MIBG scan Factsheet

Introduction

The MIBG scan looks for:

neuroblastomas – tumours that grow in the cells of the nerves
pheochromocytomas – rare tumours that grow in the adrenal glands, found on top of the kidneys
paragangliomas – rare tumours that grow near blood vessels and nerves outside the adrenal glands.

The MIBG scan uses:

a Gamma camera - a large camera that measures radiation
Lugol’s Iodine – a medication that protects your child’s thyroid gland from radiation
radiotracer – an injection of radioactive fluid that moves through the body.

The gamma camera shows the radiotracer moving through the body.

The scan is done over two days.

Before the scan

Your child’s doctor will give you a prescription for Lugol’s iodine, which you can pick up at the hospital or your local pharmacy.

Your child must take the Lugol’s iodine:

for two days before their first scan appointment
for three days after their appointment.

The dose of Lugol’s iodine must be mixed with another liquid before drinking. Follow the pharmacist's or doctor’s instructions. It’s best to mix it with a liquid that has a strong, pleasant taste, like milk or juice.

Your child will be weighed to help calculate the correct amount of radiotracer.

The risks of radiation and allergic reactions are very low. Let your child’s treatment team know if they have any allergies.

Talk to your child's doctor or treatment team if you have any concerns or questions.

Lugol’s iodine

The thyroid gland absorbs iodine from your child’s blood to make hormones. Hormones are chemicals that help control how different parts of the body work.

The thyroid cannot tell the difference between regular iodine and the iodine in radiotracers. Because the thyroid is very sensitive, it is important to protect it from radiation. Lugol’s iodine helps block the thyroid from absorbing the radiotracer.

If you have questions or concerns about Lugol’s iodine, speak to your child’s treatment team.

Numbing cream

Needles can be uncomfortable for children. Numbing cream can be used on children over two years old

If your child needs numbing cream, you will need to:

ask for it before the day of the scan
arrive 30 minutes early to the appointment so it has time to work.

Sedation

Your child must stay very still during the scan because movement can affect the images. If your child moves, the scan might need to be done again.

Some children may need sedation to help them relax and stay still. Sedation is a medicine that makes your child feel calm and sleepy.

If sedation is needed, your child will have to stop eating and drinking a few hours before the scan. Your child’s treatment team will give you more details about sedation and when to stop eating and drinking.

During the scan

The MIBG scan is done over two days.

Day one

On day one, your child will be given a dose of radiotracer. The radiotracer must be in your child’s body for 24 hours before the images can be taken.

The radiotracer is injected into your child’s vein using a small butterfly needle.

The radiotracer can also be injected through:

an intravenous (IV) cannula – a thin tube placed in a vein
a central venous access device (CVAD) - a tube placed in a large vein, usually in the chest or neck.

Day two

The images will be taken on day two. This will take around two hours, and your child will need to stay very still.

Your child will need to do a wee to empty their bladder. If your child wears nappies, you will need to change them into a new, clean nappy.

Generally, the steps of the scan are:

your child will lie on the scanning bed
a blanket with velcro straps may be used to help keep your child still
images will be taken of your child from head to toe.

SPECT-CT and CT scans

Some children may need extra scans. These can include:

single-photon emission computerised tomography (SPECT-CT) scan

A scan used to take 3D pictures to see the organs better. It takes 20 minutes to complete.

low-dose computed tomography (CT)

A scan that uses X-rays to take a detailed picture of inside the body. It takes two minutes to complete. Parents and carers must leave the room for this scan because of the X-rays.

After the scan

You can leave once the results are checked by a doctor or nuclear medicine scientist.

Your child will need to continue taking their dose of Lugol’s Iodine for three days after the scan or as instructed by the doctor.

The results will be sent to your child’s doctor within a couple of days. You will need to schedule a follow-up appointment with your child’s doctor to discuss the results.

Management

Radiation

Your child will be exposed to a small amount of radiation during the scan. The benefits of finding and treating kidney problems are greater than the small risk of this low dose.

Allergic reactions

Allergic reactions to radiotracer are very rare and usually mild. Your child’s doctor will talk to you about any potential risks before the scan. Let your child’s treatment team know if they have any allergies.

Supporting your child during the scan

Scans can be stressful for children. You can help by:

explaining why the test is needed and how it works in simple words
bringing comfort items like a blanket, toy, or dummy
asking the treatment team about support from Child Life Therapy services
arriving 30 minutes early if using numbing cream.