Noise and Bias Properties of Monoenergetic Images from DECT used for Attenuation Correction with PET/CT and SPECT/CT.

We evaluate the energy dependent noise and bias properties of monoenergetic images synthesized from dual-energy CT (DECT) acquisitions used to estimate attenuation coefficients at PET or SPECT energies. This is becoming more relevant with the increased used of quantitative imaging by PET/CT and SPECT/CT. There are, however, variations in the noise and bias properties of synthesized monoenergetic images as a function of energy. We used analytic approximations and simulations to estimate the bias and noise of synthesized monoenergetic images of a water-filled cylinder from 10 to 525 keV. The dual-energy spectra were based on the GE Lightspeed VCT scanner at 80 and 140 kVp. Both analytic calculations and simulations for increasing energy the relative noise plateaued near 140 keV (i.e. SPECT with (99m)Tc), and then remained constant with increasing energy up to 511 keV and beyond (i.e. PET). If DECT is being used for attenuation correction at higher energies, there is a noise amplification that is dependent on the energy of the synthesized monoenergetic image of linear attenuation coefficients. For SPECT and PET imaging the bias and noise levels of DECT based attenuation correction is unlikely to affect image quality.