Liver Scan (Liver-Spleen)

What is a liver scan (liver-spleen scan)?

A liver scan (or liver-spleen scan) is a type of nuclear medicine imaging test that examines your liver and, often, your spleen. These two organs lie near each other and are closely related. Conditions that affect one often affect the other.

During a nuclear medicine imaging test, a healthcare provider injects a mild radioactive material into your vein. Your liver and spleen absorb the material through your bloodstream. The material emits gamma rays, and a gamma camera scans them.

How your liver and spleen absorb the material can give your provider important information about their health. Places where they absorb more appear brighter on the gamma scanner. Places where they absorb less appear darker.

Why would I need a liver scan?

Your healthcare provider might use a liver-spleen scan to:

• Watch the progress of chronic liver disease
• Check how well a treatment is working
• Check for organ damage after a traumatic injury
• Identify lesions on your liver or spleen
• Check for systemic diseases that can affect both organs
• Look for causes of unexplained upper abdominal pain

A nuclear liver scan is just one type of medical imaging test that your healthcare provider might use to evaluate your liver and/or spleen. What’s unique about it is the way it can show how responsive and functional the cells are in different parts of your organs.

This can help identify lesions on your liver or spleen — spots where the tissues have changed and aren’t functioning normally. A liver scan can also show overall changes in your liver, like scarring (fibrosis), swelling (enlargement) or changes in blood flow or bile flow.

What happens during a liver scan (liver-spleen scan)?

Here’s what to expect during your liver scan:

1. When you arrive for your liver scan, you’ll change into a hospital gown and remove any metal from your body. You can request a sedative to help you relax if you’re nervous.
2. A radiologic technologist will inject a small amount of radioactive tracer (usually, Tc-99m sulfur colloid) through an IV into a vein in your arm. You’ll feel a prick when the needle goes in.
3. After the tracer has had a little time to absorb, you’ll lie down on a scanner bed. Your technician will position the donut-shaped scanner over your upper abdomen.
4. First, the gamma camera will scan your whole body for gamma rays. Then, the imaging scanner will begin slowly rotating around your body to produce 3D images. These images are produced by a combination SPECT/CT scan.
5. Your technician may ask you to move into different positions. You’ll need to lie very still in each position.
6. When the scanning is done, your technician will remove the IV from your arm. You’ll get up and get dressed. You can help flush the radioactive material out of your system by drinking lots of water over the next 24 hours.

How long does a liver scan take?

It takes about an hour overall. After the injection, your provider will wait 15 to 30 minutes for your organs to absorb the tracer material. Then, they’ll take two sets of images — one with the gamma camera and one with a SPECT/CT scanner — for about 15 to 20 minutes each.

What are the potential risks of having a nuclear liver scan?

Risks are few, but let your provider know if you:

• Are pregnant (the small amount of radiation may affect the fetus)
• Are breastfeeding (the radiation might contaminate your milk)
• Have any known allergy to the radioactive tracer (sulfur-colloid)

What kind of results will I get from a liver-spleen scan?

The scan produces 3D images of your liver and spleen, with gamma readings superimposed over them. Places where your organs absorbed more of the radioactive material appear brighter, like “hot spots.” Places where they didn’t absorb as much look like dark spots or “cold spots.”

Your healthcare provider will also compare absorption between the two organs. Normally, your liver should absorb more than your spleen. If your liver absorbs less than it should and your spleen absorbs more, they call it a “colloid shift.” This shows a decline in liver function.

What can a liver and spleen scan detect?

Your test results might suggest:

• Liver inflammation (hepatitis)
• Liver scarring (fibrosis and/or cirrhosis)
• Liver failure (declining liver function)
• Liver lesions, like an abscess, tumor, hemangioma or cyst
• Fat storage in your liver (steatotic liver disease or Gaucher disease)
• Portal hypertension (high blood pressure in your liver)
• Budd-Chiari syndrome (blocked or narrowed veins in your liver)
• Enlarged liver or enlarged spleen
• Splenic infarction (dead tissue in your spleen)
• Ruptured spleen

What are the next steps after I get my results?

Your liver and spleen scan results may or may not provide conclusive evidence of what your healthcare provider is looking for. They may be able to make a diagnosis and discuss treatment at this time. Or they may need to follow up on their findings with a different test.

What other scans detect liver problems?

Alternative imaging tests for liver and spleen conditions include:

• Liver ultrasound
• CT scan
• Elastography (MRE or FibroScan^®)
• MRI