MIBG Iodine Scan (NM123W)

MIBG Iodine scan

An MIBG scan is a diagnostic procedure that locates neuroendocrine cells and is used to look for uncontrolled or abnormal cell growth in the body. It can be used to identify suspected neuroblastoma or pheochromocytoma and is often required for cancer staging.

Will it hurt?

No, the test is painless. You will simply be asked to swallow a small capsule. There are no side effects from the tracer, and no restrictions following the test. You will be able to continue with your usual daily activities.

How long will I be in the department?

On day 1, at least six hours will be needed from arrival to the end of the test.

On day 2, approximately two hours will be needed

Do I need to prepare for the test?

YES.

• You will be prescribed potassium iodide tablets that you will need to pick up from Rowlands Pharmacy located in the outpatient department. The instructions for taking these are below, and will also be on the label attached to the medication box when you collect these. Potassium iodide is a thyroid blocking medicine and helps to protect your thyroid gland against the radioactive tracer injection given during the scan. It is vital that you take the doses as prescribed.
• Please contact us if you are taking any tricyclic antidepressants or antihypertensives (e.g. labetalol, diltiazem, nifedipine, verapamil, amitriptyline).
• For patients aged 16 years old and under, the potassium iodide will be arranged and prescribed by the ward, who will contact you with more information.
• Avoid clothes with metal buttons. You may be asked to remove metal objects (buckles, coins, jewellery, buttons, zips) while the pictures are being taken.

If you have any mobility issues please inform the department before attending so that we can make appropriate arrangements for you.

Potassium iodide tablets

You will need to collect the prescribed potassium iodide tablets at 9am on the morning of your appointment. You will need to collect these from Rowlands Pharmacy located in the outpatient department, and these will have been prepared for you ahead of your arrival.

You will receive SIX tablets – please take following the below instructions:

• Take TWO tablets 30 minutes prior to your day 1 appointment (before you receive the radioactive tracer injection)
• Take TWO tablets in the evening following your day 1 appointment (the evening on the day you received the radioactive tracer injection)
• Take TWO tablets in the morning of your day 2 appointment (the morning on the day after you received the radioactive tracer injection)

What to do when you arrive

Upon arrival, please check in at the reception desk located on level 3. Once checked-in, kindly take a seat in the waiting area. This allows our team to confirm your attendance and prepare for your test. This process typically takes about 15 minutes.

Staff you are likely to meet

Your care will be provided by our specialist team, including nurses, nuclear medicine technologist and radiographers, who will guide you through each step of the procedure.

Benefits

Nuclear medicine investigations provide doctors with information to help them diagnose a variety of conditions. These investigations help to confirm or rule out a suspected diagnosis, or occasionally identify a condition that was not suspected.

Risks

You have been referred for a nuclear medicine examination to help make a diagnosis or monitor your treatment. A specialist in radiology agrees that this is the best test to answer the clinical question that has been asked and that the benefit of the examination is greater than the risk. The test involves a low dose of ionising radiation equivalent to a few weeks or months of natural background radiation which we are all exposed to every day. Ionising radiation can cause cell damage that may turn cancerous however the risk of this happening from your examination is considered very low. The dose delivered will be kept as low as is practicable.

What will happen on the day of my procedure/examination?

This test is a two day procedure. How your test will be performed:

DAY 1:

30 minutes BEFORE arrival: You will have taken your first dose of TWO potassium iodide tablets.

ARRIVAL: You will be given a small injection of a radioactive tracer into a vein in your arm. You will then be given a time to return for your scan.

WAIT: There is a waiting period of four hours until your first scan. During this time you will be able to leave the department.

SCAN: When you return we will image your whole body. The images are taken with you lying on your back on an imaging bed. The camera will start over your head and slowly move down your body and you will need to lie still for up to 30 minutes.

DAY 2:

SCAN: When you arrival on day two we will again image your whole body and then perform an additional SPECT/CT. You will need to lie still for up to 1 ½ hours.

Accessibility requirements

If you require support for your appointment, e.g. if you find it hard to hear, see or be understood by others, please let the receptionist or healthcare professional know on arrival or contact us by email: cuh.accessibility@nhs.net or telephone: 01223 256998.

