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

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)847-850
Number of pages4
JournalRADIOLOGY
Volume178
Issue number3
DOIs
StatePublished - 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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