Comparative analysis of iterative reconstruction algorithms with resolution recovery and time of flight modeling for 18 F-FDG cardiac PET: A multi-center phantom study.

Background: The purpose of this study was to evaluate the image quality in cardiac ¹⁸ F-FDG PET using the time of flight (TOF) and/or point spread function (PSF) modeling in the iterative reconstruction (IR).
Methods: Three scanners and an anthropomorphic cardiac phantom with an insert simulating a transmural defect (TD) were used. Two sets of scans (with/without TD) were acquired, and four reconstruction schemes were considered: (1) IR; (2) IR + PSF, (3) IR + TOF, and (4) IR + TOF + PSF. LV wall thickness (FWHM), contrast between LV wall and inner chamber (C _IC ), and TD contrast in LV wall (C _TD ) were evaluated.
Results: Tests of the reconstruction protocols showed a decrease in FWHM from IR (13 mm) to IR + PSF (11 mm); an increase in the C _IC from IR (65%) to IR + PSF (71%) and from IR + TOF (72%) to IR + TOF + PSF (77%); and an increase in the C _TD from IR + PSF (72%) to IR + TOF (75%) and to IR + TOF + PSF (77%). Tests of the scanner/software combinations showed a decrease in FWHM from Gemini_TF (13 mm) to Biograph_mCT (12 mm) and to Discovery_690 (11 mm); an increase in the C _IC from Gemini_TF (65%) to Biograph_mCT (73%) and to Discovery_690 (75%); and an increase in the C _TD from Gemini_TF/Biograph_mCT (72%) to Discovery_690 (77%).
Conclusion: The introduction of TOF and PSF increases image quality in cardiac ¹⁸ F-FDG PET. The scanner/software combinations exhibit different performances, which should be taken into consideration when making cross comparisons.