What is HIDA Scan?

A HIDA (Hepatobiliary Iminodiacetic Acid) scan, also known as cholescintigraphy or hepatobiliary scintigraphy, is a specialized imaging test used to evaluate the health and function of your liver, gallbladder, bile ducts, and a portion of your small intestine. Think of it as a way for doctors to "see" how these organs are working together to process and move bile, a fluid essential for digestion.

Unlike X-rays or CT scans, a HIDA scan uses a small amount of radioactive tracer, injected into your bloodstream, to provide functional information. This means it shows how these organs are working, not just what they look like. A special camera detects the tracer as it moves through your system, creating images that help doctors diagnose problems. This test is particularly useful when other imaging methods haven't provided a clear diagnosis. It's a non-invasive way to check for blockages, inflammation, or other issues that could be affecting your digestive health.

Key Facts:

• Also known as cholescintigraphy or hepatobiliary scintigraphy.
• Uses a radioactive tracer to visualize organs.
• Evaluates liver, gallbladder, bile ducts, and small intestine.
• Focuses on function, not just anatomy.
• Non-invasive procedure.

Why is HIDA Scan Performed?

A HIDA scan is recommended when doctors suspect problems with the liver, gallbladder, or bile ducts. It helps diagnose a range of conditions affecting these crucial organs.

Main conditions/indications:

• Cholecystitis (Gallbladder Inflammation): Detects inflammation, often caused by gallstones.
• Bile Duct Obstructions: Identifies blockages or strictures preventing bile flow.
• Biliary Dyskinesia: Evaluates abnormal gallbladder contraction.
• Bile Leaks: Detects leaks after gallbladder surgery or trauma.
• Liver Function Assessment: Assesses the liver's ability to produce and transport bile.
• Post-Surgical Complications: Diagnoses complications like biliary leakage after surgery.
• Liver Transplant Evaluation: Monitors the liver's function after transplantation.
• Congenital Bile Duct Issues: Detects birth defects affecting the bile ducts (e.g., biliary atresia).
• Abdominal Pain: Helps to find the cause of unexplained upper abdominal pain.

When doctors recommend it:

Doctors often recommend a HIDA scan when you experience symptoms like:

• Severe abdominal pain, especially in the upper right quadrant.
• Nausea and vomiting.
• Jaundice (yellowing of the skin and eyes).
• Fever (in some cases).
• Abnormal liver function tests.

If other imaging tests, such as ultrasound, are inconclusive, a HIDA scan can provide valuable additional information for a definitive diagnosis.

Preparation for HIDA Scan

Proper preparation ensures the HIDA scan is accurate and efficient. Here's what you need to do:

Essential preparation steps:

• Fasting: You will need to fast for at least 4-6 hours before the scan. Only clear liquids (water) might be permitted. Confirm with your doctor or the imaging center.
• Medication Disclosure: Inform your doctor about all medications (prescription and over-the-counter) and supplements you're taking. Some medications, especially those affecting the digestive system, may need to be temporarily stopped.
• Hydration: Drink plenty of water in the days leading up to the scan to stay hydrated.
• Pregnancy/Breastfeeding: Inform your doctor immediately if you are pregnant or breastfeeding. The scan is generally avoided during pregnancy. If breastfeeding, discuss the necessary precautions with your doctor, as you may need to pump and discard breast milk for a period after the scan.
• Allergies: Inform the medical staff of any allergies, especially to medications or contrast dyes.
• Clothing: Wear comfortable, loose-fitting clothing. You may be asked to change into a hospital gown.
• Jewelry: Remove all jewelry and metal accessories before the scan.

India-specific tips:

• Fasting Instructions: Clarify fasting rules with the diagnostic center. Some centers may have slightly different protocols.
• Documents: Carry your doctor's referral, any previous relevant medical reports (e.g., ultrasound reports, blood tests), and your Aadhaar card or other identification.
• PCPNDT Act (If Applicable): Although a HIDA scan is not directly related to gender determination, some facilities might ask for a declaration stating the purpose of the scan, to comply with the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act. This is a routine procedure, so don't be alarmed.

What to expect:

• Arrival: Arrive at the imaging center on time.
• Check-in: You will be asked to fill out a questionnaire about your medical history and current medications.
• Explanation: The technician will explain the procedure to you.
• Comfort: You will be made comfortable on a scanning table.

The HIDA Scan Procedure

The HIDA scan procedure is straightforward and generally painless. Here's what to expect:

Step-by-step:

1. Radiotracer Injection: A small amount of radioactive tracer (typically Technetium-99m HIDA) is injected into a vein in your arm. This injection feels similar to a routine blood draw.
2. Initial Imaging: You will lie on your back on a scanning table. A gamma camera will be positioned over your abdomen to take images. The camera does not emit radiation; it only detects the tracer.
3. Image Acquisition: The camera will take images periodically over a specific time, typically 1-2 hours. Sometimes, the imaging can extend up to 4 hours. You will need to lie still during this time.
4. Gallbladder Stimulation (Optional): In some cases, a medication like Kinevac (Sincalide) or Cholecystokinin (CCK) may be injected intravenously. This medication stimulates the gallbladder to contract and empty, allowing doctors to assess its function. You might feel some mild abdominal cramping after this injection, which is normal. In other instances, another drug called Morphine is used to aid in visualizing the gallbladder.
5. Delayed Imaging (Rare): In certain situations, delayed images may be required, taken several hours (up to 24 hours) after the initial scan. You will be asked to return to the imaging center for these images.

