Improved quantitation for PET/CT image reconstruction with system modeling and anatomical priors

Accurate quantitation of positron emission tomography (PET) tracer uptake levels in tumors is important for staging and monitoring response to treatment. Quantitative accuracy in PET is particularly poor for small tumors because of system partial volume errors and smoothing operations. This work proposes a reconstruction algorithm to reduce the quantitative errors due to limited system resolution and due to necessary image noise reduction. We propose a method for finding and using the detection system response in the projection matrix of a statistical reconstruction algorithm. In addition, we use aligned anatomical information, available in PET/CT scanners, to govern the penalty term applied during each image update. These improvements are combined with Fourier rebinning in a clinically feasible algorithm for reconstructing fully three-dimensional PET data. Results from simulation and measured studies show improved quantitation of tumor values in terms of bias and variance across multiple tumor sizes and activity levels with the proposed method. At common clinical image noise levels for the detection task, the proposed method reduces the error in maximum tumor values by 11% compared to filtered back-projection and 5% compared to conventional iterative methods. (c) 2006 American Association of Physicists in Medicine.