Direct reconstruction of parametric images for brain PET with event-by-event motion correction: evaluation in two tracers across count levels.

Parametric images for dynamic positron emission tomography (PET) are typically generated by an indirect method, i.e. reconstructing a time series of emission images, then fitting a kinetic model to each voxel time activity curve. Alternatively, 'direct reconstruction', incorporates the kinetic model into the reconstruction algorithm itself, directly producing parametric images from projection data. Direct reconstruction has been shown to achieve parametric images with lower standard error than the indirect method. Here, we present direct reconstruction for brain PET using event-by-event motion correction of list-mode data, applied to two tracers. Event-by-event motion correction was implemented for direct reconstruction in the Parametric Motion-compensation OSEM List-mode Algorithm for Resolution-recovery reconstruction. The direct implementation was tested on simulated and human datasets with tracers [11C]AFM (serotonin transporter) and [11C]UCB-J (synaptic density), which follow the 1-tissue compartment model. Rigid head motion was tracked with the Vicra system. Parametric images of K 1 and distribution volume (V T  =  K 1/k 2) were compared to those generated by the indirect method by regional coefficient of variation (CoV). Performance across count levels was assessed using sub-sampled datasets. For simulated and real datasets at high counts, the two methods estimated K 1 and V T with comparable accuracy. At lower count levels, the direct method was substantially more robust to outliers than the indirect method. Compared to the indirect method, direct reconstruction reduced regional K 1 CoV by 35-48% (simulated dataset), 39-43% ([11C]AFM dataset) and 30-36% ([11C]UCB-J dataset) across count levels (averaged over regions at matched iteration); V T CoV was reduced by 51-58%, 54-60% and 30-46%, respectively. Motion correction played an important role in the dataset with larger motion: correction increased regional V T by 51% on average in the [11C]UCB-J dataset. Direct reconstruction of dynamic brain PET with event-by-event motion correction is achievable and dramatically more robust to noise in V T images than the indirect method.