Did you feel a little nervous when your doctor told you that you needed to have an MIBG scan? It's very normal for a lot of questions to come to mind, like "Um, what is this new scan? Why is this being done?" Especially when we are talking about a medical test that we have not heard of often, we feel a little scared and curious. But don't be scared at all. Today, we will talk about everything about this MIBG scan, from the smallest to the biggest, in very simple Sinhala that you can understand. Just like your friend is explaining it to you.
Simply put, what is this MIBG Scan?
Just think, there are some things inside our bodies that cannot be photographed with a normal camera. Similarly, there are some problems that cannot be captured by things like X-rays and CT scans. That's when we use special methods. MIBG scan is a test that uses such special camera technology. In medicine, we call this a 'nuclear imaging test'.
This is what happens:
A very small, safe radioactive material is injected into your body. Don't worry, this is only a small amount that will not harm you, it is just what is needed for the test. We call this material ``iodine meta-iodobenzylguanidine``. So because it is difficult to pronounce this long name, we call it MIBG for short.
This substance, called MIBG, travels through your bloodstream and attaches to certain types of cells in your body. Then, using a special camera (gamma camera), you can see where the substance has accumulated. It's like finding the glowworms in the dark.
This test is called by several other names, so don't worry if these names appear in your report.
- Iobenguane scan
- Metaiodobenzylguanidine scan
- MIBG scintigraphy
- MIBG scintiscan
Why do doctors recommend doing this MIBG scan?
An MIBG scan is often used to detect specific types of tumors in the body, see how far they have spread, and assess the effectiveness of treatment. These tumors arise from cells in our bodies called neuroendocrine cells that produce hormones.
Now let's see what the main types of nuts can be found with this scan.
| Tumor Type | A Simple Explanation |
|---|---|
| Neuroblastoma | This is a rare type of cancer that often begins in the nerve cells of children under the age of 5. |
| Pheochromocytoma | A type of tumor that develops in the adrenal glands, located above our kidneys, or elsewhere in the body. These can cause symptoms such as high blood pressure. |
| Carcinoid tumors (neuroendocrine tumors) | These are a type of slow-growing tumor that often occurs in the respiratory system or gastrointestinal system (intestinal tract). |
| Medullary thyroid carcinoma | This is a specific type of cancer that develops in the thyroid gland in our neck. |
So, you probably understand that this is not a general test, but something that is done to detect very specific conditions.
How should I prepare for this scan?
There are a few things you will be asked to do before the scan. Following these exactly is very important for the accuracy of the test.
1. There is a special medicine to take.
About a day before the scan, your doctor will tell you to take a medicine that contains iodine (sometimes called Lugol's solution). You may need to take this for a few days after the scan. Do you know why this is given? The radioactive iodine in the MIBG injection stops it from accumulating in your thyroid gland. This means that this medicine is used to protect your thyroid gland.
2. Some medications may need to be stopped for a while.
Some medications you usually take can affect the results of the MIBG scan. Therefore, your doctor will tell you to stop taking those medications for a few days or a week before the test.
But remember this: Never stop taking any medication on your own. Tell your doctor about all the medications you take, including prescription medications, over-the-counter medications, vitamins, and herbal remedies. He or she will tell you exactly which medications you should stop taking and for how long.
The table below lists some of the medications that are commonly advised to be stopped.
| Medication Category | Commonly Used For |
|---|---|
| ACE inhibitors | High Blood Pressure |
| Allergy and cold medications | Allergies and colds |
| Amiodarone | Heart rhythm disorders (Arrhythmia) |
| Antidepressants | Depression and other mental conditions |
| Calcium channel blockers | For high blood pressure and heart disease |
| Opioids | Some types of strong painkillers |
What exactly happens on the days of the scan?
An MIBG scan is not something that can be completed in one day. It is a process that takes place over several days. Usually, you will have to go to the hospital two to four times.
- Step One: Injecting the Medicine
On the first day, a doctor or nurse in the hospital will inject a tracer called MIBG into a vein in your arm or hand. This is like a regular injection. You can then go home. It takes about 24 hours for the tracer to circulate throughout your body.
- Step Two: First Scan
The next day you will have to come back to the hospital for your first scan. You will have to take off everything you are wearing, such as your clothes, watches, and necklaces, and put on a special hospital gown that they give you. Then you will be made to lie down on a bed under the scanning machine. All you have to do is stay very still , without moving at all. The scanning camera will move around your body and take pictures. You will not feel any pain during this time.
- Step Three: Re-Scans
Some people may need to come back for another scan a day or two later. This will be decided by your doctor and radiologist. Each scan can take about an hour or two.
What do you do after the scan is finished?
Since this is an outpatient test, you can go home after each scan. However, you will need to help your body eliminate the radioactive material after you go home.
The tracer substance in your body will be completely eliminated from your body in a few days. To help with this , drink plenty of fluids, such as water and fruit drinks. Then the substance will quickly leave your body with urine and feces.
Also, it is very important to wash your hands thoroughly with soap after using the toilet.
Special advice for breastfeeding mothers:
If you are a breastfeeding mother, avoid breastfeeding your baby for at least a day after the MIBG injection. Be prepared to give your baby formula during that time. Ask your doctor for more information about this.
Are there any risks with this scan?
This is a question that many people have. In fact, an MIBG scan is a very safe test. The risks involved are very low.
- Some people may experience a slight increase in blood pressure after receiving the MIBG injection. However, this usually returns to normal within a day or two. Therefore, you will be kept in the hospital for about 30 minutes after the injection, and your blood pressure will be checked before you are sent home.
- This test is not suitable for pregnant women, as the radioactive material can affect the unborn baby. Therefore, if you are pregnant or have even the slightest suspicion that you are pregnant, you should definitely tell your doctor before the test.
How long will it take for me to receive the results?
After the final scan is done, it usually takes about two to three days to get the results.
What happens is that a radiologist carefully studies all of your scans. He or she looks for areas where the MIBG substance accumulates abnormally, called 'hot spots.' These areas can indicate the presence of a tumor.
The specialist will then prepare a full report and send it to your doctor who ordered the test. Your doctor will then discuss the report with you and explain what steps you need to take next. The MIBG scan is about 85% accurate, which means it is a very reliable test.
Take-Home Message
- An MIBG scan is a very safe and specific test used to detect certain types of tumors. Don't be afraid of this.
- Before the test, take the iodine pill prescribed to protect your thyroid gland.
- Tell your doctor about all medications you are taking (including vitamins). Do not start or stop taking any medications without your doctor's advice.
- The scanning process takes several days, and it is very important to remain still during the scan.
- After the scan, drink plenty of water and fluids to help flush the tracer from your body.
- If you are pregnant or suspect you are pregnant, inform your doctor immediately.
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