Assessing small-lesion detectability and acquisition time optimisation in silicon-detector-Based PET: a phantom study

The adoption of silicon photomultiplier (SiPM) detectors over conventional photomultiplier tubes (PMTs) in Positron Emission Tomography (PET) has enhanced overall system performance. In this phantom study, small-lesion detectability was assessed for SiPM-based and PMT-based PET systems for various inhomogeneity sizes, acquisition times and activity contrasts between the inhomogeneity and background.

Six spheres of internal diameters ranging between 4.0 mm and 13.0 mm were integrated into a NEMA/IEC PET Body Phantom and filled with fluorodeoxyglucose, with a sphere activity concentration of 29.2 MBq/L and five sphere-to-background activity concentration ratios between 4 and 20. Scans were performed with an SiPM-based system and a PMT-based PET system for each sphere-to-background activity concentration ratio for acquisition times between 1 and 10 min, and image reconstruction was performed with QClear for both systems. Reconstructed images were evaluated for lesion detectability by a lesion detectability index, contrast-to-noise ratio and lesion detectability Likert scales with validation by comparison with the Rose criterion. A model to estimate the acquisition time for each sphere to be detectable was derived and acquisition time was compared.

The SiPM-based system demonstrated superior lesion detectability, identifying smaller and less active spheres with shorter acquisition times. For a sphere-to-background activity concentration ratio of 10 and a sphere internal diameter of 6.2 mm, the SiPM-based system achieved a contrast-to-noise ratio of 15.8 and a lesion detectability Likert score of 3, compared to 12.0 and 2, respectively, for the PMT-based system. The acquisition time of the SiPM-based system could be reduced by between 1.6% and 89%, depending on sphere size and sphere-to-background activity concentration ratio. The minimum CNR required for a sphere to achieve a detectability Likert score of 0.5 was 6.3, consistent with the Rose criterion.

SiPM-based PET has enhanced lesion detectability, especially for smaller, less active regions and for shorter acquisition times. A five-point Likert scale is an effective measure of lesion detectability. Guidance is also provided for choosing the acquisition time as a function of lesion size and activity uptake, and for changes in image quality testing protocols.