Neuroblastoma Patient & Family Handbook

A person having an MRI lies on a table which is rolled into a machine that surrounds them on all sides, like a tube. There are open MRI machines available for people who find themselves very anxious in a regular MRI machine. The test is painless, but the machine makes quite a bit of noise. Your child may possibly use ear plugs or a headset during the test. They must be able to lie completely still, and some children require sedation to do this. The test usually takes one to two hours to finish. Often, a dye that will improve the pictures will be injected into the vein. Because it uses magnets, MRI machines cannot have metal objects inside them. Your child will be asked to remove all metal objects, including jewelry and clothes with metal snaps or zippers. An MRI does not expose your child to any form of radiation. MIBG A meta-iodobenzylguanidine (MIBG) scan is a very important test that looks for neuroblastoma throughout the body. MIBG is a clear liquid that is injected into a vein and absorbed by neuroblastoma tumor cells. The substance lights up on a nuclear scan so the tumor cells can be detected. MIBG is a radioactive substance, but it is given in such a small amount that your child receives less radiation than from an X ray. Potassium iodine drops are taken orally in the days surrounding the scan to protect the thyroid gland from radiation. The MIBG later leaves the body in the urine. A mom who is pregnant should speak to the nuclear medicine staff about any precautions she should take in caring for her child. The nuclear scan is done 1–3 days after the injection of MIBG. Your child may require sedation or anesthesia to stay still for the scan. Higher doses of MIBG may be used later in the treatment of your child’s neuroblastoma if first-line treatments are not 100% effective. Ultrasound Ultrasound uses the echoes from high-frequency sound waves to produce a picture of internal organs or tumors. It can help find tumors in the belly, reveal a lot about the health of the kidneys and bladder, or be used to measure the size of some organs, especially the liver and spleen. The ultrasound can show blood flow through the veins and whether the blood flow is blocked by a clot. It is a painless test and uses no radiation. The child lies on a table for a short time. A cold, clear jelly is smeared on the area being examined and wipes off easily after the test. A small, round handle is placed on the jelly and moved around to get a clear picture of the tissue or organ. If the ultrasound is of the belly, the child may not be permitted to eat or drink for several hours before the test. Urine Test Urine is tested for chemicals called catecholamines , specifically vanillylmandelic acid (VMA) and homovanillic acid (HVA), which are released by neuroblastoma tumors. Only a small amount of urine may need to be collected over a 24-hour period for this test. If your child is not toilet-trained, a simple collection bag can be placed over the penis or vaginal area or a catheter can be inserted into the bladder to obtain urine for testing. You may be asked not to allow your child to have certain foods, drinks, or medications that may affect the results of this test.

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