From the Guidelines
Gallium scans are generally considered safe with minimal risks, primarily related to radiation exposure, which is relatively low compared to many other imaging procedures. The typical effective radiation dose from a gallium scan is about 6-18 mSv, depending on the specific protocol used 1. Allergic reactions to the gallium citrate radiotracer are extremely rare. There is no need for special preparation before the scan, though patients should remove metal objects and jewelry before imaging.
Key Considerations
- The procedure involves an injection of gallium citrate followed by imaging sessions 24-72 hours later.
- Patients who are pregnant or breastfeeding should inform their healthcare provider as radiation exposure poses risks to fetuses and infants.
- The scan itself is painless except for the initial needle prick during injection.
- The gallium is naturally eliminated from the body through urine and feces within 1-2 weeks.
Alternative Imaging Options
In certain cases, alternative imaging options may be considered, especially for patients with concerns about radiation exposure. For instance, MRI is highly sensitive and specific for diagnosing native vertebral osteomyelitis, with a sensitivity of 97%, specificity of 93%, and an accuracy of 94% 1. However, for patients with implantable devices or severe claustrophobia, a combination spine gallium/Tc99 bone scan can be performed as an alternative.
Benefits and Risks
The benefits of detecting inflammation, infection, or certain tumors using a gallium scan typically outweigh the minimal risks associated with the procedure. Patients with concerns about radiation exposure should discuss alternative imaging options with their healthcare provider. It's also important to consider the latest guidelines and evidence, such as the ACR Appropriateness Criteria, which provide recommendations for the use of imaging procedures, including gallium scans, in various clinical scenarios 1.
From the Research
Gallium Scan Risk
The risk associated with gallium scans is not explicitly stated in the provided studies. However, the following points can be considered:
- Gallium-67 citrate is a radiopharmaceutical used to detect tumors, stage the extent of disease, monitor response to treatment, and distinguish recurrent disease from post-treatment changes 2.
- Gallium-67 citrate scintigraphy has been compared to other imaging modalities, such as positron emission tomography (PET) and computed tomography (CT), in the diagnosis of various conditions, including hepatocellular carcinoma and lymphoma 3, 4.
- The sensitivity and specificity of gallium-67 citrate scintigraphy have been reported to be around 80% and 88%, respectively, for lymphoma assessment, and 80% and 100%, respectively, for infection assessment 4.
- Gallium-68 citrate PET-CT has been compared to gallium-67 citrate scintigraphy for infection imaging, with results showing lower sensitivity and specificity for gallium-68 citrate PET-CT 5.
- A comparative case study between gallium-67 citrate scintigraphy and gallium-68 citrate PET-CT in bone infection has been conducted, but the results are not explicitly stated in the provided text 6.
Key Findings
- Gallium-67 citrate scintigraphy is a useful tool for evaluating lymphomas and infections, particularly in countries where PET/CT services are not available 4.
- Gallium-68 citrate PET-CT may not be recommended to replace gallium-67 citrate scintigraphy for routine clinical use due to lower sensitivity and specificity, as well as insufficient confidence of reporting physicians 5.
- The choice of imaging modality depends on various factors, including the specific condition being diagnosed, the availability of imaging services, and the clinical context 3, 4, 5.