Center for Cancer and Blood Disorders

The MIBG Program for Neuroblastoma at Children’s Hospital Colorado


MIBG Program for Neuroblastoma

What is the purpose of the MIBG Program?

The MIBG Program (called “MIBG” for short) in the Center for Cancer and Blood Disorders is dedicated to the safe administration of MIBG. This type of MIBG therapy uses intravenous (IV) radiation targeted to certain cancer cells.

What is MIBG?

Metaiodobenzylguanidine (MIBG) is a treatment for certain types of cancerous tumor cells including neuroblastoma, pheochromocytoma and paraganglioma. MIBG is combined with radioactive iodine (known as 131I in chemistry) to form a substance called 131I-MIBG.  This clear liquid looks like water and is given to patients by an infusion through an IV or central line.  

How does MIBG treatment help kids and young adults with neuroblastoma?

When the radioactive MIBG is infused into a vein, it is absorbed by tumor cells. The iodine then releases radiation that kills the cancer cells.  

Although traditional radiation therapy works well against neuroblastoma, neuroblastoma can be found in multiple places in the body and can be hard to treat with the standard way of giving radiation (an external beam of radiation targeted to a certain part of the body).  In cases like this, MIBG treatment is used as a way to get radiation to the neuroblastoma cells anywhere in the body through the bloodstream.

Why choose Children’s Hospital Colorado for MIBG treatment of neuroblastoma?

Children’s Colorado is the only hospital in the Rocky Mountain region and one of only approximately 12 hospitals in the United States that offers MIBG therapy for kids.   MIBG has to be given carefully to make sure that your child is treated safely and to ensure that your family, other patients and our staff are also kept safe.   

To make our MIBG treatment as safe and comfortable as possible for your child, we’ve built a special state-of-the-art room in our new East Tower designed specifically for to this type of therapy. The room’s walls, floor, ceiling and door are lined with lead to keep the radiation inside the room.

A team of experts to care for your child  

The MIBG Program includes a specially trained team of nuclear medicine doctors, pediatric oncology doctors, nuclear medicine technologists, a radiation health physicist, pediatric oncology advance practice providers, and pediatric oncology nurses.  

In addition, the team includes specialists from our Wellness Program such as child life/therapeutic recreation specialists, social workers, a chaplain and a psychologist.  This multidisciplinary team works together to ensure that MIBG therapy is given as safely and effectively as possible, while providing important emotional support to your child and family. 

What to expect during MIBG treatment

Children are hospitalized in the special lead-lined room for about five to seven days after the infusion.  The actual infusion of the 131I-MIBG lasts approximately two hours, but your child will need to stay in the room while the radioactivity is being cleared from his or her body.  During that time, special monitors, microphones and televisions in the room allow for easy communication between the child, parents and staff. 

What to expect after the infusion

For about a week after the infusion, body fluids (urine, sweat, tears, etc.) are still radioactive and can be harmful to others. Most of the surfaces in the room are covered in plastic to protect the floor, walls and bed from radiation spills. There are also large shields around the child’s bed to protect parents and staff from the radiation.

Parents will need to provide some of your child’s care while he or she is hospitalized.  Our team will train you prior to the infusion to explain what you’ll need to do, and we’ll work closely with your family during your child’s hospital stay.  

Parents and staff must wear gloves, gowns and shoe covers to enter the room, as well a device to measure radiation exposure. A system to get rid of the radioactive urine will also be used.  

How will my child feel during MIBG treatment?

Typically, children feel pretty well during the treatment. The hardest part of the treatment usually is boredom for the child who has to stay in bed in the special room.  

To help pass the time and make the experience less stressful, our child life/therapeutic recreation specialists will work with your family to find fun activities to keep your child busy. We’ll meet with you prior to treatment to help prepare for this time when your child is confined to the room.  

Who can receive MIBG treatment?

Children with neuroblastoma that has come back or has not responded to treatment may be able to receive this therapy. Because 131I-MIBG treatment is still relatively new, the only way to receive this therapy is through participation in clinical trials and research studies.