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I131/I123 Metaiodobenzylguanidine (mIBG) Scintigraphy help locate and diagnose certain types of tumors in the body. MIBG is a substance that gathers in some tumors, particularly neuroblastoma tumors. When MIBG is combined with radioactive iodine (tracer), it provides a way to identify primary and metastatic (spread) disease. MIBG scans are helpful for locating both bone and soft tissue tumors.
❰❰ PATIENTS INSTRUCTIONS
| • This procedure requires an injection of a radioactive material. | |
| • If there is a possibility that you are pregnant, please inform the Nuclear Medicine staff. Female patients and wives of male patients should avoid becoming pregnant for 3 months. | |
| • If you are breast-feeding, please inform the Nuclear Medicine staff. Stop breast-feeding 3 weeks before receiving the dose. Stop breast-feeding after the dose and Discard the milk. | |
| • For 5 days: Take Lugol’s Solution as instructed by nuclear medicine staff. Starting one day before injection and continuing for 4 days after injection. | |
| • Avoid interfering materials listed in the other tab. | |
| • Avoid interfering drugs listed in the other tab. | |
| • Fasting is not required for this procedure. | |
| • For 3 days after the injection: Take Laxative (dulcolax) at bedtime. | |
| • For 5 days after the injection: Drink plenty of water and empty your bladder frequently. |
| • Avoid the following food and drinks for 14 days prior to radioiodine administration: | |
| o Vanillin products such as ice creams, cola, commercial cakes and pasta. | |
| o Catecholamine products such as chocolate, cocoa and blue-veined cheeses. | |
| • Stop* the following medications before MIBG administration for the duration stated: | |
| DRUG | TIME |
| Tramadol | 2 weeks |
| Cocaine | 2 weeks |
| Opioids | 2 weeks |
| ACE inhibitors (Captopril or Enalapril) | 2 weeks |
| Amphetamine-like compounds (Dopamine, Dobutamine, Metaraminol, Isoproterenol, Salbutamol, Terbutaline, Phenoterol or Xylometazoline) | 2 weeks |
| Phenmetrazine | 2 weeks |
| Methylphenidate | 2 weeks |
| Mazindol | 2 weeks |
| Fenfluramine | 2 weeks |
| Diethylpropion | 2 weeks |
| Amphetamine | 2 weeks |
| Phenilephrine (Neo-synephrine, Alconefrin, Rhinail and others) | 2 weeks |
| Ephedrine. | 2 weeks |
| Pseudoephedrine (Halofed, Sudafed, Sudrin and others) | 2 weeks |
| Phenylpropanolamine (Propagest, Sucrets cold decongestants, Entex and others) | 2 weeks |
| Calcium channel blockers (Niphepidine, Nicardipine, Amlodipine) | 3 weeks |
| Guanethidine | 3 weeks |
| Bretylium | 3 weeks |
| Reserpine | 3 weeks |
| Amiodarone | 3 weeks |
| Long-acting beta-blockers (Labetalol, Metoprolol) | 3 weeks |
| Doxepine / Doxepin (Adapin, Sinequan) | 3 weeks |
| Loxapine / Loxapin | 3 weeks |
| Amoxapine / Amoxapin (Asendin) | 3 weeks |
| Maprotoline (Ludiomil) | 3 weeks |
| Trazodone HCL (Desyrel) | 3 weeks |
| Trimipramine maleate (Surmontil) | 3 weeks |
| Imipramine and derivates, Pamole (Tofranil, Imavate, Janimine, Presamine, Sk-pramine, Tipramine) | 3 weeks |
| Protriptyine (Vivactil) | 3 weeks |
| Amitriptyline and derivates (Elavil, Endep, Etrafon, Triavil, Amitril, Emitrip, Enovil) | 3 weeks |
| Desipramine | 3 weeks |
| Butyrophenones (Droperidol, Haloperidol, Pimozide) | 4 weeks |
| Thiothixines | 4 weeks |
| Thioxanthenes (Maprotiline, Trazolone) | 4 weeks |
| Phenothiazines* (Chlorpromazine, Promethazine, Fluphenazine, Thorazine, Compazine, Mellaril and other”-zines”) | 4 weeks |
| * Check with your referral doctor if you can stop taking these drugs and use alternative ones. | |
❰❰ RADIATION SAFETY
Nuclear medicine diagnostic procedures are safe except for pregnant ladies, unless it is requested by the physician for exceptional cases. However, the procedure better to be discussed with the doctor to know the desired benefits of the test and the alternative procedures, or you can ask the the nuclear medicine specialist about the procedure.
No, you shouldn’t because nuclear medicine scans use high-energy radioisotopes, the radiation passes directly from the other person without interacting with tissues. In contrast, wearing a lead apron slows down the radiation beam, which allows it to deposit its energy in the body and interact with tissues.
The risks from diagnostic doses are usually small compared to other lifetime risks to which the patient is exposed to and the amount of radiation dose in most diagnostic procedures is less than an x-ray, CT scan, or fluoroscopy.
When the body is exposed to radiation, tissue damage may occur, which in turn may damage DNA or chromosomes, increasing the risk of genetic mutations. When a fetus is exposed to radiation doses, it may cause abnormalities in an organ or irreparable damage and if the radiation dose is too high, it may cause the death of the fetus.
The radioactive dose used in diagnostic procedures in nuclear medicine is very low, unlike radiation treatments in which the amount of radioactive dose is high and this gives the desired effect on the tissues or organs when radiotherapy. That is why the patient must undergo a pregnancy test in the event of suspicion or if the pregnancy is uncertain before starting the therapeutic doses.
In diagnostic procedures the radioactivity is very low. However, the patient may be asked to maintain a distance of approximately one meter between him and his family members for a period of time given by the nuclear medicine specialist to protect them from exposure to radiation.
One the other hand, in therapeutic procedures, the patients may present some slight risk to their family members if they do not follow the INSTRUCTIONS ON RADIATION SAFETY given to them by the nuclear medicine specialist.
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