Impact of erroneous kinetic model formulation in Direct 4D image reconstruction

Direct parametric image reconstruction has the potential to reduce variance in parameter estimates when applied to PET/CT data. One complication when estimating parametric maps in the body is the difficulty of finding one single model to describe all the different kinetics in the field of view (FOV). Contrary to the post-reconstruction kinetic analysis though, any errors (bias) from the discrepancy between the model and the observed kinetics in the direct 4D reconstruction can potentially propagate spatially from unimportant areas to areas of interest. In this work we investigate this effect on simulated 4-D datasets based on a digital body phantom. Different realistic cases were simulated including differential input functions in the FOV and organs with different kinetics. Micro-parameters (K₁, k₂,Vd, bv) where estimated using a newly proposed spatiotemporal 4D image reconstruction algorithm as well as using post-reconstruction kinetic analysis on noiseless and noisy datasets simulating [¹⁵O] H₂O kinetics in the body. Bias analysis both in noiseless and noisy data showed a bias from badly modelled areas spatially propagates to other regions of interest in the direct reconstruction. Critically though under noisy conditions even with the bias propagation, the direct reconstruction method still outperforms the conventional post-reconstruction methodology. Nevertheless there is a need to ensure that appropriate models are chosen to describe the kinetics in the entire FOV with approaches such as data-driven adaptive kinetic modelling worth exploring.