PET/MRI Offers Diagnostic, Prognostic Value in Pediatric Epilepsy

FRIDAY, Sept. 25, 2026 (HealthDay News) — Fluorodeoxyglucose ([¹⁸F]FDG) positron emission tomography (PET)/magnetic resonance imaging (MRI) offers diagnostic and prognostic value in pediatric epilepsy, according to a study published in the August issue of the Journal of Nuclear Medicine.

Concetta Luisi, M.D., from Bambino Gesu Children”s Hospital in Rome, and colleagues examined whether [¹⁸F]FDG PET/MRI would improve presurgical lesion detection compared with MRI alone in a study involving 79 pediatric patients with focal epilepsy.

The researchers found that initial MRI results were inconclusive and negative in 33 and 67 percent of patients, respectively. Suspect lesions were identified in 36 patients (46 percent) by blinded 3T-MRI, identifying additional lesions in 10 patients. Forty-six patients had concordant PET-positive/MRI-positive results in joint PET/MRI reading, while 24 and eight had PET-positive/MRI-negative results and PET-negative/MRI-negative results, respectively. High accuracy for identifying epileptogenic lesions, especially focal cortical dysplasia, was demonstrated by concordant PET-positive/MRI-positive findings. Metabolic alterations were demonstrated on PET/MRI in 70 patients (89 percent): 96 and 9 percent had hypometabolism and mixed areas of hypometabolism and hypermetabolism, respectively. In 45 of 46 patients with PET-positive/MRI-positive results and in 15 of 24 patients with PET-positive/MRI-negative results, the results were concordant with the electroclinical hypothesis. Twenty-four and five patients underwent resection or disconnection and thermocoagulation, respectively. At an average follow-up of 2.1 years, Engel class IA outcomes were achieved by 22 of these patients (76 percent).

“As more data become available, this approach could help clinicians identify the children most likely to benefit from epilepsy surgery, better understand distinct patterns of brain metabolism, and improve the integration of imaging findings with clinical and electroencephalography data to guide treatment decisions,” Luisi said in a statement.

Abstract/Full Text