This study evaluated the performance of the Biograph Vision digital PET/CT system according to the NEMA NU 2-2012 standard (published by the National Electrical Manufacturers Association [NEMA]) to allow for a reliable, reproducible, and intersystemcomparable performance measurement. Methods: The new digital PET/CT system features silicon photomultiplier-based detectors with 3.2-mm lutetium oxyorthosilicate crystals and full coverage of the scintillator area. The PET components incorporate 8 rings of 38 detector blocks, and each block contains 4 • 2 mini blocks. Each mini block consists of a 5 • 5 lutetium oxyorthosilicate array of 3.2 • 3.2 • 20 mm crystals coupled to a silicon photomultiplier array of 16 • 16 mm, resulting in an axial field of view of 26.1 cm. In this study, PET/CT system performance was evaluated for conformation with the NEMA NU 2-2012 standard, with additional measurements described in the new NEMA NU 2-2018 standard. Spatial resolution, sensitivity, count-rate performance, accuracy of attenuation and scatter correction, image quality, coregistration accuracy, and time-of-flight performance were determined. Measurements were directly compared with results from its predecessor, the Biograph mCT Flow, using existing literature. Moreover, feasibility to comply with the European Association of Nuclear Medicine Research Ltd. (EARL) criteria was evaluated, and some illustrative patient PET images were obtained. Results: The Biograph Vision showed a transverse and axial spatial resolution of 3.6 and 3.5 mm, respectively, in full width at half maximum at a 1-cm offset from the center of the field of view (measured with a 22 Na 0.25-mm point source), a NEMA sensitivity of 16.4 kcps/MBq, and a NEMA peak noise-equivalent count-rate of 306 kcps at 32 kBq/mL. Time-of-flight resolution varied from 210 to 215 as count-rate increased up to the peak noise-equivalent count-rate. The overall image contrast seen with the NEMA image quality phantom ranged from 77.2% to 89.8%. Furthermore, the system was able to comply with the current and future EARL performance criteria. Conclusion: The Biograph Vision outperforms the analog Biograph mCT Flow, and the system is able to meet European harmonizing performance standards.
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