You may have heard of an MIBG scan, or a doctor may have advised you or someone you know to have one. So, you probably have a lot of questions in your mind about what this MIBG scan is, why it is done, and how it is done. Don't worry, today we will talk about it all in a very simple way, in a way that you can understand.
What is this MIBG scan?
Simply put, an MIBG scan is a specialized test that helps detect and assess certain types of tumors inside our bodies. It belongs to a category of tests called 'nuclear imaging' . This means that it uses a small, controlled amount of radioactive material that is absorbed by certain cells in our bodies. Don't worry, it is done very safely and in appropriate doses.
In an MIBG scan, a radioactive substance called Iodine Meta-Iodobenzylguanidine , or MIBG for short, is injected into a vein as a 'tracer' – that is, like a road marker. Then, a special camera takes clear pictures of the inside of the body, watching as this tracer travels through the body and where it collects.
This test is called by several other names, for example:
- `Iobenguane scan`
- ``Metaiodobenzylguanidine scan''
- `MIBG scintigraphy`
- `MIBG scintiscan`
However, the name most people know is the MIBG scan.
What does an MIBG scan detect?
Doctors use MIBG scans to detect certain specific types of tumors, especially those that start in the neuroendocrine cells that produce hormones in our bodies. Some of these include:
- Carcinoid tumors : These are also called neuroendocrine tumors, a type of tumor that develops in the hormone-producing cell system.
- Neuroblastoma : This one is a little special. Because it is a rare type of cancer that develops in the nerve cells of children under the age of 5. Hearing this name can be a little scary, because it affects young children. But remember, these tests are there to detect the disease early and start the necessary treatment.
- Medullary thyroid carcinoma : This is a type of tumor that develops in the thyroid gland in our neck.
- Pheochromocytoma : This is a tumor that can develop in the adrenal glands located above our kidneys, or in other parts of the body.
Think about it, these neuroendocrine cells in our bodies are a very special type of cell. A chemical called MIBG can bind to these cells in a special way. That's why this scan is so effective at finding these types of tumors.
Not only this, sometimes doctors use this MIBG scan to help determine whether a cancer has spread to other parts of the body (metastasis), or to assess the effectiveness of current treatments and whether the tumor has shrunk.
Who performs this MIBG scan?
MIBG scans are usually performed by radiologists , who are specialists who use imaging technologies such as X-rays, CT scans, MRI scans, and other imaging techniques to diagnose and sometimes treat diseases. These tests are most often performed in a hospital's 'nuclear medicine department' .
How are images created from this MIBG scan?
The way this works is very simple. We mentioned earlier that certain neuroendocrine cells throughout our bodies absorb a substance called MIBG. So, when you're injected with the MIBG tracer, that substance goes to these specific cells and accumulates. Normal healthy cells don't absorb it that way.
A special scanning camera can find the exact locations where this radioactive MIBG has accumulated. Then, using that information, a computer creates pictures of the inside of the body. A medical specialist looks at these pictures carefully and analyzes them to see if they are normal or if there are any areas where MIBG has accumulated abnormally – that is, areas where a tumor might be present. If there is a tumor, the area where MIBG has accumulated will be clearly visible on the pictures as a ‘hot spot’.
How should we prepare for an MIBG scan?
There are a few things you need to do before this test. Your doctor will explain all of this to you.
The main thing is that about a day before the test, you will be asked to take a medicine containing iodine (sometimes called ``Lugol's solution''). This is given to prevent the radioactive MIBG used during the scan from affecting your thyroid gland, that is, to protect it. You may need to take this medicine for a few days after the scan.
What should we not do before the scan?
Before the MIBG scan, your doctor will ask you to stop taking some of the medications you are currently taking for a while. These medications can affect the results of the MIBG scan, making them less accurate. Some of the medications you may be asked to stop include:
- ACE inhibitors (these are a type of medication usually given for high blood pressure)
- Some medications for colds and allergies (Allergy and cold medications)
- Amiodarone, which is given for heart rhythm irregularities (arrhythmia)
- Some medications for depression and other mental conditions (Antidepressants)
- `Calcium channel blockers` (this is also a type of medicine given for high blood pressure and heart disease)
- Some strong painkillers, especially the type called `Opioids`.
The most important thing is to tell your doctor about all the medications you take – both prescription and over-the-counter. Your doctor will explain exactly which medications you should stop taking , for how long, and when. Do not stop taking any medications on your own without consulting your doctor.
What happens during an MIBG test?
