Evaluation of Penalized-Likelihood Estimation Reconstruction on a Digital Time-of-Flight PET/CT Scanner for 18 F-FDG Whole-Body Examinations
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The resolution and quantitative accuracy of PET are highly influenced by the reconstruction method. Penalized-likelihood estimation algorithms allow for fully convergent iterative reconstruction, generating a higher image contrast than ordered-subsets expectation maximization (OSEM) while limiting noise. In this study, a type of penalized reconstruction known as block-sequential regularized expectation maximization (BSREM) was compared with time-of-flight OSEM (TOF OSEM). Various strengths of noise penalization factor β were tested along with various acquisition durations and transaxial fields of view (FOVs) with the aim of evaluating the performance and clinical use of BSREM for 18F-FDG PET/CT, both quantitatively and in a qualitative visual evaluation. Methods: Eleven clinical whole-body 18F-FDG PET/CT examinations acquired on a digital TOF PET/CT scanner were included. The data were reconstructed using BSREM with point-spread function recovery and β-factors of 133, 267, 400, and 533—and using TOF OSEM with point-spread function—for various acquisition times per bed position and various FOVs. Noise level, signal-to-noise ratio (SNR), signal-to-background ratio (SBR), and SUV were analyzed. A masked evaluation of visual image quality, rating several aspects, was performed by 2 nuclear medicine physicians to complement the analysis. Results: The lowest levels of noise were reached with the highest β-factor, resulting in the highest SNR, which in turn resulted in the lowest SBR. A β-factor of 400 gave noise equivalent to TOF OSEM but produced a significant increase in SUVmax (11%), SNR (22%), and SBR (12%). BSREM with a β-factor of 533 at a decreased acquisition duration (2 min/bed position) was comparable to TOF OSEM at a full acquisition duration (3 min/bed position). Reconstructed FOV had an impact on BSREM outcome measures; SNR increased and SBR decreased when FOV was shifted from 70 to 50 cm. The evaluation of visual image quality resulted in similar scores for reconstructions, although a β-factor of 400 obtained the highest mean whereas a β-factor of 267 was ranked best in overall image quality, contrast, sharpness, and tumor detectability. Conclusion: In comparison with TOF OSEM, penalized BSREM reconstruction resulted in an increased tumor SUVmax and an improved SNR and SBR at a matched level of noise. BSREM allowed for a shorter acquisition than TOF OSEM, with equal image quality.
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Several studies on subjective image quality in whole-body [18F]FDG-PET with PL reconstruction found that image quality was highest at beta values of 450 (to 600) despite lower lesion contrast recovery or image sharpness at these beta values compared to lower values.
“Several studies on subjective image quality in whole-body [18F]FDG-PET with PL reconstruction found that image quality was highest at beta values of 450 (to 600) despite lower lesion CR or “image sharpness” at these beta values compared to lower values [41,108,112,175,179].”
From Influences on PET Quantification and Interpretation (2022) · cites this paper as [108]
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Experimental — accuracy not yet measuredUsing a commercially available PL reconstruction (GE Q.Clear), phantom studies have shown that PL reconstruction can increase CR of standardized sphere inserts compared to conventional TOF and PSF reconstruction.
“Using a commercially available PL reconstruction (General Electric [GE] Q.Clear), several phantom studies have shown that PL reconstruction can increase the CR of standardized sphere inserts compared to conventional TOF and PSF reconstruction [41,46,101,107,108].”
From Influences on PET Quantification and Interpretation (2022) · cites this paper as [108]
The Image Reconstruction and NEMA Phantom sections compare Q.Clear/BSREM with TOF OSEM using PSF compensation in a standardized sphere phantom. The phantom results report higher contrast-to-noise ratio (CNR) for BSREM at certain β-factors, but do not report an increase in contrast recovery (CR); those are different measures. No page numbers are available in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredInter-method SUV differences may no longer be significant at beta values of 300 to 600, which have been rated as optimal for visual reading of [18F]FDG-PET images by human readers.
“However, this difference is directly dependent on the user-defined penalization factor beta during PL reconstruction, and at beta values of 300 to 600, which have been rated as optimal for visual reading of [18F]FDG-PET images by human readers [107,112,113], inter-method SUV differences may no longer be significant [41,108,111].”
From Influences on PET Quantification and Interpretation (2022) · cites this paper as [108]
PL reconstruction has the potential to systematically improve SNR compared to OSEM-based algorithms.
“Based on the potential of PL reconstruction to systematically improve SNR compared to OSEM-based algorithms [108,113,168]”
From Influences on PET Quantification and Interpretation (2022) · cites this paper as [108]
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- Authors
- Lindström, E., Sundin, A., Trampal, C., Lindsjö, L., Ilan, E., Danfors, T., Antoni, G., Sörensen, J., & Lubberink, M.
- Affiliations
- Uppsala University (SE)
- Uppsala University Hospital (SE)
- Venue
- Journal of Nuclear Medicine
- Publisher
- Society of Nuclear Medicine
- Published
- 2018-02-15
- Volume
- 59
- Issue
- 7
- Pages
- 1152-1158
- ISSN
- 0161-5505 (ISSN-L)
- 2159-662X
- OpenAlex
- W2789214951
- Cited by
- 99
- References
- 18
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 11 · 2023: 13 · 2022: 14 · 2021: 18 · 2020: 12 · 2019: 10 · 2018: 1
- FWCI
- 7.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Nuclear Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Akademiska Sjukhuset
- Uppsala Universitet
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Keywords
- penalized-likelihood reconstruction, 18F-FDG PET/CT, whole-body PET, signal-to-noise ratio, signal-to-background ratio, standardized uptake value, point spread function, acquisition time, image quality, tumor detectability
- MeSH terms
- Positron Emission Tomography Computed Tomography, Image Processing, Computer-Assisted, Time Factors, Likelihood Functions, Phantoms, Imaging, Fluorodeoxyglucose F18, Whole Body Imaging
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