— 01 · At a Glance
What is an MIBG scan?
★ In one paragraph
An MIBG scan is a nuclear medicine scintigraphy (SPECT) study — not a PET scan — that locates tumours of the sympathetic nervous system. A small amount of a radioiodine-labelled tracer called MIBG (meta-iodobenzylguanidine), which behaves like the hormone noradrenaline, is injected into a vein. Cells of the adrenal medulla and sympathetic nerves take it up, so phaeochromocytoma, paraganglioma and neuroblastoma appear as areas of increased uptake.
The MIBG scan has a second, special role: it confirms whether a tumour is MIBG-avid before I-131 MIBG therapy. The same molecule that finds the tumour can, in a higher-energy radioactive form, treat it — a see-and-treat (theranostic) pairing, much like PSMA in prostate cancer and DOTATATE in neuroendocrine tumours.
At Theranostic Physicians, MIBG scintigraphy is performed in the Department of Nuclear Medicine at Fortis Memorial Research Institute (FMRI), Sector 44, Gurugram, with interpretation led by Dr. Ishita B. Sen and Dr. Dharmender Malik.
— 02 · Machine & Reader
The scan is only as good as who reads it.
An MIBG result depends on a good machine to acquire a clean study and a good reader to interpret it — and, with MIBG, on correct preparation, because interfering medications or missed thyroid blockade can ruin the scan.
- The institution. Scans are performed at Fortis Memorial Research Institute, Sector 44, Gurugram — a leading tertiary hospital with a dedicated Department of Nuclear Medicine and SPECT/CT imaging.
- The reader. Every study is interpreted by Dr. Ishita B. Sen and Dr. Dharmender Malik. MIBG has well-known normal uptake — the salivary glands, liver, heart, bowel and bladder — that must be told apart from disease, and judging avidity for therapy takes experience.
A scan is only ever as reliable as the equipment that acquires it and the physician who reads it. We hold both to the same standard.
— 03 · Mechanism
How an MIBG scan works.
MIBG is a molecule built to resemble noradrenaline (norepinephrine), the chemical messenger of the sympathetic nervous system. It is labelled with radioactive iodine so it can be imaged:
- The tracer. MIBG is labelled with iodine-123 (preferred for imaging — clearer pictures, lower radiation) or iodine-131.
- Uptake. Because it mimics noradrenaline, MIBG is taken into chromaffin and adrenergic cells through the same transporter the body uses for noradrenaline. Tumours arising from these cells concentrate it.
- Imaging. A gamma camera takes whole-body images, usually with a SPECT/CT for precise localisation, typically about 24 hours after injection.
- Thyroid protection. Because the iodine label can release free radioiodine, the thyroid is blocked with potassium iodide before and after the scan.
Some MIBG uptake is normal — in the salivary glands, liver, heart, bowel and bladder. Separating this from disease is part of expert reporting.
123I
MIBG SCAN MECHANISM
[Image: Infographic — radioiodine-labelled MIBG mimicking noradrenaline, taken up by chromaffin/adrenergic tumour cells, whole-body gamma-camera + SPECT/CT acquisition at 24 hours]
— 04 · Indications
Who needs an MIBG scan?
An MIBG scan is requested by your endocrinologist, oncologist or paediatric oncologist in specific situations:
- Phaeochromocytoma and paraganglioma. Catecholamine-producing tumours of the adrenal medulla and sympathetic paraganglia — to locate the tumour, find additional or spread disease, and assess MIBG avidity.
- Neuroblastoma. A childhood tumour for which MIBG is central to staging and to monitoring response to treatment.
- Planning MIBG therapy. To confirm a tumour is MIBG-avid before I-131 MIBG therapy.
- Selected other neuroendocrine tumours, although for many of these a DOTATATE PET scan is now preferred.
★ MIBG or DOTATATE PET?
For many neuroendocrine tumours, a Ga-68 DOTATATE PET scan is now more sensitive and is often the first choice. MIBG keeps a distinct role in phaeochromocytoma, paraganglioma and neuroblastoma, and is essential when I-131 MIBG therapy is being considered, because therapy requires the tumour to be MIBG-avid. Sometimes both scans are used to build the full picture.
— 05 · The Visit
What to expect — and how to prepare.
An MIBG scan is usually a two-day outpatient test, and the preparation is important.
01
Thyroid blockade
Because the tracer is radioiodine-labelled, you take potassium iodide (for example Lugol's iodine) starting before the injection and continuing for a few days, to protect the thyroid.
