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What Does An MIBG Scan Show?
An MIBG scan is an imaging technique in atomic medicament that involves an injection of a radioactive material recognise as meta - iodobenzylguanidine , which in short is have sex as MIBG . The radioactive substance is commonly injected in elbow vein.(1 )
MIBG is mostly done for the detecting of neuroendocrine tumors and it employ a special Vasco da Gamma tv camera ( a character of scanner ) to take images to confirm a tumor or neuroendocrine origin . Neuroendocrine tumors are tumor of nerve tissue paper bloodline , most ordinarily including pheochromocytomas ( a tumor of the adrenal gland , which is located above and on the surface of kidney ) and neuroblastomas ( genus Cancer affecting the nerve tissue ) . The most common location of neuroblastomas is kidney , but it can fall out elsewhere in the body . So , an MIBG scan may be done for the diagnosing , follow up and metastasis of a known or fresh tumor.(1 )
Paragangliomas start from supererogatory - adrenal chromaffin electric cell that produce catecholamine . These are tumors situated along the paravertebral and para - aortal Axis and paragangliomas that are fix in the adrenal medulla oblongata are make out as pheochromocytoma . Most of the pheochromocytomas are adrenal , sporadic , and solitary . Paragangliomas are mostly found intra - abdominally , next to the adrenals in 85 % of the case . The sensitivity and specificity for the detection of pheochromocytomas / paragangliomas with iodine-131 - MIBG is 77 - 90 % and 95 - 100 % , respectively ; whereas , the predisposition and specificity for iodine-123 - MIBG is 83 - 100 % and 95 - 100 % , respectively . Due to the lower radiation syndrome burden and high imaging quality , the iodine-123 - MIBG scan is more unremarkably used nowadays.(2 )
Medullary thyroid gland cancer originates from thyroid parafollicular carbon cells . While most of the cases of medullary thyroid genus Cancer are sporadic ( 75 % ) , the rest being hereditary ( 25 % ) , which are associate with genetic syndrome such as multiple endocrine neoplasia eccentric 2 ( MEN2 ) . Although , the diagnostic utility of MIBG scan in medullary thyroid cancer is limited due to its lower sensitiveness of only 30 % . The role of MIBG scan in medullary thyroid gland cancer is limit in affected role with MEN2 ( as it can detect lesions either in the thyroid or the adrenals ) and in patients in whom therapy with iodine-131 - MIBG is being considered.(2 )
Neuroblastoma is a malignity that has its origin from the crude neural crest cells that mould the sympathetic aflutter system . It is a common tumor set up in children and account for 8 - 10 % of puerility tumors . Most of the primary tumor are found in the abdomen ( 65 - 70 % ) of which adrenal secretor is the most common site . It describe for 12 - 15 % of childhood cancer deaths . MIBG scan is used to find primary neuroblastoma and is the preferred test for the detection of metastatic tumors . Iodine-123 - MIBG scan has a sensitivity and specificity of 88 - 93 % and 83 - 92 % , respectively . Iodine-123 - MIBG is the agent of choice for scintigraphy of pediatric neuroblastoma.(3 )
How To Prepare For MIBG Scan?
Since iodine radioisotope interacts with some medicinal drug , it is important to discontinue such medications around 3 day prior to the trial . These medicine let in tricyclic antidepressants , antihypertensives , cocain , sympathomimetics , and nasal decongestants containing pseudoephedrine , phenylpropanolamine , and phenylephrine.(1 )
It is authoritative to take K iodide tablet or Lugol ’s iodine resolution prior to the scan to prevent the thyroid gland gland from sop up too much of the I radioisotope . Since the thyroid gland gland is more sore and susceptible to attract radioactivity than other body parts that can lead to its malfunction , it is important to consult the dosage and timing of the medication intake . For females , it is also crucial to severalize the staff if they are pregnant or wet-nurse , since the radiation dose may not be suitable for growing foetus . It is authoritative for breastfeed woman to manage to breastfeed and consult a physician regarding precautions , since after the scan a small amount of radiation may be released from the body.(1 )
The MIBG scan is unremarkably fill in in a course of 2 days . A modest side - effect of the scan is a temporary rise in blood pressure in some patients that are monitor and commonly resolves within 48 hour of radioisotope injection.(1 )
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