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Figure 6. Normal 67Ga-gallium citrate whole body scan (left anterior, right posterior). There is normal accumulation in the liver, bone marrow and soft tissues. Uptake in the right upper quadrant of the abdomen reflects normal gut excretion.

very slowly (at 7 days post-injection the decay-corrected whole body retention is still 65%). Variable uptake in the nasopharyngeal lymphoid tissue, lacrimal glands and salivary glands can also be a normal finding. Posterior images of the abdomen may reveal faint renal uptake up to 24 hours post-injection. Thymus and spleen uptake may be prominent, particularly in children or following chemotherapy.

Abnormal patterns of gallium accumulation can be seen when the plasma carrier protein, transferrin, becomes saturated e.g., following chemotherapy, blood transfusion, hemochromatosis or iron therapy. The scan pattern tends to resemble a bone scan, with prominent skeletal uptake, little soft tissue uptake, and increased renal and bladder activity. If this is suspected then measuring serum iron and transferrin should reveal the nature of the problem.

Figure 7. Normal 99mTc-antigranulocyte antibody scan (LeukoScan®).Imaging performed 1 hour (left) and 4 hours (right) post-injection show late appearance of nonspecific bowel activity. (Courtesy of ImmunoMedics Inc., Morris Plains, NJ).
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