Anisotropic diffusion filtering of PET attenuation data to improve emission images

Attenuation correction in positron emission tomography (PET) is an essential part of clinical and research studies. However, correction using noisy transmission data acquired over short scan durations has been a problem as the noise is introduced into emission images. This study investigates the effect of smoothing the two-dimensional projections of the attenuation maps (mu-map) using the nonlinear anisotropic diffusion filtering method. Experiments are presented on a whole-body study to qualitatively evaluate the efficacy of the method in reducing the random noise and streak artefacts. The results show that image quality is significantly improved with minimal resolution loss. A reduction in statistical noise was quantitatively demonstrated when the same approach was applied to a cylindrical phantom dataset.     

Magnetic resonance imaging-guided attenuation and scatter corrections in three-dimensional brain positron emission tomography

Reliable attenuation correction represents an essential component of the long chain of modules required for the reconstruction of artifact-free, quantitative brain positron emission tomography (PET) images. In this work we demonstrate the proof of principle of segmented magnetic resonance imaging (MRI)-guided attenuation and scatter corrections in three-dimensional (3D) brain PET. We have developed a method for attenuation correction based on registered T1-weighted MRI, eliminating the need of an additional transmission (TX) scan. The MR images were realigned to preliminary reconstructions of PET data using an automatic algorithm and then segmented by means of a fuzzy clustering technique which identifies tissues of significantly different density and composition. The voxels belonging to different regions were classified into air, skull, brain tissue and nasal sinuses. These voxels were then assigned theoretical tissue-dependent attenuation coefficients as reported in the ICRU 44 report followed by Gaussian smoothing and addition of a good statistics bed image. The MRI-derived attenuation map was then forward projected to generate attenuation correction factors (ACFs) to be used for correcting the emission (EM) data. The method was evaluated and validated on 10 patient data where TX and MRI brain images were available. Qualitative and quantitative assessment of differences between TX-guided and segmented MRI-guided 3D reconstructions were performed by visual assessment and by estimating parameters of clinical interest. The results indicated a small but noticeable improvement in image quality as a consequence of the reduction of noise propagation from TX into EM data. Considering the difficulties associated with preinjection TX-based attenuation correction and the limitations of current calculated attenuation correction, MRI-based attenuation correction in 3D brain PET would likely be the method of choice for the foreseeable future as a second best approach in a busy nuclear medicine center and could be applied to other functional brain imaging modalities such as SPECT.     

Application of discrete data consistency conditions for selecting regularization parameters in PET attenuation map reconstruction

Simultaneous emission and transmission measurement is appealing in PET due to the matching of geometrical conditions between emission and transmission and reduced acquisition time for the study. A potential problem remains: when transmission statistics are low, attenuation correction could be very noisy. Although noise in the attenuation map can be controlled through regularization during statistical reconstruction, the selection of regularization parameters is usually empirical. In this paper, we investigate the use of discrete data consistency conditions (DDCC) to optimally select one or two regularization parameters. The advantages of the method are that the reconstructed attenuation map is consistent with the emission data and that it accounts for particularity in the emission reconstruction algorithm and acquisition geometry. The methodology is validated using a computer-generated whole-body phantom for both emission and transmission, neglecting random events and scattered radiation. MAP-TR was used for attenuation map reconstruction, while 3D OS-EM is used for estimating the emission image. The estimation of regularization parameters depends on the resolution of the emission image controlled by the number of iterations in OS-EM. The computer simulation shows that, on one hand, DDCC regularized attenuation map reduces propagation of the transmission scan noise to the emission image, while on the other hand DDCC prevents excessive attenuation map smoothing that could result in resolution mismatch artefacts between emission and transmission.     

Attenuation correction for three-dimensional PET using uncollimated flood-source transmission measurements

An attenuation-correction method for three-dimensional PET imaging, which obtains attenuation-correction factors from transmission measurements using an uncollimated flood source, is described. This correction is demonstrated for two different phantoms using transmission data acquired with QPET, a rotating imaging system with two planar detectors developed for imaging small volumes. The scatter amplitude in the transmission projections was a maximum of 30%; to obtain accurate attenuation-correction factors the scatter distribution was first calculated and subtracted. The attenuation-corrected emission images for both phantoms indicate that their original uniform amplitudes have been restored. The attenuation correction adds only a small amount of noise to the emission images, as evaluated from the standard deviation over a central region. For the first phantom, with maximum attenuation of 48%, the noise added was 2.6%. The second phantom was attenuated by a maximum of 37%, and 1.9% noise was added. Because the transmission data are smoothed, some artifacts are visible at the edges of the phantom where the correction factors change abruptly within the emission image.     

