Most single-photon emission computed tomography (SPECT) scanners employ a gamma camera with a large scintillator crystal and 50-100 large photomultiplier tubes (PMTs). In the past, we proposed that the weight, size and cost of a scanner could be reduced by replacing the PMTs with large-area silicon photomultiplier (SiPM) pixels in which commercial SiPMs are summed to reduce the number of readout channels. We studied the feasibility of that solution with a small homemade camera, but the question on how it could be implemented in a large camera remained open. In this work, we try to answer this question by performing Geant4 simulations of a full-body SPECT camera. We studied how the pixel size, shape and noise could affect its energy and spatial resolution. Our results suggest that it would be possible to obtain an intrinsic spatial resolution of a few mm FWHM and an energy resolution at 140 keV close to 10%, even if using pixels more than 20 times larger than standard commercial SiPMs of 6 × 6 mm2. We have also found that if SiPMs are distributed following a honeycomb structure, the spatial resolution is significantly better than if using square pixels distributed in a square grid.
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