Nuclear Medicine DMSA Scan
What is a DMSA scan? DMSA, or dimercaptosuccinic acid, is bound to technetium 99m to form the radiopharmaceutical, 99m-Tc DMSA.…Read more
An MIBG scan is a nuclear medicine scan that involves an injection of a radioactive medication (radiopharmaceutical) called iodine-123 meta-iodobenzylguanidine – MIBG for short. The radiopharmaceutical is injected into a vein usually on the inside of the elbow.
A special gamma camera (a type of scanner) takes images or pictures to confirm if there are tumours (a lump or growth) called neuroendocrine tumours. These tumours involve specific types of nerve tissues and most commonly include pheochromocytomas (a rare tumour of the adrenal gland – which is located above and on the surface of the kidneys) and neuroblastomas (cancers that affect nerve tissue). Neuroblastomas usually begin in the adrenal gland, but might also be found elsewhere in the body.
Your doctor might suspect the presence of a neuroendocrine (nerve-related) tumour. If so, your doctor may request this test for diagnosis and to detect the presence, absence, or spread of a known or new tumour.
Some medicines may need to be stopped for around 3 days before the test is carried out.
These medications include:
Talk to your referring doctor or the nuclear medicine staff where you are having your MIBG scan as to whether you need to stop any medications you are taking and for how many days before the scan.
Before having the scan, you will have to take potassium iodide tablets or Lugol’s iodine solution to prevent the thyroid gland from absorbing too much radioactivity. The thyroid gland is more susceptible to attracting radioactivity than other parts of the body, and it can lead to malfunction of the thyroid gland. The nuclear medicine facility where you are having the scan will advise you about when you need to take this medication and the dose.
It is important that you tell the staff where you are having the scan done if you are (or think you could be) pregnant or are breast-feeding.
This study may not be suitable for pregnant women because of the radiation dose to the growing foetus (unborn baby). Please discuss this with your referring doctor.
Women who are breast-feeding and people who are the primary or sole carer for small children may need to make special preparations for after the scan. This is due to the small amount of radioactivity your body may release for a while afterwards. Talk to your referring doctor or the nuclear medicine facility where you will have the scan for details and instructions as to how to manage your breast-feeding. The Australian Radiation Protection and Nuclear Safety Agency has recommendations about breast-feeding and close contact with children after nuclear medicine tests. For further information: see InsideRadiology: Nuclear Medicine.
A MIBG scan is carried out over 2 days
On the first day: You will be given an injection of radiopharmaceutical usually on the inside of the elbow. Your blood pressure will be monitored during and after this injection.
Four hours later, after the radiopharmaceutical has spread around your body, you will be given the scan. A special gamma camera (a type of scanner) will take images while you are lying on a bed. The camera will move over your body, but not touch it.
On the second day: You will return to have the images taken again. You will not have another injection
The initial injection may cause an increase in your blood pressure. If it does, you will need to stay in the radiology facility for about 30 minutes after the scan so that your blood pressure can be monitored. The chance of this happening is less than 10%.
No other side-effects are expected.
The scanned images will be taken over 2 days. On the first day there will be two visits. The first visit involves receiving an injection of a small dose of radiopharmaceutical and monitoring of blood pressure for 15–30 minutes. You will then be able to leave, and return 4 hours later for your first set of images, which will take around an hour.
The following day you will need to return for the second set of images, which will take from 60 to 90 minutes.
Apart from the possibility of an increase in blood pressure, which is a relatively rare side-effect, there are no significant risks. Any increase in blood pressure usually resolves within 48 hours after the injection and rarely requires treatment.
There is a small dose of ionising radiation that is similar to other routine medical imaging tests (see InsideRadiology: Radiation risk of medical imaging for adults and children).
The dose of the radiopharmaceutical is relatively small, approximately twice the normal annual background radiation from the environment.
If you are breast-feeding or caring for young children, see the “How do I prepare” section for more information about special precautions you may need to take.
It will help your doctor to find or confirm the presence of a tumour (a lump or growth) found on a specific type of nerve tissue. This could be a rare tumour of the adrenal gland (which is located above and on the surface of the kidneys) or a cancer that affects nerve tissue. An MIBG scan examines the whole body, so it will also help determine if the cancer has spread anywhere else within the body.
A nuclear medicine technologist will give you the injection of radioactive medication and take the images. A nuclear medicine physician (a specialist doctor) will assess and interpret the images and provide a report of the MIBG scan to your referring doctor.
MIBG scans are carried out in the nuclear medicine department of a public or private hospital or in a private radiology practice.
A report is written by the nuclear medicine physician after reviewing your images and taking into account your medical details provided by your referring doctor.
The radiology facility where you are having the scan will be able to tell you when your doctor is likely to receive the written report.
It is important that you discuss the results with the doctor who referred you, so that they can explain what the results mean for you.
Page last modified on 18/5/2018.
RANZCR® is not aware that any person intends to act or rely upon the opinions, advices or information contained in this publication or of the manner in which it might be possible to do so. It issues no invitation to any person to act or rely upon such opinions, advices or information or any of them and it accepts no responsibility for any of them.
RANZCR® intends by this statement to exclude liability for any such opinions, advices or information. The content of this publication is not intended as a substitute for medical advice. It is designed to support, not replace, the relationship that exists between a patient and his/her doctor. Some of the tests and procedures included in this publication may not be available at all radiology providers.
RANZCR® recommends that any specific questions regarding any procedure be discussed with a person's family doctor or medical specialist. Whilst every effort is made to ensure the accuracy of the information contained in this publication, RANZCR®, its Board, officers and employees assume no responsibility for its content, use, or interpretation. Each person should rely on their own inquires before making decisions that touch their own interests.