Abstract

PurposeQ.Clear is a block sequential regularized expectation maximization (BSREM) penalized-likelihood reconstruction algorithm for PET. It tries to improve image quality by controlling noise amplification during image reconstruction. In this study, the noise properties of this BSREM were compared to the ordered-subset expectation maximization (OSEM) algorithm for both phantom and patient data acquired on a state-of-the-art PET/CT.MethodsThe NEMA IQ phantom and a whole-body patient study were acquired on a GE DMI 3-rings system in list mode and different datasets with varying noise levels were generated. Phantom data was evaluated using four different contrast ratios. These were reconstructed using BSREM with different β-factors of 300–3000 and with a clinical setting used for OSEM including point spread function (PSF) and time-of-flight (TOF) information. Contrast recovery (CR), background noise levels (coefficient of variation, COV), and contrast-to-noise ratio (CNR) were used to determine the performance in the phantom data. Findings based on the phantom data were compared with clinical data. For the patient study, the SUV ratio, metabolic active tumor volumes (MATVs), and the signal-to-noise ratio (SNR) were evaluated using the liver as the background region.ResultsBased on the phantom data for the same count statistics, BSREM resulted in higher CR and CNR and lower COV than OSEM. The CR of OSEM matches to the CR of BSREM with β = 750 at high count statistics for 8:1. A similar trend was observed for the ratios 6:1 and 4:1. A dependence on sphere size, counting statistics, and contrast ratio was confirmed by the CNR of the ratio 2:1. BSREM with β = 750 for 2.5 and 1.0 min acquisition has comparable COV to the 10 and 5.0 min acquisitions using OSEM. This resulted in a noise reduction by a factor of 2–4 when using BSREM instead of OSEM. For the patient data, a similar trend was observed, and SNR was reduced by at least a factor of 2 while preserving contrast.ConclusionThe BSREM reconstruction algorithm allowed a noise reduction without a loss of contrast by a factor of 2–4 compared to OSEM reconstructions for all data evaluated. This reduction can be used to lower the injected dose or shorten the acquisition time.

Highlights

  • Fluorodeoxyglucose (FDG) Positron emission tomography (PET)/Computed tomography (CT) scans provide 3D images of metabolic activity combined with the anatomic structure

  • The block sequential regularized expectation maximization (BSREM) reconstruction algorithm allowed a noise reduction without a loss of contrast by a factor of 2–4 compared to ordered subsets expectation maximization (OSEM) reconstructions for all data evaluated

  • There is not a significant difference at high count statistics on the Contrast recovery (CR) behavior between the ratios 8:1, 6:1, and 4:1, the CR of BSREM decreases as the acquisition time reduces

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Summary

Introduction

Fluorodeoxyglucose (FDG) PET/CT scans provide 3D images of metabolic activity combined with the anatomic structure. The most commonly used PET image reconstruction algorithm in clinical practice is a statistical iterative method known as the maximum likelihood expectation maximization (MLEM) [3,4,5]. The algorithm is stopped after 2–4 iterations and 20–30 subsets These images are typically post-smoothed after reconstruction using a low-pass filter to remove noise levels and Gibbs artifacts at edges because of resolution modeling [8,9,10]. The performance and clinical use of BSREM was compared to OSEM with full modeling of PSF and TOF information for both algorithms acquired on the new Discovery MI with 3-rings (axial FOV of 15 cm) Both phantom and patient data were analyzed with regards to CR, background COV, CNR, SUV ratio, metabolic active tumor volumes (MATVs), and SNR.

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