An autoradiography method revealed intratumoral inhomogeneity in various solid tumors. It is becoming increasingly important to estimate intratumoral inhomogeneity. However, with low spatial resolution and high scatter noise, it is difficult to detect intratumoral inhomogeneity in clinical settings. We developed a new PET system with CdTe semiconductor detectors to provide images with high spatial resolution and low scatter noise. Both phantom images and patients' images were analyzed to evaluate intratumoral inhomogeneity. Methods: This study was performed with a cold spot phantom that had 6-mm-diameter cold sphenoid defects, a dual-cylinder phantom with an adjusted concentration of 1:2, and an ''H''-shaped hot phantom. These were surrounded with water. Phantom images and 18 F-FDG PET images of patients with nasopharyngeal cancer were compared with conventional bismuth germanate PET images. Profile curves for the phantoms were measured as peak-to-valley ratios to define contrast. Intratumoral inhomogeneity and tumor edge sharpness were evaluated on the images of the patients. Results: The contrast obtained with the semiconductor PET scanner (1.53) was 28% higher than that obtained with the conventional scanner (1.20) for the 6-mm-diameter cold sphenoid phantom. The contrast obtained with the semiconductor PET scanner (1.43) was 27% higher than that obtained with the conventional scanner (1.13) for the dual-cylinder phantom. Similarly, the 2-mm cold region between 1-mm hot rods was identified only by the new PET scanner and not by the conventional scanner. The new PET scanner identified intratumoral inhomogeneity in more detail than the conventional scanner in 6 of 10 patients. The tumor edge was sharper on the images obtained with the new PET scanner than on those obtained with the conventional scanner. Conclusion: These phantom and clinical studies suggested that this new PET scanner has the potential for better identification of intratumoral inhomogeneity, probably because of its high spatial resolution and low scatter noise. PET with 18 F-FDG has been widely used in oncology studies. A high-resolution PET camera permits precise evaluation of tumor localization and treatment effects. Recently, CdTe semiconductors were used for the direct conversion of g-rays without scintillator material (1,2). High energy resolution and flexibility in both the sizing and the fine arrangement of detectors are expected to improve image quality. These characteristics of semiconductor detectors may also lead to improved PET images because the high energy resolution offers a reduction in scatter noise, like that seen with g-camera and SPECT applications (1,3).A depth-of-interaction (DOI) detection system has already been used in some PET scanners, particularly in PET scanners dedicated to use for the human brain. This is because DOI information is very useful for reducing the parallax errors at the periphery of the field of view (FOV) (4,5). With both semiconductor detectors and a DOI system, high-quality PET images with low scat...