Abnormal Bilateral Lung Uptake on Gallium Scan
Provided clinical image
Question
On this gallium scan, the lungs show prominent bilateral uptake. What is the significance of this finding that a nuclear medicine technologist should recognize during quality review?
- ABilateral lung uptake is within normal limits on a gallium scan, since Ga-67 is known to distribute throughout all well-perfused organs including the pulmonary vasculature
- BProminent lung activity indicates the patient was breathing during acquisition, producing a motion artifact that mimics pathologic pulmonary uptake on both views
- CBilateral lung uptake is expected on early (24-hour) images and normally clears by 72 hours; the technologist should schedule a repeat delayed image before flagging this as abnormal
- DLung activity is not part of normal Ga-67 biodistribution; prominent bilateral uptake is abnormal and should be flagged, as it may indicate pulmonary infection or inflammation
Show the answer and explanation
D. Lung activity is not part of normal Ga-67 biodistribution; prominent bilateral uptake is abnormal and should be flagged, as it may indicate pulmonary infection or inflammation
Normal Ga-67 biodistribution includes the liver, spleen, bone marrow, lacrimal glands, and nasopharynx. The lungs should show little to no activity. Prominent bilateral pulmonary uptake is abnormal and is a classic finding in conditions such as Pneumocystis jirovecii pneumonia (PCP) in immunocompromised patients, pulmonary sarcoidosis, drug toxicity, or other diffuse pulmonary inflammatory processes. The technologist should flag this for physician review.
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