BackgroundPositron emission tomography (PET) imaging has a wide applicability in oncology, cardiology and neurology. However, a major drawback when imaging very active regions such as the bladder is the spill-in effect, leading to inaccurate quantification and obscured visualisation of nearby lesions. Therefore, this study aims at investigating and correcting for the spill-in effect from high-activity regions to the surroundings as a function of activity in the hot region, lesion size and location, system resolution and application of post-filtering using a recently proposed background correction technique. This study involves analytical simulations for the digital XCAT2 phantom and validation acquiring NEMA phantom and patient data with the GE Signa PET/MR scanner. Reconstructions were done using the ordered subset expectation maximisation (OSEM) algorithm. Dedicated point-spread function (OSEM+PSF) and a recently proposed background correction (OSEM+PSF+BC) were incorporated into the reconstruction for spill-in correction. The standardised uptake values (SUV) were compared for all reconstruction algorithms.ResultsThe simulation study revealed that lesions within 15–20 mm from the hot region were predominantly affected by the spill-in effect, leading to an increased bias and impaired lesion visualisation within the region. For OSEM, lesion SUVmax converged to the true value at low bladder activity, but as activity increased, there was an overestimation as much as 19% for proximal lesions (distance around 15–20 mm from the bladder edge) and 2–4% for distant lesions (distance larger than 20 mm from the bladder edge). As bladder SUV increases, the % SUV change for proximal lesions is about 31% and 6% for SUVmax and SUVmean, respectively, showing that the spill-in effect is more evident for the SUVmax than the SUVmean. Also, the application of post-filtering resulted in up to 65% increment in the spill-in effect around the bladder edges. For proximal lesions, PSF has no major improvement over OSEM because of the spill-in effect, coupled with the blurring effect by post-filtering. Within two voxels around the bladder, the spill-in effect in OSEM is 42% (32%), while for OSEM+PSF, it is 31% (19%), with (and without) post-filtering, respectively. But with OSEM+PSF+BC, the spill-in contribution from the bladder was relatively low (below 5%, either with or without post-filtering). These results were further validated using the NEMA phantom and patient data for which OSEM+PSF+BC showed about 70–80% spill-in reduction around the bladder edges and increased contrast-to-noise ratio up to 36% compared to OSEM and OSEM+PSF reconstructions without post-filtering.ConclusionThe spill-in effect is dependent on the activity in the hot region, lesion size and location, as well as post-filtering; and this is more evident in SUVmax than SUVmean. However, the recently proposed background correction method facilitates stability in quantification and enhances the contrast in lesions with low uptake.Electronic supplementary materialThe onli...

The combination of positron emission tomography (PET) with magnetic resonance (MR) imaging opens the way to more accurate diagnosis and improved patient management. At present, the data acquired by PET and MR scanners are essentially processed separately, and the search for ways to improve accuracy of the tomographic reconstruction via synergy of the two imaging techniques is an active area of research. The aim of the collaborative computational project on PET and MR (CCP-PETMR), supported by the UK engineering and physical sciences research council (EPSRC), is to accelerate research in synergistic PET-MR image reconstruction by providing an open access software platform for efficient implementation and validation of novel reconstruction algorithms.

In this paper, we describe the implementation of support for time-of-flight (TOF) positron emission tomography (PET) for both listmode and sinogram data in the open source software for tomographic image reconstruction (STIR). We provide validation and performance characterization using simulated data from the open source GATE Monte Carlo toolbox, with TOF configurations spanning from 81.2 to 209.6 ps. The coincidence detector resolution was corrected for the timing resolution deterioration due to the contribution of the crystal length. Comparison between the reconstruction of listmode and sinogram data demonstrated good agreement in both TOF and non-TOF cases in terms of relative absolute error. To reduce the reconstruction time, we assessed the truncation of the TOF kernel along lines-of-response (LOR). Rejection of LOR elements beyond four times the TOF standard deviation provides significant acceleration of without compromising the image quality. Further narrowing of the kernel can provide extra time reduction but with the gradual introduction of error in the reconstructed images. As expected, TOF reconstruction performs better than non-TOF in terms of both contrast-recovery-coefficient (CRC) and signal-to-noise ratio (SNR). CRC achieves convergence faster with TOF, at lower noise levels. SNR with TOF was superior for early iterations, but with quick deterioration. Higher timing resolution further improved reconstruction performance, while TOF bin mashing was shown to have only a small impact on reconstructed images.