Attenuation correction for small animal PET tomographs

Attenuation correction is one of the important corrections required for quantitative positron emission tomography (PET). This work will compare the quantitative accuracy of attenuation correction using a simple global scale factor with traditional transmission-based methods acquired either with a small animal PET or a small animal x-ray computed tomography (CT) scanner. Two phantoms (one mouse-sized and one rat-sized) and two animal subjects (one mouse and one rat) were scanned in CTI Concorde Microsystem's microPET Focus for emission and transmission data and in ImTek's MicroCAT II for transmission data. PET emission image values were calibrated against a scintillation well counter. Results indicate that the scale factor method of attenuation correction places the average measured activity concentration about the expected value, without correcting for the cupping artefact from attenuation. Noise analysis in the phantom studies with the PET-based method shows that noise in the transmission data increases the noise in the corrected emission data. The CT-based method was accurate and delivered low-noise images suitable for both PET data correction and PET tracer localization.     

Accuracy of CT-based attenuation correction in PET/CT bone imaging

We evaluate the accuracy of scaling CT images for attenuation correction of PET data measured for bone. While the standard tri-linear approach has been well tested for soft tissues, the impact of CT-based attenuation correction on the accuracy of tracer uptake in bone has not been reported in detail. We measured the accuracy of attenuation coefficients of bovine femur segments and patient data using a tri-linear method applied to CT images obtained at different kVp settings. Attenuation values at 511 keV obtained with a (68)Ga/(68)Ge transmission scan were used as a reference standard. The impact of inaccurate attenuation images on PET standardized uptake values (SUVs) was then evaluated using simulated emission images and emission images from five patients with elevated levels of FDG uptake in bone at disease sites. The CT-based linear attenuation images of the bovine femur segments underestimated the true values by 2.9 ± 0.3% for cancellous bone regardless of kVp. For compact bone the underestimation ranged from 1.3% at 140 kVp to 14.1% at 80 kVp. In the patient scans at 140 kVp the underestimation was approximately 2% averaged over all bony regions. The sensitivity analysis indicated that errors in PET SUVs in bone are approximately proportional to errors in the estimated attenuation coefficients for the same regions. The variability in SUV bias also increased approximately linearly with the error in linear attenuation coefficients. These results suggest that bias in bone uptake SUVs of PET tracers ranges from 2.4% to 5.9% when using CT scans at 140 and 120 kVp for attenuation correction. Lower kVp scans have the potential for considerably more error in dense bone. This bias is present in any PET tracer with bone uptake but may be clinically insignificant for many imaging tasks. However, errors from CT-based attenuation correction methods should be carefully evaluated if quantitation of tracer uptake in bone is important.     

Simultaneous iterative reconstruction for emission and attenuation images in positron emission tomography

The quality of the attenuation correction strongly influences the outcome of the reconstructed emission scan in positron emission tomography. Usually the attenuation correction factors are calculated from the transmission and blank scan and thereafter applied during the reconstruction on the emission data. However, this is not an optimal treatment of the available data, because the emission data themselves contain additional information about attenuation: The optimal treatment must use this information for the determination of the attenuation correction factors. Therefore, our purpose is to investigate a simultaneous emission and attenuation image reconstruction using a maximum likelihood estimator, which takes the attenuation information in the emission data into account. The total maximum likelihood function for emission and transmission is used to derive a one-dimensional Newton-like algorithm for the calculation of the emission and attenuation image. Log-likelihood convergence, mean differences, and the mean of squared differences for the emission image and the attenuation correction factors of a mathematical thorax phantom were determined and compared. As a result we obtain images improved with respect to log likelihood in all cases and with respect to our figures of merit in most cases. We conclude that the simultaneous reconstruction can improve the performance of image reconstruction.     

Iterative reconstruction for attenuation correction in positron emission tomography: maximum likelihood for transmission and blank scan.

