Investigating the Impact of Voxel Size and Postfiltering on Quantitative Analysis of Positron Emission Tomography/Computed Tomography: A Phantom Study

Aim: This study aims to investigate the influence of voxel size and postfiltering on the quantification of standardized uptake value (SUV) in positron emission tomography/computed tomography (PET/CT) images. Materials and Methods: National Electrical Manufacturers Association phantom with the spheres of different sizes were utilized to simulate the lesions. The phantom was scanned using a PET/CT scanner, and the acquired images were reconstructed using two different matrix sizes, (192 x 192) and (256 x 256), and a wide range of postfiltering values. Results: The findings demonstrated that postfiltering significantly affected SUV measurements. The changes in postfiltering values can result in overestimation or underestimation of SUV values, highlighting the importance of carefully selecting appropriate filters. Increasing the matrix size improved SUVmax and SUVmean values, particularly for small-sized spheres. Smaller voxel reconstructions slightly reduced partial volume effects and partially enhanced SUV quantification. Conclusions: Careful consideration of postfiltering values and matrix size selection can lead to better SUV quantification. These findings emphasize the need to optimize the reconstruction parameters to enhance the clinical utility of PET/CT in detecting and evaluating malignant lesions.