The MIBG scan is usually done over several days, in several stages. Don't worry, let's see how it works, it's very simple:
1. Injecting the tracer: First, a doctor or trained nurse injects the MIBG tracer into a blood vessel in your arm or hand. This is like getting a regular injection, and it doesn't feel very painful.
2. Allowing the tracer to spread: After that, it takes about 24 hours for the tracer to spread throughout your body and be absorbed by the relevant cells. So, during this time, you can go home. You can also do your work as usual.
3. First scan: You will have to come in for your first scan the next day. Then, you will be asked to remove your bed clothes, all jewelry (earrings, necklaces, rings, etc.), and put on a special gown provided by the hospital.
4. Scanning: You will then lie on a bed under a scanner. It is very important to remain still during this time, without moving at all. If you move, the images may not be clear. The gamma camera in the scanner will slowly rotate around you and take pictures of the inside of your body. This can take anywhere from 30 minutes to an hour, or even longer.
5. Repeat scans: Most people will need to come back for another scan either the next day or a few days later (for example, in 48 or 72 hours). This will be determined by your doctor based on your condition and the disease being investigated. You will need to remain as still as before each time.
How long does this scan take?
The MIBG test process can usually take two to four days , which means you have to come and go to the hospital. A single scan session can take about one to two hours . So, it's a good idea to plan your day accordingly.
What happens after the scan is finished?
The MIBG scan is an outpatient procedure . This means that you can go home the same day after each scan. There is no need to stay in the hospital.
After the scan, the radioactive material in your body will pass out of your body in your urine and stool over a few days. To speed this up, drink plenty of water and other fluids. It is also important to wash your hands thoroughly with soap and water after using the toilet. This will remove any MIBG particles that may be on your hands, and it will not affect others.
If you are a breastfeeding mother, plan to formula feed your baby for at least a day (24 hours) after the MIBG injection. Talk to your doctor about this for further advice.
Is there any risk in this?
MIBG scans are very safe . There is nothing to be concerned about. However, there are a few minor risks that can occur in rare cases.
After the tracer is injected, some people may experience a slight increase in blood pressure. However, it usually returns to normal within a day or two. That's why you will often be monitored in the doctor's office for about 30 minutes after the MIBG injection to check your blood pressure.
Another very important thing is that this radioactive tracer can be harmful to a developing fetus. Therefore, if you are pregnant, this test may not be suitable for you. You should definitely talk to your doctor about this and let him or her know. Also, it is very important to inform your doctor if you are planning to become pregnant.
How long does it take to get results?
After the final scan is done, it usually takes a few days for the results to come back. The radiologist will carefully analyze the scan images and look for any areas of MIBG accumulation (which could indicate a tumor). He or she will then prepare a full report and send it to the doctor who ordered the test. Your doctor will review the report, discuss the results with you, and tell you what your next steps are.
How accurate is this scan?
The results of the MIBG scan are relatively reliable. That is, it can be said that this test has an average accuracy of about 85% .
If your doctor suspects you have a neuroendocrine tumor, he or she will likely order an MIBG scan. Remember, this involves injecting a radioactive substance (tracer) into your bloodstream and taking pictures of the inside of your body with a special camera. Because neuroendocrine cells absorb this tracer, they show up clearly on the images. This can be very helpful in diagnosing the disease and planning treatment.
So, what are the most important things to remember from what we've talked about?
Okay, we've talked a lot about the MIBG scan. Finally, it's helpful to keep these points in mind:
- An MIBG scan is an important test used to detect and monitor the status of certain types of tumors, especially neuroendocrine tumors .
- Although a small amount of radioactive material (tracer) is used in this, doctors have confirmed that it is largely safe . Don't be too scared about it.
- You may need to stop taking certain medications before the test, and you may also need to take a special medicine containing iodine . Follow all of these exactly as your doctor tells you.
- The scan can last for several days, but it usually takes about an hour or two at a time. It is very important to remain still during the scan, without moving, for the results to be clear.
- After the test, you should drink plenty of fluids, such as water , to help the tracer leave your body quickly.
- If you are pregnant, trying to get pregnant, or breastfeeding , it is essential to tell your doctor in advance.
It's normal to feel a little scared and nervous when asked to have a test like this. But remember, all of these tests are done to help you get the most accurate information about your health condition and get you started on the best treatment possible. If you have any questions or concerns about the MIBG scan, don't hesitate to talk to your doctor or a member of the medical staff. They are here to help.
` MIBG scan, MIBG scan, neuroendocrine tumors, neuroblastoma, cancer diagnosis, nuclear medicine
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