Experimental Comparison of Lesion Detectability for Four Fully-3D PET Reconstruction Schemes

The objective of this work was to evaluate the lesion detection performance of four fully-3D positron emission tomography (PET) reconstruction schemes using experimentally acquired data. A multi-compartment anthropomorphic phantom was set up to mimic whole-body 18 F-fluorodeoxyglucose (FDG) cancer imaging and scanned 12 times in 3D mode, obtaining count levels typical of noisy clinical scans. Eight of the scans had 26 68 Ge "shell-less" lesions (6, 8-, 10-, 12-, 16-mm diameter) placed throughout the phantom with various target: background ratios. This provided lesion-present and lesion-absent datasets with known truth appropriate for evaluating lesion detectability by localization receiver operating characteristic (LROC) methods. Four reconstruction schemes were studied: 1) Fourier rebinning (FORE) followed by 2D attenuation-weighted ordered-subsets expectation-maximization, 2) fully-3D AW-OSEM, 3) fully-3D ordinary-Poisson line-of-response (LOR-)OSEM; and 4) fully-3D LOR-OSEM with an accurate point-spread function (PSF) model. Two forms of LROC analysis were performed. First, a channelized nonprewhitened (CNPW) observer was used to optimize processing parameters (number of iterations, post-reconstruction filter) for the human observer study. Human observers then rated each image and selected the most-likely lesion location. The area under the LROC curve (A(LROC)) and the probability of correct localization were used as figures-of-merit. The results of the human observer study found no statistically significant difference between FORE and AW-OSEM3D (A(LROC) = 0.41 and 0.36, respectively), an increase in lesion detection performance for LOR-OSEM3D (A(LROC) = 0.45, p = 0.076), and additional improvement with the use of the PSF model (A(LROC) = 0.55, p = 0.024). The numerical CNPW observer provided the same rankings among algorithms, but obtained different values of ALROC. These results show improved lesion detection performance for the reconstruction algorithms with more sophisticated statistical and imaging models as compared to the previous-generation algorithms.