Improvement of Spatial Resolution with Iterative PET Reconstruction using UltraFast TOF

The impact of Time-of-Flight (TOF) on positron emission tomography (PET) spatial resolution is generally considered negligible. In this work, a two-step approach based on simulations of two-dimensional scanner configurations is taken to show that ultra-fast TOF has the potential to overcome the limitation induced by the physical size of detectors on spatial resolution. An estimation of the lower bound on spatial resolution using point sources is provided, followed by a qualitative assessment of the resolution obtained using a Hot Spot phantom. The impact of detector width, TOF resolution and TOF binning on the achieved spatial resolution is also studied. While gain beyond the expected blur due to detector size is demonstrated, the detector size remains one limiting factor albeit less prominent. The dependence on acquisition statistics to reach the full potential of TOF-induced gain in spatial resolution is demonstrated. A simulated brain phantom acquired with a fictive three-dimensional PET scanner was qualitatively analyzed and structures smaller than the typical limit are clearly made visible by reconstructing the images with a ∼13-ps TOF resolution. A potential application of this feature of ultra-fast TOF would be the design of clinical PET scanners achieving spatial resolution beyond the current state-of-the-art.