Parents And Care Givers Radiation Exposure From High Dose 131I-MIBG Therapy In Pediatrics With NBL; A KFSHRC - Saudi Arabia Initial Experience

Research Article

Author(s): Mohammed Al Rowaily*

Published: March 20, 2026     DOI: 10.33552/ACRCI.2026.05.000604

Abstract: To Our Knowledge, There Are No Curative Salvage Treatments Available To Date. It Is In This Scenario That 131I-MIBG Has Been Widely Investigated As A Potential Therapeutic Radiopharmaceutical. This High Avidity Of MIBG For NBL Makes It An Ideal Radiopharmaceutical For Therapy As Well As Imaging. KFSHRC As A Major Centre In Middle East Provide This Treatment And Capable Of Using High Dose 131I-MIBG Therapy Because Of Availability Autologous Stem Cell. Radiation Exposure To Parents And Caregiver Was Investigated To Provide High Safety Level. Background: High-risk And Relapsed Neuroblastoma (NBL) Presents A Significant Therapeutic Challenge, With A Pronounced Lack Of Curative Salvage Regimens. 131I-Metaiodobenzylguanidine (131I-MIBG) Therapy, Leveraging The High Avidity Of Neuroblastoma Cells For The MIBG Molecule, Has Emerged As A Potent Targeted Radiopharmaceutical Option. As A Major Referral Centre, King Faisal Specialist Hospital And Research Centre (KFSHRC) Is Uniquely Positioned In The Middle East To Deliver High-dose 131I-MIBG Therapy, Supported By Its Robust Autologous Stem Cell Transplantation Program. This Study Reports Our Initial Experience, With A Specific Focus On Quantifying Radiation Exposure To Parents And Caregivers To Validate Established Safety Protocols. Methods: We Analysed Data From Three Pediatric Patients Who Received A Total Of Five Therapeutic Doses. The First Two Doses Were Administered At 444 MBq Kg−1 (12 MCi Kg-1), And The Subsequent Three At An Escalated Dose Of 666 MBq Kg-1 (18 MCi Kg-1). Radiation Exposure Rates (in MSv/ Hour) Were Meticulously Measured For A Representative Administered Activity Of 200 MCi (7400 MBq) At Varying Distances (0.5 To 5 Meters) Over A Four-day Post-therapy Period. Urinary Excretion Rates Of The Radiopharmaceutical Were Also Tracked. Results: Monitoring Revealed A Rapid Clearance Of 131I-MIBG, With Over 50% Of The Injected Activity Excreted In The Urine Within The First 24 Hours, Over 75% By 48 Hours, And Over 90% By 72 Hours. Correspondingly, Radiation Exposure Rates Demonstrated A Rapid Decline, Consistent With This Pharmacokinetic Profile. All Measured Exposure Levels For Caregivers, Even At Close Proximity (0.5 M) During Necessary Interactions, Were Well Below International Safety Limits. Conclusion: High-dose 131I-MIBG Therapy For Neuroblastoma Can Be Safely And Effectively Administered At KFSHRC. The Comprehensive Radiation Safety Data Confirm That With Proper Protocols, The Exposure To Parents And Caregivers Is Minimal And Within Internationally Mandated Constraints, Thereby Affirming The Feasibility Of This Advanced Treatment In The Region.

Article Formats: PDF | Fulltext