[Clinical practice guideline for integrated PET/MRI in refractory epilepsy(2026 edition)].

To further standardize the clinical use of integrated PET/MRI brain imaging for refractory epilepsy in China, improve the level of individualized precision diagnosis and treatment, promote standardized management, and provide evidence-based and consensus recommendations for clinicians and imaging professionals, experts in nuclear medicine, radiology, neurology, and related fields developed this guideline through a consensus process informed by the available research evidence and clinical practice. Epilepsy is one of the most common chronic neurological disorders, and accurate preoperative localization of the epileptogenic zone in patients with refractory epilepsy remains a major clinical challenge. Integrated PET/MRI enables simultaneous, one-stop acquisition of multidimensional information, including cerebral metabolism, high-resolution anatomical detail, and functional features, and can be used for epileptogenic focus localization, surgical planning, and assessment of important functional regions, making it an important imaging tool for precision care in refractory epilepsy. As integrated PET/MRI systems become increasingly available in China, broader clinical implementation continues to face challenges, including appropriate patient selection and indications, standardization of scanning workflows, image quality control, consistency in image interpretation, and reporting standards. With a focus on clinical feasibility, this guideline provides recommendations across key domains, including indications, examination and quality-control procedures, image interpretation, and standardized reporting, to promote the standardized use of integrated PET/MRI in the care of refractory epilepsy and advance related clinical translation.