02
Medication review
Several common drugs block MIBG uptake — including some antihypertensives (such as labetalol and certain calcium-channel blockers), tricyclic antidepressants, and decongestants and other sympathomimetics. Your doctor will advise which to pause, and for how long. Do not stop any medication without medical advice.
03
Injection
The MIBG tracer is given as a slow intravenous injection — slow because rapid injection can briefly affect blood pressure and heart rate.
04
Imaging at ~24 hours
You return about 24 hours later for whole-body images and a SPECT/CT, each session roughly 30 to 60 minutes. Sometimes further images are taken at 48 hours. Dr. Sen and Dr. Malik interpret the study.
Out-of-town and international patients are helped with scheduling so the two-day sequence and thyroid protection are arranged correctly.
— 06 · Accuracy
What an MIBG scan shows — and its limits.
MIBG is a specific marker of sympathetic-nervous-system tumours, which is its strength and its boundary.
- Where it excels. Confirming and locating phaeochromocytoma, paraganglioma and neuroblastoma, detecting spread, and — uniquely — confirming MIBG avidity to guide therapy.
- Its limits. Some tumours, particularly certain paragangliomas (including SDHB-related and many head-and-neck paragangliomas), take up little MIBG and are better seen on a DOTATATE PET scan. Small lesions can be missed, and several medications can suppress uptake if not paused.
- SPECT/CT helps. Adding CT to the SPECT images pins down exactly where uptake is, improving accuracy.
For the wider difference between this kind of functional imaging and an anatomical scan, see PET scan vs CT scan.
— 07 · See-and-Treat
From scan to therapy.
The MIBG scan is one of the original theranostic tests. The molecule that finds the tumour can also treat it: where the diagnostic scan uses I-123 MIBG to image, I-131 MIBG therapy uses a higher-energy form of the very same molecule to deliver radiation to MIBG-avid tumour cells.
This is why an MIBG scan is often performed specifically to plan treatment — in selected metastatic or inoperable phaeochromocytoma and paraganglioma, and in neuroblastoma. A scan showing strong MIBG avidity is what makes that pathway possible. To discuss whether MIBG-based therapy may apply, our team can guide you.
If you already have MIBG images from elsewhere and want an independent expert opinion, our Second Read service provides a formal re-read.
— 08 · Pricing
Cost of an MIBG scan in India.
The MIBG scan is billed by Fortis Memorial Research Institute. The price you pay is the same hospital counter price for everyone — with no commission added for booking through our team. We do not discount; the value is in the accuracy of the scan and the physician who reads it.
| Scan |
Cost |
Includes |
|
MIBG scintigraphy (I-123, with SPECT/CT)
|
₹ [ ADD PRICE ] |
Tracer + imaging + expert report |
— 09 · Safety
Is an MIBG scan safe?
Yes — an MIBG scan is a safe, well-tolerated test.
Tracer & side effects
- The tracer is given in a tiny amount; reactions are rare. It is injected slowly, because rapid injection can briefly raise blood pressure or heart rate.
- Thyroid-protection tablets (potassium iodide) are taken before and after the scan as instructed.
Radiation
- The radiation dose is moderate, and lower with I-123 than with the older I-131.
- The radioactivity decays over a few days; routine precautions about close contact may be advised.
Medications, pregnancy & breastfeeding
- Tell the team about all your medications, since several can affect the scan — but never stop any without medical advice.
- Tell the team if there is any possibility of pregnancy or if you are breastfeeding.
— 10 · Booking
Book an MIBG scan.
MIBG scintigraphy is performed at the Department of Nuclear Medicine, Fortis Memorial Research Institute, Sector 44, Gurugram — the single centre where we deliver scans — with interpretation led by Dr. Ishita B. Sen and Dr. Dharmender Malik.
★ Referrals welcome
We accept and welcome referrals from your treating physician — endocrinologist, oncologist, paediatric oncologist or family doctor. If you are a clinician referring a patient, contact us directly and we will coordinate scheduling and ensure the report reaches you. Patients may also arrange a scan directly; we always share the final report with your treating doctor.
★ How to book
Message the coordination team on WhatsApp +91 8700 668431 or email info@nuclearmedicinetherapy.in with your name, city, a brief history, and a current medication list (important for MIBG). We confirm the two-day schedule, thyroid-protection and medication instructions, and the price quote. Out-of-town and international patients are helped with scheduling and logistics.
Already have MIBG images from another centre? Request an independent expert opinion through our Second Read service without travelling.
Frequently asked questions.
What is an MIBG scan?
