USEFULNESS OF [F-18] FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY IN PEDIATRIC EPILEPSY SURGERY

We sought to analyze our experience with pediatric epilepsy surgery pa tients to determine the place of [F-18]fluorodeoxyglucose (FDG) positr on emission tomography (FDG-PET) in the preoperative evaluation of suc h children relative to chronic invasive intracranial monitoring, Fifty -six children who received an interictal FDG-PET as part of a phase 1 epilepsy surgery evaluation were compared with 44 children who did not have this study in a retrospective analysis of 100 patients accrued o ver a 4-year period. There was no significant difference between the t wo groups of children in terms of age or follow-up or was there a sign ificant difference between the FDG-PET group and the no-FDG-PET group in regard to the numbers of children who had surgery, the type of proc edure done, whether chronic invasive intracranial monitoring was perfo rmed, or outcome, The hypometabolic area demonstrated on interictal FD G-PET was concordant with that of the epileptogenic zone as mapped out with ictal recordings from subdural electrodes in 2 of 13 patients in whom a complete data set was available for comparison, In the other 1 1 children there was either poor agreement between interictal FDG-PET and ictal electrocorticographic data or the interictal FDG-PET was nor mal in the face of an epileptogenic focus which was successfully mappe d by invasive electrophysiologic techniques and excised, We conclude t hat one cannot exclude a child with intractable partial seizures from surgical consideration because the interictal FDG-PET is normal; nor i s there sufficient correlation between the interictal hypometabolic ar ea on FDG-PET and the epileptogenic zone in terms of anatomic location and size to justify forgoing chronic invasive intracranial monitoring In children with intractable partial seizures being evaluated for epi lepsy surgery unless there is absolute concordance between all neuroim aging, clinical, and video-electroencephalographic data.