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We compare the image quality of SPECT reconstruction with and without an anatomical prior. Area under the localization-response operating characteristic (LROC) curve is our figure of merit. Simulated Ga-67 citrate images, a SPECT lymph-nodule imaging agent, were generated using the MCAT digital phantom. Reconstructed images were read by human observers. Several reconstruction strategies are compared, including rescaled block iterative (RBI) and maximum-a-posteriori (MAP) with various priors. We find that MAP reconstruction using prior knowledge of organ and lesion boundaries significantly improves lesion-detection performance (p < 0.05). Pseudo-lesion boundaries, regions without increased uptake which are incorrectly treated as prior knowledge of lesion boundaries, do not decrease performance.