Comparison of 2D and 3D qualitative whole body positron emission tomography (PET) without attenuation or scatter correction

The increased sensitivity of 3D PET reduces image noise but can also result in a loss of contrast due to higher scatter fractions. Phantom studies were performed to compare tumor detectability in 2D and 3D qualitative whole body PET without scatter or attenuation correction. Lesion detectability was defined as: detectability=contrast/noise=(⟨lesion⟩-⟨liver⟩)/ σ_liver, where ⟨lesion⟩ and ⟨liver⟩ are the average of lesion and liver regions of interest (ROIs), respectively. Liver, heart, and soft tissue sections of a Data Spectrum torso phantom containing a Teflon spine insert were filled with F-18 to match relative concentrations found in clinical FDG studies. Spherical lesions of 1.2 and 2.2 cm diameter were placed in the liver with a lesion to liver activity concentration ratio of 2:1. Resulting 2D and 3D images were compared for equivalent whole body acquisition times. Circular ROIs, half the diameter of the lesions, were placed on the tumors and the surrounding background. Background ROIs were normalized to account for the spatially variant bias caused by the absence of the scatter and attenuation corrections. Detectability was greater in the 3D images over the range of count densities and lesion sizes studied, although the difference in detectability between 2D and 3D decreases with decreasing lesion size. These results suggest that 3D imaging is preferable to 2D imaging for clinical qualitative whole body scanning without scatter or attenuation correction. Further studies representing a larger range of clinical applications are required