Liver & Spleen Scan

What is a liver and spleen scan?

A liver and spleen scan is a type of nuclear medicine imaging test that looks specifically at your liver and spleen. These two organs occupy the upper parts of your abdomen (belly). Conditions affecting one can often affect the other.

Nuclear medicine imaging uses a device called a gamma camera to follow a radioactive tracer that’s injected into your body. How your organs absorb the material can tell your provider how those organs are functioning and highlight areas that might be damaged.

Why would I need a liver and spleen scan?

A nuclear liver and spleen scan is just one type of medical imaging that healthcare providers 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 areas of your organs.

This can help identify lesions in your liver or spleen — spots where the tissues have changed and aren’t functioning normally. The scan can also show overall changes such as fibrosis, swelling and altered bile or blood flow. This is helpful for assessing organ damage.

How is the scan used?

Your healthcare provider may use a liver and spleen scan to:

• Watch the progress of chronic liver disease.
• Watch the progress of healing or treatment.
• Assess organ damage after a traumatic injury.
• Identify wounds or lesions on the organs.
• Look for the cause of unexplained upper abdominal pain.
• Check for systemic problems affecting both organs.

What types of conditions can a liver and spleen scan detect?

Test results might suggest:

• Liver inflammation (hepatitis).
• Liver scarring (fibrosis and/or cirrhosis).
• Fatty liver disease (fat storage in your liver).
• Enlarged liver.
• Enlarged spleen.
• Hyperactive spleen (hypersplenism).
• Portal hypertension (high blood pressure in your liver).
• Budd-Chiari syndrome (blocked or narrowed veins in your liver).
• Splenic artery aneurysm (bulge in an artery).
• Ruptured spleen.
• Splenic infarction (tissue death).
• Liver failure (reduced functionality).
• Liver lesions, such as an abscess, benign tumor, liver hemangioma or liver cyst.
• Cancer of the liver or spleen.
• Metastatic cancer that’s spread from somewhere else.
• Gaucher disease affecting these organs.

How does a liver and spleen scan work?

A radioactive tracer injected into your vein travels through your bloodstream to your liver and spleen, which absorb the material. The tracer emits gamma rays, and a gamma camera “reads” these signals to locate the material in your organs.

These gamma readings are then superimposed over 3D images of your organs, produced by a combination SPECT/CT scan. (SPECT stands for single-photon emission computed tomography, and CT stands for computed tomography.)

How do I prepare for a liver scan?

Your provider will discuss the test with you and ask you to sign your consent. You’ll change into a hospital gown and remove any metal from your body that the scanner might detect. You can request a sedative to help you relax if you’re nervous.

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. Then they’ll take two sets of images, one with the gamma camera and one with a CT scanner, for about 15 to 20 minutes each.

What happens during a liver scan?

• 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.
• 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.
• The camera will scan your whole body for gamma rays. Then it’ll begin slowly rotating around your body to produce 3D images.
• Your technician may ask you to move into different positions for the camera. You’ll need to lie very still in each position.
• When the scanning is done, your technician will withdraw the IV from your arm and you can get up and dress.

What are the risks or complications of the procedure?

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 the milk.
• Have any known allergy to the radioactive tracer (sulfur-colloid).

Will I feel anything?

You might notice the IV in your arm. You won’t feel the scan, but some people might be uncomfortable lying still in different positions. You won’t feel the radioactive tracer in your system, but you can help flush it out by drinking lots of water over the next 24 hours.

How does the test show results?

After the radionucleotide goes into your vein, it travels to your liver and spleen, which absorb the material. Places where the tracer is absorbed more than others appear as bright areas or “hot spots” in images, while areas where it doesn’t absorb look like dark spots or “cold spots”.

Your technician 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 diminished liver functionality.

What happens 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 CT scan.
• Spleen CT scan.
• Abdominal ultrasound.
• Liver elastography (MRE or FibroScan® ultrasound).
• Liver/spleen MRI.

A note from Cleveland Clinic

A nuclear medicine liver and spleen scan offers healthcare providers a unique view of these two partner organs and how they’re doing. This scan can help your provider diagnose conditions affecting both organs. It can also help assess damage, disease progression and healing. Talk to your provider if you have questions or concerns about the test or the results you receive.