While the first time-of-flight (TOF)-positron emission tomography (PET) systems were already built in the early 1980s, limited clinical studies were acquired on these scanners. PET was still a research tool, and the available TOF-PET systems were experimental. Due to a combination of low stopping power and limited spatial resolution (caused by limited light output of the scintillators), these systems could not compete with bismuth germanate (BGO)-based PET scanners. Developments on TOF system were limited for about a decade but started again around 2000. The combination of fast photomultipliers, scintillators with high density, modern electronics, and faster computing power for image reconstruction have made it possible to introduce this principle in clinical TOF-PET systems. This paper reviews recent developments in system design, image reconstruction, corrections, and the potential in new applications for TOF-PET. After explaining the basic principles of time-of-flight, the difficulties in detector technology and electronics to obtain a good and stable timing resolution are shortly explained. The available clinical systems and prototypes under development are described in detail. The development of this type of PET scanner also requires modified image reconstruction with accurate modeling and correction methods. The additional dimension introduced by the time difference motivates a shift from sinogram- to listmode-based reconstruction. This reconstruction is however rather slow and therefore rebinning techniques specific for TOF data have been proposed. The main motivation for TOF-PET remains the large potential for image quality improvement and more accurate quantification for a given number of counts. The gain is related to the ratio of object size and spatial extent of the TOF kernel and is therefore particularly relevant for heavy patients, where image quality degrades significantly due to increased attenuation (low counts) and high scatter fractions. The original calculations for the gain were based on analytical methods. Recent publications for iterative reconstruction have shown that it is difficult to quantify TOF gain into one factor. The gain depends on the measured distribution, the location within the object, and the count rate. In a clinical situation, the gain can be used to either increase the standardized uptake value (SUV) or reduce the image acquisition time or administered dose. The localized nature of the TOF kernel makes it possible to utilize local tomography reconstruction or to separate emission from transmission data. The introduction of TOF also improves the joint estimation of transmission and emission images from emission data only. TOF is also interesting for new applications of PET-like isotopes with low branching ratio for positron fraction. The local nature also reduces the need for fine angular sampling, which makes TOF interesting for limited angle situations like breast PET and online dose imaging in proton or hadron therapy. The aim of this review is to introduce the reader i...

The aim of this work is the evaluation of the design for a nonconventional PET scanner, the voxel imaging PET (VIP), based on pixelated room-temperature CdTe detectors yielding a true 3-D impact point with a density of 450 channels/cm(3), for a total 6 336 000 channels in a seamless ring shaped volume. The system is simulated and evaluated following the prescriptions of the NEMA NU 2-2001 and the NEMA NU 4-2008 standards. Results show that the excellent energy resolution of the CdTe detectors (1.6% for 511 keV photons), together with the small voxel pitch (1 × 1 × 2 mm(3)), and the crack-free ring geometry, give the design the potential to overcome the current limitations of PET scanners and to approach the intrinsic image resolution limits set by physics. The VIP is expected to reach a competitive sensitivity and a superior signal purity with respect to values commonly quoted for state-of-the-art scintillating crystal PETs. The system can provide 14 cps/kBq with a scatter fraction of 3.95% and 21 cps/kBq with a scatter fraction of 0.73% according to NEMA NU 2-2001 and NEMA NU 4-2008, respectively. The calculated NEC curve has a peak value of 122 kcps at 5.3 kBq/mL for NEMA NU 2-2001 and 908 kcps at 1.6 MBq/mL for NEMA NU 4-2008. The proposed scanner can achieve an image resolution of ~ 1 mm full-width at half-maximum in all directions. The virtually noise-free data sample leads to direct positive impact on the quality of the reconstructed images. As a consequence, high-quality high-resolution images can be obtained with significantly lower number of events compared to conventional scanners. Overall, simulation results suggest the VIP scanner can be operated either at normal dose for fast scanning and high patient throughput, or at low dose to decrease the patient radioactivity exposure. The design evaluation presented in this work is driving the development and the optimization of a fully operative prototype to prove the feasibility of the VIP concept.

We report on the characterization of 2 mm thick CdTe diode detector with Schottky contacts to be employed in a novel conceptual design of PET scanner. Results at -8 • C with an applied bias voltage of -1000 V/mm show a 1.2% FWHM energy resolution at 511 keV. Coincidence time resolution has been measured by triggering on the preamplifier output signal to improve the timing resolution of the detector. Results at the same bias and temperature conditions show a FWHM of 6 ns with a minimum acceptance energy of 500 keV.These results show that pixelated CdTe Schottky diode is an excellent candidate for the development of next generation nuclear medical imaging devices such as PET, Compton gamma cameras, and especially PET-MRI hybrid systems when used in a magnetic field immune configuration.

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