Pregnancy status

As a standard precaution, it is normally recommended to avoid radioactive tests during pregnancy. Please note that certain radioactive substances may pass into breast milk in small quantities. If you are currently breastfeeding, or if you know or suspect you may be pregnant, please contact our department in advance to discussion your situation. We also ask that you inform our staff upon arrival so we can ensure your safety and provide appropriate guidance.

We have a legal responsibility to enquire if you are pregnant. Any patient aged between 12-55 years will be asked if there is a possibility they could be pregnant. This is important for us to know before you have your examination involving ionising radiation. You can discuss this with a healthcare professional in private if you wish.

Medication

Bring a list of all of your medicines and a current repeat prescription from your GP as this will be helpful in the review of your preparation.

Can I bring someone with me?

To ensure the safety and comfort of all patients, we kindly request that you limit your companions to one adult during your visit. Please note that children and pregnant women are unable to accompany you in the department due to safety precautions. Your companion may be asked to wait outside during your procedure. We appreciate your cooperation and understanding. Should you require any special assistance, please contact us in advance.

Childcare whilst in department

Staff are unable to look after or supervise children whilst your procedure/examination is taking place. Please make alternative arrangements for the care of your children whilst you attend for your procedure/examination. If you attend an appointment with children with no one to look after them whilst you have your examination/procedure, then your appointment will unfortunately have to be cancelled and rescheduled.

Personal belongings

Please keep all your personal belongings with you at all times during your visit as we cannot accept responsibility for any lost, stolen or damaged items. Rest assure that you will be able to take these items with you into the scanning rooms.

Travelling abroad?

Please be aware that most airports have sensitive radiation monitors which detect very small amounts of radiation and may detect a residual trace from your test.

We advise you keep and travel with your appointment letter if you are travelling within 14 days after your scheduled scan. If you inform us of your travel we can provide you with a signed travel letter at your appointment. If residual trace is detected, the airport may have to contact our department as a precaution.

What happens after my procedure/examination?

Once we have verified the quality of your scan and have confirmed we have all the necessary information, you will be able to leave the department. You may resume all normal activities as there no restrictions following this test.

Possible side effects and additional aftercare

This test itself has no associated side effects. However, you may experience mild symptoms related to temporarily pausing of certain mediations in preparation for the procedure. If you have any persistent or concerning effects after resuming your regular medication please contact your GP for advice.

How, when and by whom will my results be communicated?

Imaging examinations are reported in order of clinical priority to ensure those with the highest urgency are reported first. Your referring team or clinician will be responsible for communicating reports back to you.

While results are available through MyChart, please note there is a standard 3 week delay between when the examination is reported to when it appears on your portal. This allows your clinical team adequate time to review and act on your results before they are released to you.

Are there any alternative tests?

If this test isn’t suitable for you, please contact your referring clinician to discuss alternatives. They can recommend the best options based on your individual needs.

Contacts/Further information

The Nuclear Medicine department is located on level 3, in the outpatient department of the hospital. If you have any queries or cannot make your appointment please contact the department as soon as possible on 01223 217145.

Opening times: Monday-Friday 8am-5pm.

Facilities available

Our clinic provides a toilet with disability access for your convenience, as well as a dedicated baby changing room and an alternative waiting area for returning patients. Please note that the waiting area and toilet facilities are reserved for radioactive patients only, as part of our safety protocols. If you are not a radioactive patient alternative restroom facilities can be found around the corner in the outpatient

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Directions to the department

The nuclear medicine department is located on level 3, at the outpatient end of the hospital.

My Chart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device

More information is available on our website: My Chart

Question, concern or complaint?

Firstly speak to your nurse, doctor or other staff member as soon as you can so they can do their best to put things right straightaway.

If you don’t feel able to speak directly to the people caring for you, contact the patient advice and liaison service (PALS). Please call 01223 216756 9am to 4pm Monday to Friday, via email at cuh.pals@nhs.net, or via a form available via link on the CUH PALS webpage.

PALS is open every weekday, and you can leave a message in the evenings and weekends.