Clinical evaluation of whole-body oncologic PET with time-of-flight and point-spread function for the hybrid PET/MR system

PurposeHybrid positron emission tomography/magnetic resonance (PET/MR) imaging is a new multimodality imaging technology that can provide structural and functional information simultaneously. The aim of this study was to investigate the effects of the time-of-flight (TOF) and point-spread function (PSF) on small lesions observed in PET/MR images from clinical patient image sets.Materials and methodsThis study evaluated 54 small lesions in 14 patients who had undergone ¹⁸F-fluorodeoxyglucose (FDG) PET/MR. Lesions up to 30 mm in diameter were included. The PET data were reconstructed with a baseline ordered-subsets expectation-maximization (OSEM) algorithm, OSEM + PSF, OSEM + TOF and OSEM + TOF + PSF. PET image quality and small lesions were visually evaluated and scored by a 3-point scale. A quantitative analysis was then performed using the mean and maximum standardized uptake value (SUV) of the small lesions (SUV_mean and SUV_max). The lesions were divided into two groups according to the long-axis diameter and the location respectively and evaluated with each reconstruction algorithm. We also evaluated the background signal by analyzing the SUV_liver.ResultsOSEM + TOF + PSF provided the highest value and OSEM + TOF or PSF showed a higher value than OSEM for the visual assessment and quantitative analysis. The combination of TOF and PSF increased the SUV_mean by 26.6% and the SUV_max by 30.0%. The SUV_liverwas not influenced by PSF or TOF. For the OSEM + TOF + PSF model, the change in SUV_mean and SUV_max for lesions <10 mm in diameter was 31.9% and 35.8%, and 24.5% and 27.6% for lesions 10–30 mm in diameter, respectively. The abdominal lesions obtained the higher SUV than those of chest on the images with TOF and/or PSF.ConclusionApplication of TOF and PSF significantly increased the SUV of small lesions in hybrid PET/MR images, potentially improving small lesion detectability.