The quality of the attenuation correction strongly influences the outcome of the reconstructed emission scan in positron emission tomography. The calculation of the attenuation correction factors must take into account the Poisson nature of the radioactive decay process, because-for a reasonable scan duration-the transmission measurements contain lines of response with low count numbers in the case of large attenuation factors. Our purpose in this study is to investigate a maximum likelihood estimator for attenuation correction factor calculation in positron emission tomography, which incorporates the Poisson nature of the radioactive decay into transmission and blank measurement. Therefore, the correct maximum likelihood function is used to derive two estimators for the calculation of the attenuation coefficient image and the corresponding attenuation correction factors depending on the measured blank and transmission data. Log likelihood convergence, mean differences, and the mean of squared differences for the attenuation correction factors of a mathematical thorax phantom were determined and compared. The algorithms yield adequate attenuation correction factors, however, the algorithm taking the noise in the blank scan into account can perform better for noisy blank scans. We conclude that maximum likelihood-including blank likelihood-is advantageous to reconstruct attenuation correction factors for low statistic blank and good statistic transmission data. For normal blank and transmission statistics the implementation of the statistical nature of the blank is not mandatory.     

Accurate attenuation correction for a 3D PET system

An accurate attenuation correction has been developed for a small-volume three-dimensional positron emission tomography (PET) system. Transmission data were measured as twenty-four 2D slices which were reconstructed and combined to form a 3D attenuation image. Emission data were reconstructed using a backproject-then-filter technique, and each event was corrected for attenuation at backprojection time by a reprojection through the attenuation image. This correction restores the spatial invariance of the point response function, thus allowing a valid deconvolution and producing an undistorted emission image. Scattering corrections were not applied to either the transmission or the emission data but simulation studies indicated that scattering made only a small contribution to the attenuation measurement. Results are presented for two phantoms, in which transmission scans of 57,500 and 18,700 events/slice were used to correct emission images of 5.2 and 2.8 million events. Although the attenuation images had poor statistical accuracy and a resolution of 13 mm, the method resulted in accurate attenuation-corrected images with no degradation in image resolution (which was 3 mm for the first emission image), and with little effect on image noise.     

Accelerated EM reconstruction in total-body PET: potential for improving tumour detectability

Total-body positron emission tomography (PET) is a useful diagnostic tool for evaluating malignant disease. However, tumour detection is limited by image artefacts due to the lack of attenuation correction and noise. Attenuation correction may be possible using transmission data acquired after or simultaneously with emission data. Despite the elimination of attenuation artefacts, however, tumour detection is still hampered by noise, which is amplified during image reconstruction by filtered backprojection (FBP). We have investigated, as an alternative to FBP, an accelerated expectation maximization (EM) algorithm for its potential to improve tumour detectability in total-body PET. Signal to noise ratio (SNR), calculated for a tumour with respect to the surrounding background, is used as a figure of merit. A software tumour phantom, with conditions typical of those encountered in a total-body PET study using simultaneous acquisition, is used to optimize and compare various reconstruction approaches. Accelerated EM reconstruction followed by two-dimensional filtering is shown to yield significantly higher SNR than FBP for a range of tumour sizes, concentrations and counting statistics (deltaSNR = 6.3 +/- 3.9, p < 0.001). The methods developed are illustrated by examples derived from physical phantom and patient data.     

Effect of motion on tracer activity determination in CT attenuation corrected PET images: a lung phantom study

Respiratory motion is known to affect the quantitation of 18FDG uptake in lung lesions. The aim of the study was to investigate the magnitude of errors in tracer activity determination due to motion, and its dependence upon CT attenuation at different phases of the motion cycle. To estimate these errors we have compared maximum activity concentrations determined from PET/CT images of a lung phantom at rest and under simulated respiratory motion. The NEMA 2001 IEC body phantom, containing six hollow spheres with diameters 37, 28, 22, 17, 13, and 10 mm, was used in this study. To mimic lung tissue density, the phantom (excluding spheres) was filled with low density polystyrene beads and water. The phantom spheres were filled with 18FDG solution setting the target-to-background activity concentration ratio at 8:1. PET/CT data were acquired with the phantom at rest, and while it was undergoing periodic motion along the longitudinal axis of the scanner with a range of displacement being 2 cm, and a period of 5 s. The phantom at rest and in motion was scanned using manufacturer provided standard helical/clinical protocol, a helical CT scan followed by a PET emission scan. The moving phantom was also scanned using a 4D-CT protocol that provides volume image sets at different phases of the motion cycle. To estimate the effect of motion on quantitation of activities in six spheres, we have examined the activity concentration data for (a) the stationary phantom, (b) the phantom undergoing simulated respiratory motion, and (c) a moving phantom acquired with PET/4D-CT protocol in which attenuation correction was performed with CT images acquired at different phases of motion cycle. The data for the phantom at rest and in motion acquired with the standard helical/clinical protocol showed that the activity concentration in the spheres can be underestimated by as much as 75%, depending on the sphere diameter. We have also demonstrated that fluctuations in sphere's activity concentration from one PET/CT scan to another acquired with standard helical/clinical protocol can arise as a consequence of spatial mismatch between the sphere's location in PET emission and the CT data.     

