Opracowanie szablonu PET dostosowanego do wieku dziecka na podstawie regularności rozwoju mózgu: poprawa dokładności lokalizacji ogniska padaczki w lekoopornej epilepsji u dzieci

This study aims to systematically analyse developmental regularities of brain glucose metabolism in children covering the whole paediatric age range and establish age-specific paediatric 2-[F]fluoro-2-deoxy-D-glucose PET brain templates, thereby improving the accuracy of neuroimaging lesion localization in paediatric populations. A retrospective study was conducted, including a pseudo-control group and an epilepsy group. The pseudo-control group data were used to analyse the cerebral glucose metabolism and establish age-specific paediatric statistical parametric mapping templates. Semi-quantitative parameters (mean standardized uptake value, maximum standardized uptake value) were calculated for each region, and standardized uptake ratio was compared across different reference regions. Age-related trends of these metabolic parameters were analysed to derive paediatric cerebral metabolic developmental patterns. 2-[F]fluoro-2-deoxy-D-glucose PET images of patients with epilepsy were performed using both the established paediatric template and the standard adult template. Taking surgical resection and electrocorticography results as the gold standard, the accuracy of epileptogenic zone localization by the two templates was compared. The mean standardized uptake value and maximum standardized uptake value in the pseudo-control group showed a significant positive correlation with age, with no significant differences between sex or hemispheres ( > 0.05). In the internal and external validation cohorts, the diagnostic accuracy of the paediatric statistical parametric mapping template for epileptogenic zone localization was 79.0%, which was significantly higher than 72.5% of the adult template ( = 0.033). Stratified analysis showed that the paediatric template had consistent advantages across sex and superior performance in epileptogenic zone localization of frontal and temporal lobes. The advantage of the paediatric template was consistent in both internal and external validation cohorts. The age-specific paediatric statistical parametric mapping template has superior overall diagnostic efficacy in epileptogenic zone localization of paediatric drug-resistant epilepsy, with stable advantages across sex and unique value in specific brain regions. It can overcome the limitations of adult templates in adapting to paediatric brain development characteristics, providing a more accurate and reliable tool for preoperative epileptogenic zone localization in paediatric drug-resistant epilepsy.