Duration, comfort level:

• The scan itself usually takes 1-2 hours, but it can extend to 4 hours or require delayed images.
• The procedure is generally painless. Lying still for an extended period can be uncomfortable for some.
• Mild cramping may occur after the CCK injection.

What happens during the test:

The radioactive tracer travels through your bloodstream to the liver, where it's processed and excreted into the bile ducts, then into the gallbladder, and finally into the small intestine. The gamma camera detects the tracer's movement and creates images of these organs. The radiologist will assess how well each organ is functioning based on the tracer's distribution and movement.

Understanding Results

HIDA scan results are interpreted by a radiologist who analyzes the images to assess the function of your liver, gallbladder, and bile ducts.

Normal vs. abnormal:

• Normal: The tracer moves normally through the liver, gallbladder, bile ducts, and small intestine. The gallbladder fills within a reasonable time and empties properly after stimulation with CCK (if used).

• Abnormal:

  • Cholecystitis (Gallbladder Inflammation): The gallbladder may not be visualized, or the tracer may take longer than expected to enter.
  • Bile Duct Obstruction: The tracer may not be able to pass through the bile ducts, indicating a blockage.
  • Biliary Dyskinesia: The gallbladder ejection fraction (the percentage of bile the gallbladder releases after stimulation) is abnormally low. A normal ejection fraction is typically greater than 35-40%.
  • Bile Leak: Tracer is seen leaking outside of the biliary system.
  • Other Abnormalities: The radiologist will note any unusual findings, such as abnormal size or shape of the organs.

What results mean:

• Normal results indicate that your liver, gallbladder, and bile ducts are functioning properly.
• Abnormal results can indicate various conditions requiring further investigation and treatment. The specific meaning of the results will depend on the pattern of tracer distribution and the clinical context.

Next steps:

The radiologist will send a report to your referring doctor, who will discuss the results with you and recommend further actions. These may include:

• Further imaging tests: Such as ultrasound, CT scan, or MRI.
• Medication: To treat inflammation or other underlying conditions.
• Lifestyle changes: Such as dietary modifications.
• Surgery: In cases of severe cholecystitis or bile duct obstruction.

It is crucial to discuss your HIDA scan results with your doctor to understand their implications and to develop an appropriate treatment plan.

Costs in India

The cost of a HIDA scan in India can vary depending on several factors, including the city, the diagnostic center (government vs. private), and the specific protocols used.

Price range in ₹:

• Tier-1 Cities (e.g., Delhi, Mumbai, Bangalore, Chennai): ₹3,500 - ₹6,500
• Tier-2 Cities (e.g., Pune, Ahmedabad, Hyderabad, Kolkata): ₹3,000 - ₹5,500

Government vs. private:

• Government Hospitals: HIDA scans are typically more affordable in government hospitals than in private centers. However, there may be longer waiting times.
• Private Diagnostic Centers: These centers often offer shorter waiting times and more advanced equipment but may charge higher fees.

Insurance tips:

• Check with your health insurance provider to see if the HIDA scan is covered under your policy.
• Some insurance companies may require pre-authorization for the scan.
• Inquire about the network hospitals and diagnostic centers covered by your insurance.

It's always best to call the diagnostic center directly to inquire about the exact cost of the HIDA scan and any applicable discounts or payment options.

How Ayu Helps

Ayu makes managing your health records simple and secure.

• You can easily store your HIDA scan results digitally on Ayu, ensuring they are always accessible.
• Track your results over time to monitor changes and share them with your doctor securely via a QR code, facilitating better communication and personalized care.

FAQ

Q1: Is a HIDA scan painful?

A: No, a HIDA scan is generally painless. You may feel a slight pinch during the IV injection. Some people experience mild cramping after the CCK injection, but it's usually temporary.

Q2: How much radiation is involved in a HIDA scan?

A: The amount of radiation is minimal and considered safe. The benefits of the scan in diagnosing your condition outweigh the small risk associated with radiation exposure.

Q3: How long does it take to get the results of a HIDA scan?

A: The radiologist typically interprets the scan results within 24-48 hours. Your doctor will then discuss the results with you.

Q4: Can I eat after the HIDA scan?

A: Yes, you can resume your normal diet immediately after the scan, unless your doctor instructs otherwise.

Q5: What if I am claustrophobic?

A: A HIDA scan is an open procedure, meaning the camera doesn't enclose you. If you're concerned about anxiety, talk to your doctor about relaxation techniques or medication.

Q6: Are there any alternatives to a HIDA scan?

A: Alternatives include ultrasound, CT scan, and MRI. However, a HIDA scan is often preferred for evaluating gallbladder and bile duct function. Your doctor will determine the best imaging test based on your specific situation.

Q7: What if I'm breastfeeding?

A: If you are breastfeeding, inform your doctor. You will likely need to pump and discard breast milk for a certain period after the scan to allow the radioactive tracer to clear from your system. Your doctor will provide specific instructions.

Q8: Can I drive myself home after the scan?

A: Yes, you can usually drive yourself home after the scan, unless you experience any unexpected side effects. However, if you receive medication for anxiety or pain, it's best to have someone drive you.