Radiotherapy and nuclear medicine basics: interictal FDG PET in epilepsy: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Radiology · Radiotherapy and nuclear medicine basics: interictal FDG PET in epilepsy

Sample item

A patient with drug-resistant temporal lobe epilepsy has mesial temporal sclerosis on MRI. What is the typical interictal FDG PET finding?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Hypometabolism in the epileptogenic temporal lobe

Between seizures the epileptogenic focus has reduced glucose metabolism, which helps lateralise it before surgery. During a seizure, perfusion and metabolism rise in the focus, as seen on ictal SPECT.

Option by option

  • A. Hypermetabolism in the epileptogenic temporal lobe

    Hypermetabolism is seen during a seizure, not between seizures.

  • B. Diffuse bilateral cortical hypometabolism

    Diffuse bilateral hypometabolism would not lateralise a focus and suggests a generalised process.

  • C. Increased uptake in the basal ganglia

    Increased basal ganglia uptake does not localise a temporal lobe focus.

  • D. Hypometabolism in the epileptogenic temporal lobe (correct)

    Correct. The interictal focus is hypometabolic on FDG PET.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Hypometabolism in the epileptogenic temporal lobe. Between seizures the epileptogenic focus has reduced glucose metabolism, which helps lateralise it before surgery.

Why is "Hypermetabolism in the epileptogenic temporal lobe" not the answer?

Hypermetabolism is seen during a seizure, not between seizures.

Why is "Diffuse bilateral cortical hypometabolism" not the answer?

Diffuse bilateral hypometabolism would not lateralise a focus and suggests a generalised process.

Why is "Increased uptake in the basal ganglia" not the answer?

Increased basal ganglia uptake does not localise a temporal lobe focus.

What concept does this question test?

It tests Radiotherapy and nuclear medicine basics: interictal FDG PET in epilepsy in Radiology. During a seizure, perfusion and metabolism rise in the focus, as seen on ictal SPECT.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Radiotherapy and nuclear medicine basics: interictal FDG PET in epilepsy?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.