Quantifying FDG-PET to Guide Epilepsy Surgery: New Insights

Strategic Insights -

Research from Vanderbilt University Medical Center has shed light on the benefits of quantifying F-Fluorodeoxyglucose (FDG) positron emission tomography (PET) scans in guiding epilepsy surgery. The study, published in the journal Epilepsia, found that quantifying FDG-PET laterality can distinguish between patients who achieve long-term freedom from disabling seizures and those who do not.

Key Takeaways:

  • Surgical resection of the seizure onset zone can be an effective treatment for patients with drug-resistant focal epilepsy, with ~62% of patients becoming seizure-free after surgery.
  • Quantifying FDG-PET laterality can distinguish between patients who achieve long-term freedom from disabling seizures (3 years) and those who do not, outperforming standard clinical assessment (area under the curve [AUC] = .83 vs. .68).
  • The quantified FDG-PET method generalized to nine patients with extratemporal lobe focal epilepsy.
  • The study suggests that the quantified FDG-PET method could be used prospectively in the clinic to aid in surgical guidance and patient counseling.
  • The research was supported by the National Institutes of Health.
  • The study included 55 patients who underwent resective epilepsy surgery, 46 of whom had temporal lobe epilepsy.

Statistics:

  • ~62% of patients became seizure-free after surgery.
  • Quantifying FDG-PET laterality achieved an AUC of .83 in distinguishing between patients who achieved long-term freedom from disabling seizures and those who did not.
  • The standard clinical assessment achieved an AUC of .68.
  • 55 patients were included in the study.
  • 46 patients had temporal lobe epilepsy.
  • 9 patients had extratemporal lobe focal epilepsy.

Sources:

  • Epilepsia. Operator: Surgical targeting of lateralized 18F-fluorodeoxyglucose positron emission tomography hypometabolism relates to long-term epilepsy surgery outcomes. 2025;66(8):2816-2829.
  • Wiley. Operator: (www.wiley.com/; onlinelibrary.wiley.com/journal/10.1111/(ISSN)1528-1167)
  • NewsRx. Operator: Findings from Vanderbilt University Medical Center in Epilepsy Provides New Insights (Surgical targeting of lateralized 18F-fluorodeoxyglucose positron emission tomography hypometabolism relates to long-term epilepsy surgery outcomes). Health & Medicine Week. September 19, 2025; p 797.