An integrated PET/CT simulation framework for virtual imaging trials and quantitative performance evaluation

Area of Science:

• Medical Imaging
• Radiology
• Computational Modeling

Background:

• Quantitative Positron Emission Tomography/Computed Tomography (PET/CT) imaging is crucial for accurate diagnosis and treatment monitoring.
• Variability in PET/CT acquisition protocols can significantly impact quantitative results.
• Developing standardized and validated methods for protocol evaluation is essential.

Purpose of the Study:

• To demonstrate the utility of integrated PET/CT virtual imaging trials (VITs).
• To evaluate PET/CT acquisition protocols and identify sources of quantitative variability under controlled conditions.
• To support multi-modality imaging optimization and quantitative performance assessment.

Main Methods:

• Developed an integrated PET/CT simulation framework combining SimSET (PET) and DukeSim (CT).
• Verified geometric concordance using in-silico coregistration and validated with a NEMA IEC body phantom.
• Assessed impacts of respiratory phase mismatch, CT protocol selection, and dose reduction on PET quantification.

Main Results:

• Achieved geometric concordance with a PET/CT centroid difference of 1.83 mm.
• Simulated PET quantification agreed with clinical scans (SUV within 6% with CT-AC).
• Identified clinically significant differences in PET quantification due to respiratory mismatch and CT protocol selection.

Conclusions:

• The integrated PET/CT simulation framework facilitates reproducible investigations of imaging protocols.
• VITs enable controlled evaluation of multi-modality imaging optimization.
• Supports quantitative performance evaluation under clinically relevant conditions.