Can a HIDA (Hepatobiliary Iminodiacetic Acid) scan be performed with intravenous (IV) glucose running?

HIDA Scan Should Not Be Performed with IV Glucose Running

Intravenous fluids containing glucose should be discontinued at least 4 hours before a HIDA scan to prevent interference with the diagnostic accuracy of the test. 1

Rationale for Discontinuing IV Glucose

HIDA (Hepatobiliary Iminodiacetic Acid) scans require specific patient preparation to ensure accurate diagnostic results:

• Parenteral nutrition and intravenous fluids containing glucose must be discontinued at least 4 hours before FDG injection for nuclear imaging procedures, including HIDA scans 1
• IV glucose can alter the body's insulin response, which may interfere with tracer uptake and excretion through the hepatobiliary system 1
• The main objectives of patient preparation include ensuring low blood glucose and low insulinemia, as insulin directly affects uptake patterns that can compromise image quality 1

Patient Preparation Requirements for HIDA Scan

Proper preparation is essential for accurate HIDA scan results:

• Patients should fast for a minimum of 4 hours prior to the HIDA scan 2
• Any infusion used for intravenous prehydration must not contain glucose 1
• Patients should remain seated or recumbent during the procedure to minimize muscle uptake of the radiotracer 1
• For patients requiring IV hydration, non-glucose containing solutions should be used 1

Clinical Implications

Failure to follow proper preparation protocols can lead to:

• False-positive or false-negative results that may lead to incorrect diagnosis 1
• Reduced sensitivity and specificity of the HIDA scan 2
• Potentially unnecessary surgical interventions if diagnostic accuracy is compromised 3

Special Considerations for Diabetic Patients

For diabetic patients requiring glucose management:

• Blood glucose should be checked upon arrival at the imaging center 1
• If IV fluids are needed, use non-glucose containing solutions 1
• For patients on insulin therapy, basal insulin may need adjustment according to institutional protocols, but glucose-containing IV fluids should still be avoided 1
• If the patient has poorly controlled diabetes, consultation with the diabetes care team may be necessary to safely manage glucose levels during the fasting period 1

Alternative Approaches

If a patient absolutely requires glucose-containing IV fluids due to medical necessity:

• Consider postponing the HIDA scan until the patient's condition stabilizes 1
• Consult with nuclear medicine specialists to determine if alternative imaging modalities might be appropriate 1
• If the HIDA scan cannot be delayed, document the presence of IV glucose in the patient's record so it can be considered during image interpretation 1

Conclusion

Following proper preparation protocols for HIDA scans is essential for accurate diagnosis and patient management. IV glucose should be discontinued at least 4 hours before the procedure to ensure optimal diagnostic accuracy.