Time-of-Flight Information Improved the Detectability of Subcentimeter Spheres Using a Clinical PET/CT Scanner

Recent advancements in clinical PET/CT scanners have improved the detectability of small lesions. However, the ideal reconstruction parameters for detecting small lesions have not yet been sufficiently clarified. The purpose of this study was to investigate the detectability of subcentimeter spheres using a clinical PET/CT scanner. Methods: We used a clinical PET/CT scanner to obtain the data of a National Electrical Manufacturers Association body phantom consisting of 6 small spheres (inner diameters, 4.0, 5.0, 6.2, 7.9, 10, and 37 mm) containing ¹⁸F solution. The background activity was 2.65 kBq/mL, and the sphere-to-background ratio was 8. The PET data obtained for 2 and 120 min were reconstructed using ordered-subsets expectation maximization (OSEM), OSEM + point-spread function (PSF), and OSEM + time-of-flight (TOF) with voxel sizes of 2.04 × 2.04 × 2.00 mm (2-mm voxels) and 4.07 × 4.07 × 3.99 mm (4-mm voxels). A gaussian filter was not used. The image quality was evaluated by visual assessment, as well as by physical assessment of the detectability index and recovery coefficients. Results: According to the visual assessment, the detectability of the spheres improved using TOF and a longer acquisition. Using the OSEM+TOF model, the smallest visually detected spheres were 5 mm in diameter with a 120-min acquisition and 6 mm in diameter with a 2-min acquisition. According to physical assessment, the detectability of spheres 10 mm or smaller using the OSEM+TOF image was superior to that using the OSEM image. In addition, the detectability of each hot sphere and recovery coefficient with 2-mm voxels was superior to that with 4-mm voxels. Although OSEM+PSF images showed less background noise, detectability and the recovery coefficient were not improved for spheres 8 mm or smaller. Conclusion: The TOF model with 2-mm voxels improved the detectability of subcentimeter hot spheres on a clinical PET/CT scanner.