Experimental investigation of factors affecting the absolute recovery coefficients in iodine-124 PET lesion imaging.

The use of recovery coefficients (RCs) in (124)I PET lesion imaging is a simple method to correct the imaged activity concentration (AC) primarily for the partial-volume effect and, to a minor extent, for the prompt gamma coincidence effect. The aim of this phantom study was to experimentally investigate a number of various factors affecting the (124)I RCs. Three RC-based correction approaches were considered. These approaches differ with respect to the volume of interest (VOI) drawn, which determines the imaged AC and the RCs: a single voxel VOI containing the maximum value (maximum RC), a spherical VOI with a diameter of the scanner resolution (resolution RC) and a VOI equaling the physical object volume (isovolume RC). Measurements were performed using mainly a stand-alone PET scanner (EXACT HR(+)) and a latest-generation PET/CT scanner (BIOGRAPH mCT). The RCs were determined using a cylindrical phantom containing spheres or rotational ellipsoids and were derived from images acquired with a reference acquisition protocol. For each type of RC, the influence of the following factors on the RC was assessed: object shape, background activity spill in and iterative image reconstruction parameters. To evaluate the robustness of the RC-based correction approaches, the percentage deviation between RC-corrected and true ACs was determined from images acquired with a clinical acquisition protocol of different AC regimes. The observed results of the shape and spill-in effects were compared with simulation data derived from a convolution-based model. The study demonstrated that the shape effect was negligible and, therefore, was in agreement with theoretical expectations. In contradiction to the simulation results, the observed spill-in effect was unexpectedly small. To avoid variations in the determination of RCs due to reconstruction parameter changes, image reconstruction with a pixel length of about one-third or less of the scanner resolution and an OSEM 1 x 32 algorithm or one with somewhat higher number of effective iterations are recommended. Using the clinical acquisition protocol, the phantom study indicated that the resolution- or isovolume-based recovery-correction approaches appeared to be more appropriate to recover the ACs from patient data; however, the application of the three RC-based correction approaches to small lesions containing low ACs was, in particular, associated with large underestimations. The phantom study had several limitations, which were discussed in detail.