Why is TOF PET reconstruction a more robust method in the presence of inconsistent data?

In order to obtain an accurate and quantitative positron emission tomography (PET) image, emission data need to be corrected for random coincidences, photon attenuation and Compton scattering of photons in the tissue, and detector efficiency response or normalization. The accuracy of these corrections strongly affects the quality of the PET image. There is evidence that time-of-flight (TOF) PET reconstruction is less sensitive than non-TOF reconstruction to inconsistencies between emission data and corrections. The purpose of this study is to analyze and discuss such experimental evidence. In this work, inconsistent correction data (inconsistent normalization, absence of scatter correction and mismatched attenuation correction) are introduced in experimental phantom data. Both TOF and non-TOF reconstructed images are analyzed to examine the effect of flawed data. The behavior of TOF reconstruction in respiratory artifacts, a very common example of inconsistency in the data, is studied in patient images. TOF reconstruction is less sensitive to mismatched attenuation correction, erroneous normalization and poorly estimated scatter correction. Such robustness depends strongly on the time resolution of the TOF PET scanner. In particular, the robustness of TOF in the presence of attenuation correction inconsistencies is discussed, using a simulation of a simple model of respiratory artifacts. We expect new generations of PET scanners, with improved time resolution, to be less and less sensitive to poor quality normalization, scatter and attenuation corrections. This not only reduces artifacts in the PET image, but also opens the way to less stringent requirements for the quality of the CT image (reducing either the equipment cost or the dose to the patient), and for the normalization protocols (simplifying or shortening the normalization procedures). Moreover, TOF reconstruction can be beneficial in multimodalities such as PET/MR, where a direct attenuation measurement is not available and attenuation correction can only be approximated.     

Single and dual energy attenuation correction in PET/CT in the presence of iodine based contrast agents

In present positron emission tomography (PET)/computed tomography (CT) scanners, PET attenuation correction is performed by relying on the information given by a single CT scan. The scaling of the linear attenuation coefficients from CT x-ray energy to PET 511 keV gamma energy is prone to errors especially in the presence of CT contrast agents. Attenuation correction based upon two CT scans at different energies but performed at the same time and patient position should reduce such errors and therefore improve the accuracy of the reconstructed PET images at the cost of introduced additional noise. Such CT scans could be provided by future PET/CT scanners that have either dual source CT or energy sensitive CT. Three different dual energy scaling methods for attenuation correction are introduced and assessed by measurements with a modified NEMA 1994 phantom with different CT contrast agent concentrations. The scaling is achieved by differentiating between (1) Compton and photoelectric effect, (2) atomic number and density, or (3) water-bone and water-iodine scaling schemes. The scaling method (3) is called hybrid dual energy computed tomography attenuation correction (hybrid DECTAC). All three dual energy scaling methods lead to a reduction of contrast agent artifacts with respect to single energy scaling. The hybrid DECTAC method resulted in PET images with the weakest artifacts. Both, the hybrid DECTAC and Compton/photoelectric effect scaling resulted also in images with the lowest PET background variability. Atomic number/density scaling and Compton/photoelectric effect scaling had problems to correctly scale water, hybrid DECTAC scaling and single energy scaling to correctly scale Teflon. Atomic number/density scaling and hybrid DECTAC could be generalized to reduce these problems.     

