What is a liver scan?

A liver scan is an imaging test to look at your liver and see how well it's working. This test may also be called a liver-spleen scan because the healthcare provider often looks at the spleen at the same time.

A liver scan is a type of nuclear medicine procedure. This means that a tiny amount of a radioactive matter is used during the scan. The radioactive matter (radioactive tracer) is absorbed by normal liver tissue. The rest of the radioactive tracer is absorbed by your spleen and bone marrow.

The radioactive tracer sends out gamma rays. These are picked up by the scanner to make a picture of your liver.

The areas of the liver where the radioactive tracer collects in greater amounts are called "hot spots." The areas that don't absorb the tracer and appear less bright on the scan image are referred to as "cold spots."

Other related procedures that may be used to diagnose problems of the liver include abdominal X-rays, abdominal ultrasound, computed tomography (CT scan) of the abdomen or liver, or a liver biopsy.

Anatomy of the liver

The liver is the largest organ in the body. This dark reddish brown organ is located in the upper right side of the abdomen, beneath the diaphragm, and on top of the stomach, right kidney, and intestines.

The wedge-shaped liver is made up of 2 main lobes. Each lobe is made up of thousands of lobules. These lobules are connected to small ducts that connect with larger ducts to ultimately form the hepatic duct. The hepatic duct moves the bile (fluid that helps break down fats and gets rid of wastes in the body) that is made by the liver cells to the gallbladder and duodenum (the first part of the small intestine).

The liver carries out many important functions, such as:

• Making bile. Bile is a fluid that helps break down fats and gets rid of wastes in the body

• Changing food into energy

• Clearing the blood of drugs and other poisonous substances

• Producing certain proteins for blood plasma

• Regulating blood clotting

The spleen, an egg-shaped organ that lies between the stomach and the diaphragm on the left side of the body, helps to keep the blood healthy. The spleen plays a role in the production of lymphocytes (white blood cells that fight infection and disease), destruction of red blood cells, and filtration and storage of blood.

The biliary system is made up of the organs and ducts (bile ducts, gallbladder, and associated structures) that make and transport bile.

Why might I need a liver scan?

A liver scan may be done to look for diseases, such as cancer, hepatitis, or cirrhosis. It can also see if your liver or spleen is larger than normal. It can be used to further evaluate known masses in the liver.

A liver scan may be done to see how well the liver or spleen is working after trauma to the belly. You may also have this scan if you have pain in the upper right area of your belly.

You may need this scan if you have liver disease. Your healthcare provider may use the scan to see how well your treatment is working. Portal hypertension (elevated blood pressure within the liver's circulation) may be detected with a liver scan when more of the radionuclide is absorbed by the spleen rather than the liver.

Your healthcare provider may have other reasons to advise a liver scan.

What are the risks of a liver scan?

The risk from the radioactive tracer is very low. The amount used in the test is very small. You may feel some slight discomfort when the tracer is injected. Allergic reactions to the tracer are rare, but they may happen.

Lying on the scanning table during the procedure may cause some discomfort or pain for certain people.

Tell your healthcare provider if you:

• Are allergic to or sensitive to medicines, contrast dyes, or latex.

• Are pregnant or think that you might be pregnant. The scan may not be safe for the fetus.

• Are breastfeeding. The tracer may contaminate your breastmilk.

You may have other risks that are unique to you. Be sure to discuss any concerns with your healthcare provider before the procedure.

Certain things may make a liver scan less accurate. These include:

• Having radioactive tracer in your body from another recent nuclear medicine test

• Having barium in your digestive tract from a recent barium test

How do I get ready for a liver scan?

• Your healthcare provider will explain the procedure to you. Ask them any questions you have about the procedure.

• You may be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything is not clear.

• You don’t usually need to stop eating or drinking before the scan.

• Tell your provider if you are allergic to or sensitive to latex, medicines, contrast dyes, or iodine.

• Tell your provider if you are pregnant or think you may be pregnant.

• Follow any other instructions your provider gives you to get ready.

What happens during a liver scan?

You may have a liver scan as an outpatient or as part of your stay in a hospital. The way the test is done may vary depending on your condition and your healthcare provider's practices.

Generally, a liver scan follows this process:

1. You will be asked to remove any clothing, jewelry, or other objects that may get in the way of the test.

2. If you are asked to remove your clothing, you will be given a gown to wear.

3. An IV (intravenous) line will be started in the hand or arm so that you can be given the radioactive tracer.

4. The radioactive tracer will be injected into your vein. The tracer will be allowed to collect in the liver tissue for about 30 minutes. If it takes longer for the tracer to collect, you may be asked to come back the next day to finish the scan.

5. You will be asked to lie still on a scanning table. You will need to stay still during the scan. If you move, it may affect the quality of the scan.

6. The scanner will be placed over your belly.

7. The technologist may move you during the scan to get images of all the surfaces of the liver.

8. When the scan is done, the IV line will be removed.

The liver scan is not painful. But you may have some discomfort or pain from lying still during the test. This may be because of recent surgery or a joint injury. The technologist will use all possible comfort measures and do the scan as quickly as possible to reduce any discomfort or pain.

What happens after a liver scan?

You should move slowly when getting up from the scanner table to prevent any dizziness or lightheadedness.

You may be told to drink plenty of fluids and empty your bladder often for about a day after the scan. This will help flush the tracer from your body.

The medical staff will check the IV site for any signs of redness or swelling. Tell your healthcare provider if you see any pain, redness, or swelling at the IV site after you go home. These may be signs of infection or another type of reaction.

You may go back to your usual diet and activities as directed by your healthcare provider.

Your healthcare provider may give you other instructions, depending on your situation.

Next steps

Before you agree to the test or procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure