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PET has been used for the presurgical localization of epileptic foci for more than 20 y; still, its clinical role in children with intractable epilepsy remains unclear, largely because of variable analytic approaches and different outcome measures. The purpose of the present study was to evaluate and optimize the performance (lateralization and lobar localization value of epileptic foci) of objective voxel-based analysis of ¹⁸F-FDG PET scans in a pediatric epilepsy population. Twenty children with intractable focal epilepsy (mean age ± SD, 11 ± 4 y; age range, 6–18 y) who underwent interictal ¹⁸F-FDG PET, followed by 2-stage epilepsy surgery with chronic subdural electrocorticographic monitoring, and were seizure-free after surgery were included in this study. PET images were analyzed using both a visual-analysis and a statistical parametric mapping (SPM) method. Lateralization value and performance of …