer. The radioactivity of a tracer decreases over a period of hours, days, or weeks. The tracer stays in the body until it is eliminated as waste, usually in the urine or stool (feces).

During a gallium scan, the tracer (radioactive gallium citrate) is injected into a vein in the arm. It travels through the bloodstream and into the body's tissues, primarily the bones, liver, intestine, and areas of tissue where inflammation or a buildup of white blood cells (WBCs) is present. It often takes the tracer a few days to build up in these areas, so in most cases a scan is done at 2 days and again at 3 days after the tracer is injected. Areas where the tracer builds up in higher-than-normal amounts show up as bright or "hot" spots in the pictures. The problem areas may be caused by infection, certain inflammatory diseases, or a tumor.

Why It Is Done

A gallium scan is done to:

  • Detect the source of an infection that is causing a fever (called a fever of unknown origin).
  • Detect an abscess or certain infections, especially in the bones.
  • Monitor the response to antibiotic treatment.
  • Diagnose inflammatory conditions such as pulmonary fibrosis or sarcoidosis.
  • Detect certain types of cancer (such as lymphoma). A gallium scan also may be done to see if cancer has spread (metastasized) to other areas of the body, or to watch how well a cancer treatment is working.

How To Prepare

Before the gallium scan, tell your doctor if:

  • You are or might be pregnant.
  • You are breast-feeding. If you will no longer be breast-feeding after the test, you will be asked to stop breast-feeding 2 weeks before the test so that the radioactive tracer will not build up in your breast tissue. If you will continue to breast-feed after the test, it is recommended that you not use your breast milk for 4 weeks after a gallium scan because the tracer can be passed to your baby. Some doctors may advise you to stop breast-feeding completely after this scan.
  • Within the 4 days before the gallium scan, you have had an X-ray test using barium contrast material (such as a barium enema) or have taken a medicine (such as Pepto-Bismol) that contains bismuth. Barium and bismuth can interfere with test results.

Gallium builds up in the large intestine (colon) before it is eliminated in the stool. You may need to take a laxative the night before the scan and have an enema 1 to 2 hours before the scan to prevent the gallium in your colon from interfering with pictures of the area being studied.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?).

How It Is Done

A gallium scan is usually done by a nuclear medicine technologist. The scan pictures are usually interpreted by a radiologist or nuclear medicine specialist.

The technologist cleans the site on your arm where the radioactive tracer will be injected. A small amount of the radioactive tracer is then injected. You will need to return for the diagnostic scans. Gallium scans are usually done 24 hours (1 day), 48 hours (2 days), and 72 hours (3 days) after the tracer is injected.

When you come in for the scan, you will need to remove any jewelry that might interfere with the scan. You may need to take off all or most of your clothes, depending on which area is being examined (you may be allowed to keep on your underwear if it does not interfere with the test). You will be given a cloth or paper covering to use during the test.

You will lie on your back on a table, and a large scanning camera will be positioned closely above you. After the radioactive tracer is injected, the camera will scan for radiation released by the tracer and produce pictures of the tracer in your tissues. The camera may move slowly above and around your body. The camera does not produce any radiation, so you are not exposed to any additional radiation while the scan is being done.

You may be asked to move into different positions so the area of interest can be viewed from other angles. You need to lie very still during each scan to avoid blurring the pictures. You may be asked to hold your breath briefly during some of the scans.

Each scan may take about 60 to 90 minutes.

How It Feels

You may feel nothing at all from the needle puncture when the tracer is injected, or you may feel a brief sting or pinch as the needle goes through the skin. Otherwise, a gallium scan is usually painless. You may find it difficult to remain still during the scan. Ask for a pillow or blanket to make yourself as comfortable as possible before the scan begins.

Risks

There is always a slight risk of damage to cells or tissue from being exposed to any radiation, including the low level of radiation released by the radioactive tracer used for this test.

Allergic reactions to the radioactive tracer are rare. Most of the tracer will be eliminated from your body (through your urine or stool) within 4 days. The amount of radiation is so small that it is not a risk for people to come in contact with you following the test.

Sometimes you may have soreness or swelling at the injection site. These symptoms can usually be relieved by applying moist, warm compresses to your arm.

Results

A gallium scan is a nuclear medicine test that uses a special camera to take pictures of certain tissues in the body after a radioactive tracer (radionuclide or radioisotope) makes them visible. The results of a gallium scan are usually available within 2 days after the scans are completed.

Gallium scan
Normal:

The collection and activity of gallium in the bones, liver, spleen, and large intestine (colon) is normal. No areas of unusual gallium accumulation are seen.

Abnormal:

An abnormally high gallium accumulation (hot spot) is present in one or more areas of the body, possibly meaning inflammation, infection, or a tumor.

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

  • Pregnancy. A gallium scan is not usually done during pregnancy because the radiation could damage the developing baby (fetus).
  • Having barium or bismuth in your system. If a gallium scan is needed, it should be done before any tests that use barium (such as a barium enema). Taking a medicine (such as Pepto-Bismol) that contains bismuth can also interfere with a gallium scan.
  • Not being able to remain still during the test.

What To Think About

  • A gallium scan is used for specific types of cancers, mainly of the lymph nodes, bones, or bone marrow. A normal scan does not exclude the possibility of cancer, because some types of cancer do not show up on a gallium scan. A gallium scan also cannot determine whether a tumor is cancerous (malignant) or noncancerous (benign).
  • The results of a gallium scan should be interpreted along with the results of other tests, such as a physical exam, blood tests, and X-rays. In many cases, results obtained from a magnetic resonance imaging (MRI) or positron emission tomography (PET) may be as accurate as the results obtained from a gallium scan. For more information, see the topics Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET).
  • If other nuclear scanning tests need to be done, these tests should be scheduled before a gallium scan because the gallium tracer stays in the body longer than other tracer compounds.

References

Other Works Consulted

  • Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
  • Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
  • Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Howard Schaff, MD - Diagnostic Radiology
Last Revised December 5, 2010

Last Revised: December 5, 2010

Author: Healthwise Staff

Medical Review: Kathleen Romito, MD - Family Medicine & Howard Schaff, MD - Diagnostic Radiology

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