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Procedure:

• You have been referred for an Adrenal I-123(MIBG) Scan in which imaging is done 24 hours after a small injection of tracer is given.

• An Adrenal I-123(MIBG) Scan is very sensitive in showing tumours of neuroendocrine origin, particularly those of the sympathoadrenal system (phaeochromocytomas, paragangliomas and neuroblastomas), although other neuroendocrine tumours (carcinoids, medullary thyroid carcinoma, etc...) are also visualised.

• In addition, MIBG can be employed to study disorders of sympathetic innervation, for example of the heart.

• The test involves some preparation (see "Patient Preparation" below).

• You will need to take 0.6mls of Lugol’s Iodine on Sunday, Monday, Tuesday (day of injection), Wednesday (day of scan) & possibly Thursday. It is advisable to take this in the morning and it should be mixed with coca cola as the taste is not pleasant!

• After the correct preparation is followed, a small injection of  I-123(MIBG) “tracer” is given into a vein in the arm. This tracer is Iodine-123 Metaiodobenzylguanidine and is the combination of the benzyl group of bretylium and the guanidine group of guanethidine.

• This is given on any given Tuesday (due to strict delivery criteria from the overseas manufacturer).

• Normally there are no harmful side effects but occasionally slight "hot" flushing has been noted in some patients.

• You are allowed to EAT and DRINK on the days of the test.

• Once you have received the I-123(MIBG) injection on Tuesday, you are required to return to the department on Wednesday for your images.

• Images are done of your whole body using a Gamma Camera (1). This takes 20 minutes and is painless.

• Often we require 3D imaging of your abdomen 'after' your whole body images. This is called SPECT/CT (2) imaging.

• With SPECT/CT imaging, the same Gamma Camera simply rotates around your body, taking images all the time. This can take 40 minutes.

• You receive a slight radiation dose by having an Adrenal I-123(MIBG) Scan with SPECT/CT ~ up to 1.9 times your yearly background radiation (3).

 

Patient Preparation:

• You must visit our Department 1 week before your test so that we can give you a small bottle containing Lugol’s Iodine.

• If you cannot come to the department 1 week earlier, you will need to obtain the Lugol's Iodine from your local pharmacy.

• You will need to take 0.6mls of Lugol’s Iodine on Sunday, Monday, Tuesday, Wednesday & possibly Thursday. It is advisable to take this in the morning and it should be mixed with coca cola as the taste is not pleasant!

• You must inform us of any medications you are on, in particular any Antihistamines, Cough Medicines, Antidepressants or any blood pressure medications.

• You will need to cease your medications for a few days prior to the test. Please click here to see the chart of Medications and their withdrawal periods....

• If you are pregnant, trying to fall pregnant or breast feeding, you must inform our staff.

• If you have had prior imaging e.g. PET, Nuclear Scan, CT, MRI, X-Ray, Ultrasound, etc... please bring these with you.

• Please also bring your referral and any blood results that you may have had done.

• Wear comfortable clothing and minimise the amount of metal jewellery you have on (all metal objects will need to be removed prior to imaging).

• Important Note: You cannot have this test if you have had a PET or Nuclear Scan within 24 hours prior to this test. If you have had Iodine-131 therapy, allow 4-weeks before having this test. Please ring to discuss booking options.

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Breast-Feeding Mothers: Once you have been given the tracer, you need to stop breast-feeding for 24hrs. During this time, you need to express and discard your breast milk as often as required. You will need to bottle-feed your child during this period.

 

Cost (4):

• Due to the extreme cost of importing I-123 (MIBG), your out-of-pocket expense will be approximately $600.00.

• The total cost of the test is $1449.32 and Medicare will give you back approx. $849.32.

• CANCELLATIONS: Can only be done if we are notified BEFORE the THURSDAY preceding the I-123 (MIBG) delivery i.e. the Thursday before the Tuesday injection.

• Cancellations later than this means you will be charged for the cost of the isotope : $1050.00 (which you CANNOT claim back from any health fund or Medicare).

 

⁽¹⁾ A Gamma Camera is a device that detects gamma-rays (gamma-rays are very similar to x-rays) and does not emit any radiation.

⁽²⁾ SPECT/CT imaging (Single Photon Emission Computer Tomography / Computer Tomography). CT does emit radiation

⁽³⁾ We all receive a yearly background radiation dose ~ 2.4mSv. Adrenal I-123(MIBG) Scan with SPECT/CT ~ 4.6mSv = 1.9 times yearly background dose.

(4) Costings accurate as of 12.3.2013. These values may change without notification. Confirmation of costs can be done by contacting the department on 9519 9666.