An MIBG scan is a nuclear medicine scintigraphy (SPECT) study — not a PET scan — that locates tumours of the sympathetic nervous system. A radioiodine-labelled tracer called MIBG, which behaves like noradrenaline, is injected and taken up by chromaffin and adrenergic cells, so phaeochromocytoma, paraganglioma and neuroblastoma show increased uptake. It also confirms MIBG avidity before I-131 MIBG therapy.
What does an MIBG scan detect?
Mainly phaeochromocytoma and paraganglioma (catecholamine-producing tumours) and neuroblastoma in children — to find the primary, detect spread, and confirm the tumour takes up MIBG before therapy. For many other neuroendocrine tumours, a Ga-68 DOTATATE PET scan is now usually more sensitive.
Is an MIBG scan a PET scan?
No. An MIBG scan is a scintigraphy study done with a gamma camera, usually with SPECT/CT, using a radioiodine-labelled tracer (I-123 or I-131). It is different from a PET scan. For some of the same tumours a DOTATATE PET scan is an alternative; the choice depends on the tumour type and whether MIBG therapy is being considered.
How do I prepare for an MIBG scan?
Two things matter. Thyroid blockade — you take potassium iodide (such as Lugol's iodine) before and after the scan to protect the thyroid. And medications — several common drugs (some antihypertensives such as labetalol and certain calcium-channel blockers, tricyclic antidepressants, decongestants and other sympathomimetics) can block uptake and may need pausing under your doctor's guidance. You will get a specific list when booking. Never stop a medication without medical advice.
How long does an MIBG scan take?
It is usually a two-day test: the tracer is injected on day one, and imaging is done about 24 hours later, sometimes with further images at 48 hours, often including a SPECT/CT. Each imaging session takes roughly 30 to 60 minutes. Thyroid-protection tablets continue for a few days.
How much does an MIBG scan cost in India?
Is an MIBG scan safe?
Yes. The tracer is given in a tiny amount and reactions are rare; it is injected slowly because rapid injection can briefly affect blood pressure and heart rate. The radiation dose is moderate and lower with I-123 than the older I-131. Thyroid-protection tablets are taken as instructed. Tell the team about all medications and any possibility of pregnancy or breastfeeding.
What does an MIBG-avid scan mean?
MIBG-avid means the tumour takes up the tracer. This matters because the same molecule can treat it: a tumour that is MIBG-avid on the diagnostic scan may be suitable for I-131 MIBG therapy, where a higher-energy form of the same tracer delivers radiation to the tumour. This see-and-treat pairing is why the scan is often done specifically to plan therapy.
MIBG scintigraphy is performed at the Department of Nuclear Medicine, Fortis Memorial Research Institute, Sector 44, Gurugram, with interpretation led by Dr. Ishita B. Sen and Dr. Dharmender Malik. Appointments are coordinated on WhatsApp +91 8700 668431; referrals from treating physicians are welcome.
Written & Medically Reviewed By
Dr. Ishita B. Sen
MBBS · DRM · DNB (Nuclear Medicine) · 30+ years in nuclear medicine
Director and Head, Department of Nuclear Medicine and Molecular Imaging, Fortis Memorial Research Institute. Visiting fellowships at Memorial Sloan Kettering Cancer Center, New York and University of Marburg, Germany. Past President, Association of Nuclear Medicine Physicians of India.
FellowshipsMSK New York · Marburg
Past PresidentANMPI
SpecialityMolecular Imaging & Theranostics
Full profile
References & citations
- Bombardieri E, Giammarile F, Aktolun C, et al. 131I/123I-metaiodobenzylguanidine (MIBG) scintigraphy: procedure guidelines for tumour imaging. European Journal of Nuclear Medicine and Molecular Imaging, 2010;37(12):2436–2446.
- Jacobson AF, Deng H, Lombard J, et al. 123I-meta-iodobenzylguanidine scintigraphy for the detection of neuroblastoma and phaeochromocytoma: results of a meta-analysis. Journal of Clinical Endocrinology & Metabolism, 2010;95(6):2596–2606.
- Pryma DA, Chin BB, Noto RB, et al. Efficacy and safety of high-specific-activity 131I-MIBG therapy in patients with advanced phaeochromocytoma or paraganglioma. Journal of Nuclear Medicine, 2019;60(5):623–630.
- Wong KK, Chondrogiannis S, Bhatt S, et al. The role of MIBG and somatostatin-receptor imaging in neuroendocrine tumours — comparative considerations. Seminars in Nuclear Medicine (review literature on MIBG vs DOTATATE).