Author: Dr Dee Nandurkar*

What are the prerequisites for having an MIBG scan done?

A MIBG scan is commonly used for detection of neuroendocrine tumours such as neuroblastoma and phaeochromocytoma. It can also aid detection of carcinoid and medullary thyroid carcinoma. Results of serum and urinary catecholamines may be necessary prior to approval of the scan by the nuclear medicine department. This scan should not be performed on a pregnant patient and, if clinically suspected, a negative pregnancy test in a woman of child bearing age may be needed.

What are the absolute contraindications for an MIBG scan?

This study may not be suitable for pregnant women. The benefit versus risk should be discussed with the nuclear medicine specialist.

Women who are breastfeeding and people who are the primary or sole carer for small children may need to make special preparations after the test to stop breastfeeding for a short time and to avoid close contact with young children due to the small amount of radioactivity released for a while after the test.

Patients should discuss this with their referring doctor or the nuclear medicine practice where they will have the test for details. See nuclear medicine for further information about the precautions to take with nuclear medicine studies for breastfeeding patients and those in close contact with children.

What are the relative contraindications for an MIBG scan?

There are no relative contraindications.

What are the adverse effects of an MIBG scan?

There is a relatively small risk of transient increase in blood pressure at the time of the initial injection. The patient is generally monitored in the nuclear medicine department for this over the initial 30 minutes.

Are there alternative imaging tests, interventions or surgical procedures to an MIBG scan?

MIBG Scan is the test of choice for detection of a phaeochromocytoma and neuroblastoma. The poorly differentiated tumours can be MIBG negative and these are better detected with PET scans, which generally perform better in detection of more aggressive neuroendocrine tumours. The PET scans can yield false negative results in well differentiated, slow growing tumours.

MIBG imaging performs better with a benign phaeochromocytoma, whilst octreotide and PET scans are more sensitive for detection of a malignant phaeochromocytoma.

Generally MIBG imaging is superior to PET imaging for neuroblastoma. However, PET is beneficial in tumours that fail to concentrate MIBG or are weakly MIBG positive.

Some neuroendocrine tumours such as the paragangliomas can be MIBG negative but may be detected with indium 111-pentetreotide (octreotide scan).

Anatomic imaging with CT and MRI is often complimentary as it is sensitive but not specific.

*The author has no conflict of interest with this topic.

Page last modified on 26/7/2017.

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