Misunderstood – hepatobiliary scans
A commonly misunderstood concept in nuclear medicine for students is interpretation of hepatobiliary scan images and the possible blockages that are associated with them. This requires knowledge of the biliary tree and the production of bile. If you think of the biliary tree as a set of pipes, with water flowing representing the bile, it may help. Depending on where there is a blockage in the bile tree, we can attribute that as a clue to the pathology. Perhaps there is a delay in the appearance of the bile in certain areas, or it never appears. This can help guide us on the type of intervention we can consider as well to get more information. This also can help emphasize the fact that once the tracer is released from the liver, it is bound by compartmentalization i.e., the physical passageways control where it goes. There is difficulty with many students understanding this process as the uptake into the liver is by active transport.
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