European Radiology

, Volume 29, Issue 4, pp 2146–2156 | Cite as

Impact of image reconstruction methods on quantitative accuracy and variability of FDG-PET volumetric and textural measures in solid tumors

  • Ali Ketabi
  • Pardis GhafarianEmail author
  • Mohammad Amin Mosleh-Shirazi
  • Seyed Rabi Mahdavi
  • Arman Rahmim
  • Mohammad Reza AyEmail author
Nuclear Medicine



This study aims to assess the impact of different image reconstruction methods on PET/CT quantitative volumetric and textural parameters and the inter-reconstruction variability of these measurements.


A total of 25 oncology patients with 65 lesions (between 2017 and 2018) and a phantom with signal-to-background ratios (SBR) of 2 and 4 were included. All images were retrospectively reconstructed using OSEM, PSF only, TOF only, and TOFPSF with 3-, 5-, and 6.4-mm Gaussian filters. The metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured. The relative percent error (ΔMTV and ΔTLG) with respect to true values, volume recovery coefficients, and Dice similarity coefficient, as well as inter-reconstruction variabilities were quantified and assessed. In clinical scans, textural features (coefficient of variation, skewness, and kurtosis) were determined.


Among reconstruction methods, mean ΔMTV differed by -163.5 ± 14.1% to 6.3 ± 6.2% at SBR2 and -42.7 ± 36.7% to 8.6 ± 3.1 at SBR4. Dice similarity coefficient significantly increased by increasing SBR from 2 to 4, ranging from 25.7 to 83.4% between reconstruction methods. Mean ΔTLG was -12.0 ± 1.7 for diameters > 17 mm and -17.8 ± 7.8 for diameters ≤ 17 mm at SBR4. It was -31.7 ± 4.3 for diameters > 17 mm and -14.2 ± 5.8 for diameters ≤ 17 mm at SBR2. Textural features were prone to variations by reconstruction methods (p < 0.05).


Inter-reconstruction variability was significantly affected by the target size, SBR, and cut-off threshold value. In small tumors, inter-reconstruction variability was noteworthy, and quantitative parameters were strongly affected. TOFPSF reconstruction with small filter size produced greater improvements in performance and accuracy in quantitative PET/CT imaging.

Key Points

• Quantitative volumetric PET evaluation is critical for the analysis of tumors.

• However, volumetric and textural evaluation is prone to important variations according to different image reconstruction settings.

• TOFPSF reconstruction with small filter size improves quantitative analysis.


PET-CT Image reconstruction Tumor burden Radiation oncology 



Coefficient of variation


Computed tomography




Full width at half maximum


General electric


3D-OSEM algorithm referred to as HD






Metabolic tumor volume


National electrical manufacturers association


Ordered subset expectation maximization


Positron emission tomography


Point spread function


Signal-to-background ratios


Standard deviation


Standard deviation of inter-reconstruction variation for each VOI


Standard deviation of voxel intensity distribution for each VOI


Standard uptake value


Maximum standard uptake value


Mean standard uptake value


Total lesion glycolysis


Time of flight


Time of flight and point spread function


Volume of interest


Volume recovery coefficients



This study has received funding by the Tehran University of Medical Sciences, Tehran, Iran, under grant number 28212; and Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Compliance with ethical standards


The scientific guarantor of this publication is Mohammad Reza Ay, PhD, Professor of Medical Physics.

Conflict of interest

The authors declare that they have no conflict of interest.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• Retrospective

• Diagnostic or prognostic study/experimental

• Performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of Medical Physics and Biomedical Engineering, School of MedicineTehran University of Medical SciencesTehranIran
  2. 2.Research Center for Molecular and Cellular ImagingTehran University of Medical SciencesTehranIran
  3. 3.Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD)Shahid Beheshti University of Medical SciencesTehranIran
  4. 4.PET/CT and Cyclotron Center, Masih Daneshvari HospitalShahid Beheshti University of Medical SciencesTehranIran
  5. 5.Ionizing and Nonionizing Radiation Protection Research Center and Department of Radio-OncologyShiraz University of Medical SciencesShirazIran
  6. 6.Department of Medical Physics, Faculty of MedicineIran University of Medical SciencesTehranIran
  7. 7.Department of Radiology and Radiological ScienceJohns Hopkins UniversityBaltimoreUSA
  8. 8.Departments of Radiology and Physics & AstronomyUniversity of British ColumbiaVancouverCanada

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