Are Quantitative Errors Reduced with Time-of-Flight Reconstruction When Using Imperfect MR-Based Attenuation Maps for 18F-FDG PET/MR Neuroimaging?

We studied whether TOF reduces error propagation from attenuation correction to PET image reconstruction in PET/MR neuroimaging, by using imperfect attenuation maps in a clinical PET/MR system with 525 ps timing resolution. Ten subjects who had undergone F-18-FDG PET neuroimaging were included. Attenuation maps using a single value (0.100 cm(-1)) with and without air, and a 3-class attenuation map with soft tissue (0.096 cm(-1)), air and bone (0.151 cm(-1)) were used. CT-based attenuation correction was used as a reference. Volume-of-interest (VOI) analysis was conducted. Mean bias and standard deviation across the brain was studied. Regional correlations and concordance were evaluated. Statistical testing was conducted. Average bias and standard deviation were slightly reduced in the majority (23-26 out of 35) of the VOI with TOF. Bias was reduced near the cortex, nasal sinuses, and in the mid-brain with TOF. Bland-Altman and regression analysis showed small improvements with TOF. However, the overall effect of TOF to quantitative accuracy was small (3% at maximum) and significant only for two attenuation maps out of three at 525 ps timing resolution. In conclusion, TOF might reduce the quantitative errors due to attenuation correction in PET/MR neuroimaging, but this effect needs to be further investigated on systems with better timing resolution.

Automated summary

This study investigated whether TOF technology reduces error propagation from attenuation correction to PET image reconstruction in PET/MR neuroimaging. The results showed that TOF can slightly reduce average bias and standard deviation in the majority of the brain's volume-of-interest (VOI), but the overall effect on quantitative accuracy is small and significant only in certain attenuation maps with 525 ps timing resolution.