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 ldquoshell-lessrdquo 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
A

_LROC
. 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.