# MIBG imaging and 131I-MIBG therapy

Source: https://onco.cc/technologies/mibg-theranostics/  
OnCo record `mibg-theranostics` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A noradrenaline look-alike that neuroblastoma cells swallow: labelled with a small amount of radioactivity it shows the tumour on a scan; with a large amount it treats it.

## Summary

123I-MIBG scintigraphy/SPECT is the standard staging scan (Curie score) in neuroblastoma, being partly replaced by 18F-MFBG PET. Therapeutic 131I-MIBG produces responses in ~30% of relapsed patients; COG ANBL1531 tested adding it to induction (results awaited). Also used in pheochromocytoma/paraganglioma (Azedra, discontinued 2024).

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-07
- Principle: Norepinephrine transporter (NET) uptake concentrates radio-iodinated MIBG in adrenergic tumours; 131I delivers beta radiation.
- Since: 1985
- Strengths: Theranostic pair with decades of use; Targets NET-positive disease irrespective of GD2
- Limitations: Prolonged isolation and radiation precautions in children; Myelosuppression requiring stem-cell support at high doses; Azedra withdrawal reduced supply

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Iobenguane
- Wikipedia: https://en.wikipedia.org/wiki/Iobenguane

## Connected records

- cancers: [High-risk neuroblastoma](https://onco.cc/cancers/neuroblastoma-high-risk/), [Intermediate-risk neuroblastoma](https://onco.cc/cancers/neuroblastoma-intermediate-risk/), [Metastatic pheochromocytoma and paraganglioma](https://onco.cc/cancers/metastatic-ppgl/), [Neuroblastoma (paediatric)](https://onco.cc/cancers/neuroblastoma/), [Neuroendocrine tumours](https://onco.cc/cancers/neuroendocrine/), [Pheochromocytoma and paraganglioma (PPGL)](https://onco.cc/cancers/pheochromocytoma-paraganglioma/)
- fronts: [Imaging](https://onco.cc/fronts/imaging/), [Radiopharmaceuticals & Theranostics](https://onco.cc/fronts/radiopharma/)
- technologies: [PET (positron emission tomography)](https://onco.cc/technologies/pet/), [Radioligand therapy (beta emitters)](https://onco.cc/technologies/radioligand-therapy/), [SPECT & bone scan](https://onco.cc/technologies/spect/)
- drugs: [131I-MIBG (iobenguane I-131) therapy](https://onco.cc/drugs/i131-mibg/)
- trials: [COG ANBL1531](https://onco.cc/trials/anbl1531/)
- ideas: [18F-MFBG PET replacing 123I-MIBG scintigraphy](https://onco.cc/ideas/idea-mfbg-pet-replaces-mibg/)
- bottlenecks: [Rare and paediatric cancers without markets](https://onco.cc/bottlenecks/b-rare-cancers/)
- terms: [MIBG Curie and SIOPEN scores](https://onco.cc/terms/curie-siopen-score/), [Urinary catecholamine metabolites (VMA and HVA)](https://onco.cc/terms/urinary-catecholamines/)
- roadmaps: [Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first](https://onco.cc/roadmaps/paediatric-oncology-roadmap/)

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