Event-based motion correction for PET transmission measurements with a rotating point source

Accurate attenuation correction is important for quantitative positron emission tomography (PET) studies. When performing transmission measurements using an external rotating radioactive source, object motion during the transmission scan can distort the attenuation correction factors computed as the ratio of the blank to transmission counts, and cause errors and artefacts in reconstructed PET images. In this paper we report a compensation method for rigid body motion during PET transmission measurements, in which list mode transmission data are motion corrected event-by-event, based on known motion, to ensure that all events which traverse the same path through the object are recorded on a common line of response (LOR). As a result, the motion-corrected transmission LOR may record a combination of events originally detected on different LORs. To ensure that the corresponding blank LOR records events from the same combination of contributing LORs, the list mode blank data are spatially transformed event-by-event based on the same motion information. The number of counts recorded on the resulting blank LOR is then equivalent to the number of counts that would have been recorded on the corresponding motion-corrected transmission LOR in the absence of any attenuating object. The proposed method has been verified in phantom studies with both stepwise movements and continuous motion. We found that attenuation maps derived from motion-corrected transmission and blank data agree well with those of the stationary phantom and are significantly better than uncorrected attenuation data.     

Phased attenuation correction in respiration correlated computed tomography/positron emitted tomography

The motion of lung tumors with respiration causes difficulties in the imaging with computed tomography (CT) and positronemitted tomography (PET). Since an accurate knowledge of the position of the tumor and the surrounding tissues is needed for radiation treatment planning, it is important to improve CT/PET image acquisition. The purpose of this study was to evaluate the potential to improve image acquisition using phased attenuation correction in respiration correlated CT/PET, where data of both modalities were binned retrospectively. Respiration correlated scans were made on a Siemens Biograph Sensation 16 CT/PET scanner which was modified to make a low pitch CT scan and list mode PET scan possible. A lollipop phantom was used in the experiments. The sphere with a diameter of 3.1 cm was filled with approximately 20 MBq 18F-FDG. Three longitudinal movement amplitudes were tested: 2.5, 3.9, and 4.8 cm. After collection of the raw CT data, list mode PET data, and the respiratory signal CT/PET images were binned to ten phases with the help of in-house-built software. Each PET phase was corrected for attenuation with CT data of the corresponding phase. For comparison, the attenuation correction was also performed with nonrespiration correlated (non-RC) CT data. The volume and the amplitude of the movement were calculated for every phaseof both the CT and PET data (with phased attenuation correction). Maximum and average activity concentrations were compared between the phased and nonphased attenuation corrected PET. With a standard non-RC CT/PET scan, the volume was underestimated by as much as 46% in CT and the PET volume was overestimated to 370%. The volumes found with RC-CT/PET scanning had average deviations of 1.9% (+/- 4.8%) and 1.5% (+/- 3.4%) from the actual volume, for the CT and PET volumes, respectively. Evaluation of the maximum activity concentration showed a clear displacement in the images with non-RC attenuation correction, and activity values were on average14% (+/- 12%) lower than with phased attenuation correction. The standard deviation of the maximum activity values found in the different phases was a factor of 10 smaller when phased attenuation correction was applied. In this phantom study, we have shown that a combination of respiration correlated CT/PET scanning with application of phased attenuation correction can improve the imaging of moving objects and can lead to improved volume estimation and a more precise localization and quantification of the activity.     

Evaluation of transmission methodology and attenuation correction for the microPET Focus 220 animal scanner

An accurate, low noise estimate of photon attenuation in the subject is required for quantitative microPET studies of molecular tracer distributions in vivo. In this work, several transmission-based measurement techniques were compared, including coincidence mode with and without rod windowing, singles mode with two different energy sources ((68)Ge and (57)Co), and postinjection transmission scanning. In addition, the effectiveness of transmission segmentation and the propagation of transmission bias and noise into the emission images were examined. The (57)Co singles measurements provided the most accurate attenuation coefficients and superior signal-to-noise ratio, while (68)Ge singles measurements were degraded due to scattering from the object. Scatter correction of (68)Ge transmission data improved the accuracy for a 10 cm phantom but over-corrected for a mouse phantom. (57)Co scanning also resulted in low bias and noise in postinjection transmission scans for emission activities up to 20 MBq. Segmentation worked most reliably for transmission data acquired with (57)Co but the minor improvement in accuracy of attenuation coefficients and signal-to-noise may not justify its use, particularly for small subjects. We conclude that (57)Co singles transmission scanning is the most suitable method for measured attenuation correction on the microPET Focus 220 animal scanner.     

