Mapping the distribution of amobarbital sodium in the intracarotid Wada test by use of Tc-99m HMPAO with SPECT

Petra J. Jeffery; Lee H. Monsein; Zsolt Szabo; John Hart; Robert S. Fisher; Ronald P. Lesser; Gerard M. Debrun; Barry Gordon; Henry N. Wagner; Edwaldo E. Camargo

doi:10.1148/radiology.178.3.1994430

Mapping the distribution of amobarbital sodium in the intracarotid Wada test by use of Tc-99m HMPAO with SPECT

Petra J. Jeffery, Lee H. Monsein, Zsolt Szabo, John Hart, Robert S. Fisher, Ronald P. Lesser, Gerard M. Debrun, Barry Gordon, Henry N. Wagner, Edwaldo E. Camargo

School of Medicine

Research output: Contribution to journal › Article › peer-review

63 Scopus citations

Abstract

The intracarotid amobarbital sodium, or Wada, test has been used to localize speech and memory function prior to surgical treatment of temporal lobe seizures. The authors mixed technetium-99m hexamethylpropyleneamine oxime (HMPAO) with amobarbital sodium and injected the mixture in 25 patients with epilepsy. Single photon emission computed tomography (SPECT) of the brain was then performed to determine intracerebral distribution of the amobarbital sodium. Results of SPECT were compared with those of conventional and digital subtraction angiography (DSA). The distribution of Tc-99m HMPAO and, presumably, amobarbital sodium varied from patient to patient. SPECT revealed a statistically different distribution from that predicted with conventional angiography. The distribution also often differed from that of DSA, although the difference was not significant. SPECT revealed infrequent delivery to mesial temporal lobe structures. This emphasizes the need for caution in the use of the intracarotid amobarbital sodium test to predict the outcome of removal of these areas.

Original language	English (US)
Pages (from-to)	847-850
Number of pages	4
Journal	RADIOLOGY
Volume	178
Issue number	3
DOIs	https://doi.org/10.1148/radiology.178.3.1994430
State	Published - Mar 1991

Keywords

Angiography, preoperative, 17.124
Brain, perfusion, 134.89
Cerebral blood vessels, radionuclide studies, 17.1299
Emission CT
Epilepsy, 134.89
Radionuclide imaging, comparative studies

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

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10.1148/radiology.178.3.1994430

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title = "Mapping the distribution of amobarbital sodium in the intracarotid Wada test by use of Tc-99m HMPAO with SPECT",

abstract = "The intracarotid amobarbital sodium, or Wada, test has been used to localize speech and memory function prior to surgical treatment of temporal lobe seizures. The authors mixed technetium-99m hexamethylpropyleneamine oxime (HMPAO) with amobarbital sodium and injected the mixture in 25 patients with epilepsy. Single photon emission computed tomography (SPECT) of the brain was then performed to determine intracerebral distribution of the amobarbital sodium. Results of SPECT were compared with those of conventional and digital subtraction angiography (DSA). The distribution of Tc-99m HMPAO and, presumably, amobarbital sodium varied from patient to patient. SPECT revealed a statistically different distribution from that predicted with conventional angiography. The distribution also often differed from that of DSA, although the difference was not significant. SPECT revealed infrequent delivery to mesial temporal lobe structures. This emphasizes the need for caution in the use of the intracarotid amobarbital sodium test to predict the outcome of removal of these areas.",

keywords = "Angiography, preoperative, 17.124, Brain, perfusion, 134.89, Cerebral blood vessels, radionuclide studies, 17.1299, Emission CT, Epilepsy, 134.89, Radionuclide imaging, comparative studies",

author = "Jeffery, {Petra J.} and Monsein, {Lee H.} and Zsolt Szabo and John Hart and Fisher, {Robert S.} and Lesser, {Ronald P.} and Debrun, {Gerard M.} and Barry Gordon and Wagner, {Henry N.} and Camargo, {Edwaldo E.}",

year = "1991",

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AU - Jeffery, Petra J.

AU - Monsein, Lee H.

AU - Szabo, Zsolt

AU - Hart, John

AU - Fisher, Robert S.

AU - Lesser, Ronald P.

AU - Debrun, Gerard M.

AU - Gordon, Barry

AU - Wagner, Henry N.

AU - Camargo, Edwaldo E.

PY - 1991/3

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N2 - The intracarotid amobarbital sodium, or Wada, test has been used to localize speech and memory function prior to surgical treatment of temporal lobe seizures. The authors mixed technetium-99m hexamethylpropyleneamine oxime (HMPAO) with amobarbital sodium and injected the mixture in 25 patients with epilepsy. Single photon emission computed tomography (SPECT) of the brain was then performed to determine intracerebral distribution of the amobarbital sodium. Results of SPECT were compared with those of conventional and digital subtraction angiography (DSA). The distribution of Tc-99m HMPAO and, presumably, amobarbital sodium varied from patient to patient. SPECT revealed a statistically different distribution from that predicted with conventional angiography. The distribution also often differed from that of DSA, although the difference was not significant. SPECT revealed infrequent delivery to mesial temporal lobe structures. This emphasizes the need for caution in the use of the intracarotid amobarbital sodium test to predict the outcome of removal of these areas.

AB - The intracarotid amobarbital sodium, or Wada, test has been used to localize speech and memory function prior to surgical treatment of temporal lobe seizures. The authors mixed technetium-99m hexamethylpropyleneamine oxime (HMPAO) with amobarbital sodium and injected the mixture in 25 patients with epilepsy. Single photon emission computed tomography (SPECT) of the brain was then performed to determine intracerebral distribution of the amobarbital sodium. Results of SPECT were compared with those of conventional and digital subtraction angiography (DSA). The distribution of Tc-99m HMPAO and, presumably, amobarbital sodium varied from patient to patient. SPECT revealed a statistically different distribution from that predicted with conventional angiography. The distribution also often differed from that of DSA, although the difference was not significant. SPECT revealed infrequent delivery to mesial temporal lobe structures. This emphasizes the need for caution in the use of the intracarotid amobarbital sodium test to predict the outcome of removal of these areas.

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KW - Radionuclide imaging, comparative studies

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Mapping the distribution of amobarbital sodium in the intracarotid Wada test by use of Tc-99m HMPAO with SPECT

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