MIBG & Iodine Allergy

You can kind of call me a pro scanner by now, I’ve only done like a thousand. (Okay, maybe not 1000, but A LOT)

My insides like taking pictures just as much as my outside.

It’s that time again, MIBG time! An MIBG is specifically designed to visualize certain types of neuroendocrine tumors like mine, pheochromocytoma being the focus of my discussion as this is the cancer I have.

As many of you know – MIBG is also used as a therapeutic agent as well, I just had my radioactive treatment in January, and this scan is just another segment of my follow up protocol before we dive into the next steps of my treatment.

For those of you who are about to have an MIBG scan and are wondering what it’s all about, I figured I would give you the deets! I even make it more fun and complicates as always as I have an allergy to iodine & contrast – so I’ll explain what the protocol is when this is the case.



MIBG Scan 

Alright pheo friends, your nuclear medical centre or cancer centre should call you and book a date for your injection, and then you will have your scan date booked anywhere from 2-3 days later.

Example:

Monday – Injection     Thursday – MIBG Scan

Why?

The MIBG product takes time to attach to the tumor cells.

BEFORE you go in for your injection they will need to send a prescription of thyroid blocker to your local pharmacy.

The protocol for the thyroid blocker varies depending on the type given, for example – because I have an allergy to iodine – I am given potassium perchlorate and so the timing and protocol differs for this product from Lugol’s iodine. Please refer to your doctor’s instruction when taking your thyroid blocker, but ALWAYS ensure you take your thyroid blocker before your scan!!!  

NO EXCEPTIONS! 

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Day 1: Go into receive your dose of radioactive “glow” as I like to call it, ha! We have to think positive now don’t we?  I have to start taking Benadryl early in the morning (around 6am) for a 10pm injection, and then continue taking 50mg doses every 6hours for 24-48hours. I have to stay and be monitored after receiving my injection for at least an hour and make sure I don’t have any initial reaction while at the hospital, and if I am okay, I can go home and continue with my allergy protocol.

You won’t be scanned on this day, just poked and injected with some good old radioactive mixtures, it will do it’s magic and hopefully find it’s way to your tumor cells… and then you will go back in 2-3 days (whenever your appt is) and complete your actual scanning portion!

(Edit- Question answered: This portion isn’t like a PET scan where you will spend at least an hour with a warm blanket in that beautiful reclining chair, it is a very quick injection of radioactive material, (in a comfy recliner though!) 😜

There is no fasting required for an MIBG scan, or injection, neither part 1 or 2 requires fasting protocol unless your doctor instructs otherwise, but out of the 5+ times, I have never.

There are SOME medications they may require you stop taking before your scan, the nuclear medicine team will discuss this with your endocrinologist, surgeon, oncologist, whoever ordered the scan for you. Some medications can interfere with the result of the scan, it can lead to false results as the test relies on norepinephrine uptake and some medications can interfere with this pathway. They will inform you if you need to or not.

I’m sure you can ask for a blanket if you’re cold, they’re always such sweethearts. The only “waiting period” is for when you have an allergy, they typically ask you to wait to be monitored, because my nuclear medicine team is amazing, I get a comfy stretcher and a warm blanket 😉 I hope this answers your questions Cathy!  💛

Tomorrow (or today rather, as I have to be up in a couple of hours to go…!) I will be doing part 2 of my MIBG scan, I will update you on the exciting details of the scanning portion.

If you have questions, leave them down below!

I forgot the most important part… don’t forget to smile, laugh, and stay fab!

MIBG - Injection

10 comments

  1. Do you get a warm blanket and a room to yourself of an hour? Or is that only us “lucky” ones who get FDG PETs and don’t have to return in three days for the scan?

    Excellent description . . . Although do you also have the “not allowed to eat or drink” anything but plain water part?

    Thank you for including and educating us about all the is involved.

    Liked by 1 person

  2. I have an iodine allergy as well. After throwing up every time in the CAT scan tube and no one listening, I told my oncologist I wanted MRIs instead. No dice as I have a total hip replacement due to an old sports injury. So then I said no more CTs with contrast until some one figures out how to deal with barfing in the tube. My god your stuck in a tube, hot , feeling like you have to pee and then you puke on yourself….life just doesn’t get any better…..not!

    Cheryl in Ottawa

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    • Ah Cheryl! Do they prep you for the scan?! 😳 The CT contrast dye isn’t the same as the MIBG iodine, I’m allergic to both it seems but more allergic to the ct contrast (most people react more to the CT contrast it seems)! – and it requires a special prep (prednisone, Benadryl) please tell me they do this for you before doing your scans?

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      • No they do nothing. Yet because I refused to do another one , I was given a prescription for Decadron with a specific schedule dosages prior to the test and the night before. Hopefully it works!

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