Attenuation correction of four dimensional (4D) PET using phase-correlated 4D-computed tomography

The image quality in a conventional positron emission tomography (PET)/computed tomography (CT) scanner is degraded by respiratory motion because of erroneous attenuation correction when three-dimensional image acquisition is used. To overcome this problem, time-resolved data acquisition (4D) is required. For this, a Siemens Biograph 16 PET/CT scanner has been modified and its normal capability has been extended to a true 4D-PET/4D-CT imaging device including phase-correlated attenuation correction. To verify the correct functionality of this device, experiments on a respiratory motion phantom that allowed movement in two dimensions have been performed. The measurements showed good spatial correlation as well as good time synchronization between the PET and CT data. Furthermore, the motion pattern of the phantom and the shape of the activity distribution have been examined, and the volume of the reconstructed PET images has been analyzed. The results demonstrate the feasibility of such a procedure, and we therefore recommend that 4D-PET data should be reconstructed using 4D-CT data, which can be acquired on the same machine.     

A dual modality approach to quantitative quality control in emission tomography

Routine quality control (QC) and optimization of image quality of reconstructed images in single photon emission computed tomography (SPECT) and positron emission tomography (PET) remains a relatively qualitative exercise. With the advent of combined SPECT/CT and PET/CT devices, and accurate post hoc co-registration algorithms, the potential exists to utilize high resolution structural information for QC evaluation in addition to their use for anatomical correlation in clinical studies. The aim of this work was to explore, in principle, the uses of x-ray CT data of QC phantoms used in SPECT and PET to develop more objective assessments of performance of the emission tomographic (ET) devices and reconstructed data. A CT reconstruction of a novel ET QC phantom was segmented into the various compartments it contained. Using software, the voxel values in the different compartments were then altered to correspond to the concentration of the radioactivity in the actual scan of the same phantom on the SPECT system. This produces a high resolution version of a 'perfect' ET scan. Image co-registration techniques were then used to spatially align the synthetic high resolution SPECT scan to the measured SPECT scan. Various parameters can then be objectively derived from the registered data, for example, image contrast, spatial resolution, spatial non-uniformity, etc. In this study, we have used this approach to estimate spatial resolution (full width at half maximum, FWHM) and recovered contrast in reconstructed images of a SPECT phantom. Two independent methods were used to measure spatial resolution, obtaining excellent agreement. In conclusion, the ability to produce high resolution synthetic phantoms in emission tomography QC affords an objective approach to assessing system performance and optimizing protocols which is readily automated and quantifiable.     

Normalisation and reconstruction of PET data acquired by a multi-ring camera with septa retracted.

Emission scan data acquired by a multi-ring PET camera operated with septa retracted must be corrected for (1) geometrical and detector sensitivity variations between the different lines of response (normalisation), (2) photon attenuation, and (3) mispositioned events due to photon scattering. These corrections must be applied to the full 3-D set of lines of response before reconstruction. The standard normalisation and attenuation correction procedures for 2-D scans increase the statistical noise in the emission scan, a problem which becomes even more serious in 3-D because of the large number of LORs involved (approximately 8 million). This paper will describe a fully 3-D reconstruction algorithm for multi-angle PET data incorporating a practical normalisation and attenuation correction procedure which minimises the increase in emission scan statistical noise. The correction factors are derived from 2-D, septa extended scans. The algorithm is currently used to reconstruct 3-D emission data from an ECAT 953B, a sixteen-ring PET camera with retractable septa.     

Computer-assisted quantification of lung tumors in respiratory gated PET/CT images: phantom study

A computer-aided method was developed to automatically localize tumors in lung PET images of discrete bins within the breathing cycle, followed by an algorithm that registers all the information of a complete respiratory cycle into a single reference bin. Four registration/integration algorithms: Centroid Based, Intensity Based, Rigid Body, and Optical Flow registration were compared as well as two registration schemes: Direct scheme and Successive scheme. Validation was demonstrated by conducting experiments with the computerized 4D NCAT phantom and with a dynamic lung–chest phantom imaged using a GE PET/CT System. Iterations were conducted on different size simulated tumors. Static tumors without respiratory motion were used as gold standard; quantitative results were compared with respect to tumor activity concentration, cross-correlation coefficient, relative noise level, and computation time. After motion correction, the best compromise between short PET scan time and reduced image noise can be achieved, while quantification and clinical analysis become faster and more precise.