MIBG Therapy

What is MIBG Therapy?

MIBG stands for MetaIodoBenzylGuanidine and is a form of radiation therapy directed specifically to neuroblastoma cells, sparing normal tissue from high doses of radiation. When given in low doses, MIBG is useful for imaging of neuroblastoma. When given in higher doses, MIBG can be used as a treatment for patients with high-risk neuroblastoma tumors that have spread from where a tumor originally began and is harder to treat, or a tumor that has come back after initial treatment (relapsed).

How does MIBG therapy work?

MIBG is a clear liquid that looks like water and is “taken up” by neuroblastoma cells. When given to a patient, it not only helps to see where the neuroblastoma cells are in the body (scanning) but also helps in seeking the tumor cells for treatment.

MIBG is combined with radioactive material called Iodine-131 (I-131) to produce radioactive MIBG (I-MIBG) which then attack neuroblastoma cells. It is administered through intravenous (IV) tubing which is connected to a syringe with the I-MIGB dose that is then run through an infusion pump located on a lead-shielded cart. The infusion process generally takes 2 to 2 ½ hours.

What are the advantages of coming to Mott for MIBG therapy?

MIBG was invented at the University of Michigan over 30 years ago to be used to “scan” and identify tumors like neuroblastoma. Over the past 20 years, it has also been used it to treat patients with this tumor, making the team at Mott one of the most well experienced you’ll find in the country. 

I-MIBG treatment is specialized. The use of I-MIBG is strongly regulated and it can only be used in hospitals that are equipped (set up) to control the radiation and have staff properly trained in its use. At Mott, our special-equipped room is located on 12 West for this treatment and the staff is specially trained in how to care for patients undergoing I-MIBG treatment.

Radiation is a powerful tool against cancers, but it can also harm healthy tissue if there is too much for too long. Because I-MIBG has a very short time when it is most active, the timing of when it is made and shipped is carefully planned. That is why a patient’s admission to the hospital is timed very carefully. At Mott, this treatment is only given to one patient at one time.

What to expect euring your stay for MIBG therapy?

You will have a visit or phone conference call with the health care team before being admitted which will include:

  • an overview of I-MIGB treatment.
  • what caregivers can expect.
  • radiation safety overview.

The team will schedule a visit on the Monday before you are admitted for a final check-up and review of the plan. Our child life specialist and psychologist will meet with you and your child to help prepare them for the treatment and hospital stay. You will also receive a tour of the unit/room and further radiation safety training.

There is a room for one caregiver to stay overnight during the treatment and it’s located just outside the patient’s room.  The caregiver’s room includes a recliner, sink, cabinet, and video monitor where you can always see and interact with the patient. Other adult caregivers may visit during the day following standard visitation rules.

All caregivers, including parents and nurses, must follow strict rules during MIBG treatment to limit the exposure to radiation. Many safeguards will be in place, including using protective clothing and staying behind lead shields when in the MIGB therapy room.  Most surfaces of the room such as floors, bedrails, light switches, and toilet will be covered with plastic. This makes it easier to clean the room the treatment is over.

On the left: MIBG therapy patient room with lead shields; center: doorway between the MIBG therapy room and caregiver’s room; on the right: the caregiver’s room
On the left: MIBG therapy patient room with lead shields; center: doorway between the MIBG therapy room and caregiver’s room; on the right: the caregiver’s room


Next steps

If you are interested in learning more about MIBG therapy or scheduling an appointment, please call 734-936-9814.