Interictal Dynamic FDG-PET Outperforms Static PET Signal Quality Across Most Brain Regions in Focal Epilepsy

Interictal dynamic FDG-PET (iD-PET) showed superior signal quality vs. static PET in 21/36 brain ROIs at >90% probability and 29/36 at >80%, using a new Bayesian method (BRESQ). Largest gains were in bilateral mesial temporal and lateral occipital regions — key epilepsy surgery…

• Retrospective cohort of adult focal epilepsy patients undergoing pre-surgical evaluation; exact n not reported in source. A novel Bayesian Regional Estimated Signal Quality (BRESQ) framework was developed to objectively compare signal quality by ROI, adjusting for ROI size and neighboring regions.
• iD-PET exceeded static PET at >95% probability in 8/36 ROIs, with the five largest differences in bilateral mesial temporal, bilateral lateral occipital, and left inferior frontal base — regions frequently implicated in refractory epilepsy surgery planning.
• Key limitation: only signal quality (not clinical diagnostic accuracy metrics such as sensitivity/specificity for seizure-onset zone localization or surgical outcomes) was evaluated; external validation of the BRESQ method has not yet been reported.

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