What is I-131-MIBG therapy?

I-131-MIBG therapy is a type of radiation therapy used to kill cancer cells in children with certain kinds of cancer. It’s a way to get radiation inside your child’s body to target cancer cells wherever they are.

The medicine is a clear fluid that looks like water. Your child receives this treatment by infusion through a thin tube into a vein. The tube is called an intravenous (IV) line or central line. The fluid is slowly pumped through the tube into your child’s bloodstream so it can travel through their body.

The fluid contains I-131 and MIBG. I-131 is a kind of radioactive iodine. This is what gives off radiation to destroy the cancer. When it is attached to MIBG (another chemical), it brings the radiation into the tumor.

Once inside the cancer cells, the iodine gives off particles of radiation (beta radiation) that travel outward about half an inch in all directions. This kills the cancer cells and the cells around them.

The infusion is done in the hospital. It takes about 2 hours. After the infusion, you and your child stay in the hospital for about a week. For 5 to 7 days, your child’s body fluids (like pee, sweat and spit) will give off radiation that could harm others. Our team follows special plans to care for your child while making sure to contain the radiation.

  • I-131-MIBG therapy is used for neuroblastoma and some tumors of the adrenal glands (pheochromacytoma).

    Radiation works well against neuroblastoma. But neuroblastoma may spread to many places in a child’s body. So the most common way of giving radiation – sending a beam of radiation toward 1 spot – is not always useful. I-131-MIBG therapy is a way to get radiation to neuroblastoma cells all around the inside of your child’s body through the bloodstream.

  • This is a newer option, so usually it is offered only through research studies (clinical trials). At Seattle Children’s, I-131-MIBG therapy may be an option for children with high-risk neuroblastoma in these ways:

    • A “compassionate use” option for children with disease that does not respond well to treatment (refractory) or that has come back (recurrent). This means the U.S. Food and Drug Administration lets these patients take the drug before it is approved and without taking part in a clinical trial. Our doctors have worked with the Children’s Oncology Group and New Approaches to Neuroblastoma Therapy to make I-131-MIBG available.
    • A clinical trial for children who are newly diagnosed with high-risk neuroblastoma.

    In the future, I-131-MIBG therapy may be used as part of the treatment for all children with high-risk neuroblastoma. Before this can happen, researchers need more research results to tell whether standard treatment plus I-131-MIBG therapy may work at least as well as standard treatment alone.

What’s special about I-131-MIBG therapy at Seattle Children’s?

Seattle Children’s is the only hospital in the Pacific Northwest and 1 of only about 12 centers in the country that offer I-131-MIBG therapy for children. It’s part of our commitment to bring the best and newest treatments to all children with cancer.

We take great care to treat your child safely while keeping your family, other patients and the hospital staff safe. Seattle Children’s has special rooms, equipment and a full team of healthcare providers with special training to offer this treatment.

To learn more, see:

Your Child’s Team

Your child will be cared for by a compassionate, expert team of doctors, nurses, technologists and social workers. Team members are trained to give I-131-MIBG therapy safely.

  • Parents are key members of the care team. During the week after the infusion, you will need to provide some of your child’s care. Before treatment starts, the team will give you detailed training about what you will need to do. We work closely with you during your child’s hospital stay.

    This guide prepares you to give care to your child during treatment.

  • Our team is led by a doctor with special training in diagnosing, treating and preventing blood diseases and cancers. That branch of medicine is called hematology-oncology.

  • Doctors specially trained in nuclear medicine use radioactive substances to diagnose, treat and research illness.

  • Advanced practice providers include advanced registered nurse practitioners (ARNP) and physician assistants (PA). They work closely with doctors and can provide care independently. These providers diagnose and treat patients and can prescribe medicines. Throughout your child’s treatment, they are available to answer questions and share advice. They teach patients and families and give follow-up care after your child leaves the hospital.

  • Our certified nuclear medicine technologists prepare radioactive materials for patients who are getting some types of imaging studies.

    • Lisa Aldape, CNMT, PET/CT supervisor
    • Marian Abrahamson, CNMT
    • Danielle Watkins, CNMT
    • Kristin Petkavich, CNMT
    • Aileen Corpuz, CNMT

  • To protect the safety of our patients and staff, our radiation safety officer oversees the use of radiation for diagnosis and treatment.

    • Barb Michieli, MS

  • Our social worker provides emotional and practical support throughout your child’s treatment.

    • Ashlei Brooks, MSW

Contact Us

For more information, please call 206-987-2106 or send us an email.

Contact the Cancer and Blood Disorders Center at 206-987-2106 for an appointment, a second opinion or more information.

To make an appointment, you can call us directly or get a referral from your child’s primary care provider. We encourage you to coordinate with your pediatrician or family doctor when coming to Seattle Children’s.

Providers, see how to refer a patient.