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Preoperative FDG\u2010PET scans of 37 children with intractable epilepsy (31 with non\u2010localizing MRI) were compared with age\u2010matched pseudo\u2010normal pediatric control PET data. Hypo\u2010\/hypermetabolic maps were transformed to 3D\u2010MRI brain surface to compare the locations of metabolic changes with electrode coordinates of the ECoG\u2010defined seizure onset zone (SOZ) and interictal spiking. While hypometabolic clusters showed a good agreement with the SOZ on the lobar level (sensitivity\/specificity\u2009=\u20090.74\/0.64), detailed surface\u2010distance analysis demonstrated that large portions of ECoG\u2010defined SOZ and interictal spiking area were located at least 3 cm beyond hypometabolic regions with the same statistical threshold (sensitivity\/specificity\u2009=\u20090.18\u20130.25\/0.94\u20130.90 for overlap 3\u2010cm distance); for a lower threshold, sensitivity for SOZ at 3 cm increased to 0.39 with a modest compromise of specificity. Performance of FDG\u2010PET SPM was slightly better in children with smaller as compared with widespread SOZ. The results demonstrate that SPM utilizing age\u2010matched pseudocontrols can reliably detect the lobe of seizure onset. However, the spatial mismatch between metabolic and EEG epileptiform abnormalities indicates that a more complete SOZ detection could be achieved by extending intracranial electrode coverage at least 3 cm beyond the metabolic abnormality. Considering that the extent of feasible electrode coverage is limited, localization information from other modalities is particularly important to optimize grid coverage in cases of large hypometabolic cortex. <jats:italic>Hum Brain Mapp 38:3098\u20133112, 2017<\/jats:italic>. \u00a9 <jats:bold>2017 Wiley Periodicals, Inc.<\/jats:bold><\/jats:p>","DOI":"10.1002\/hbm.23577","type":"journal-article","created":{"date-parts":[[2017,3,21]],"date-time":"2017-03-21T07:56:04Z","timestamp":1490082964000},"page":"3098-3112","source":"Crossref","is-referenced-by-count":20,"title":["Objective 3<scp>D<\/scp> surface evaluation of intracranial electrophysiologic correlates of cerebral glucose metabolic abnormalities in children with focal epilepsy"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4498-0939","authenticated-orcid":false,"given":"Jeong\u2010Won","family":"Jeong","sequence":"first","affiliation":[{"name":"Departments of Pediatrics and Neurology, School of Medicine Wayne State University Detroit Michigan"},{"name":"Translational Imaging Laboratory PET Center, Children's Hospital of Michigan Detroit Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8391-4067","authenticated-orcid":false,"given":"Eishi","family":"Asano","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Neurology, School of Medicine Wayne State University Detroit Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinod","family":"Kumar Pilli","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Neurology, School of Medicine Wayne State University Detroit Michigan"},{"name":"Translational Imaging Laboratory PET Center, Children's Hospital of Michigan Detroit Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuo","family":"Nakai","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Neurology, School of Medicine Wayne State University Detroit Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry T.","family":"Chugani","sequence":"additional","affiliation":[{"name":"Department of Neurology Nemours DuPont Hospital for Children Wilmington Delaware"},{"name":"Thomas Jefferson University School of Medicine Philadelphia Pennysylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csaba","family":"Juh\u00e1sz","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Neurology, School of Medicine Wayne State University Detroit Michigan"},{"name":"Translational Imaging Laboratory PET Center, Children's Hospital of Michigan Detroit 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