Impact of time-of-flight PET/CT with a large axial field of view for reducing whole-body acquisition time

The aim of this study was to evaluate the imaging performance of 39- and 52-ring time-of-flight (TOF) PET/CT scanners. We also assessed the potential of reducing the scanning time using a 52-ring TOF PET/CT scanner. Methods: PET/CT scanners with 39- and 52-ring lutetium oxyorthosilicate detectors were evaluated. The axial fields of view were 16.2 and 21.6 cm, respectively. We used a National Electrical Manufacturers Association International Electrotechnical Commission body phantom filled with an ¹⁸F solution containing background activity of 5.31 and 2.65 kBq/mL for the studies. The sphere-to-background ratio was 4:1. The PET data were acquired for 10 min in 3-dimensional list mode and then reconstructed with both ordered-subsets reconstruction maximization and ordered-subsets reconstruction maximization plus point-spread function plus time-of-flight algorithms. PET images with different acquisition times were reconstructed (from 1 to 10 min). The image quality was physically assessed using the sensitivity, noise-equivalent counting rate, coefficient of variation of background activity, and relative recovery coefficient. Results: The total system sensitivities of the 39- and 52-ring scanners were 5.6 and 9.3 kcps/MBq, respectively. Compared with the 39-ring scanner, the noise-equivalent counting rate of the 52-ring scanner was 60% higher for both the high-activity and the low-activity models. The recovery coefficient was consistent, irrespective of the number of detector rings. The coefficient of variation of the 52-ring scanner using a 3-min acquisition time was equivalent to that of the 39-ring scanner using a 4-min acquisition time. Conclusion: The image quality of the 52-ring scanner is superior to that of the 39-ring scanner. The acquisition time per bed position of the 52-ring system can be reduced by about 25% without compromising image quality. In addition, the number of bed positions required is 25% lower for the 52-ring system. Finally, the examination time required for a whole-body PET scan is considered to be reduced by about 40% if the 52-ring scanner is used.