The study aimed to evaluate the beta penalization factor of the BSREM reconstruction algorithm on a five-ring BGO-based PET CT system and compared it with conventional reconstructions.

Retrospective study involves 30 breast cancer patient data of 18F-fluorodeoxyglucose (18F-FDG) PET CT for reconstruction with OSEM, OSEM + PSF, and BSREM under variable β factors ranging from 200 to 600 in the steps of 50. Liver noise, lesion SUVmax, SBR, and SNR for each reconstruction were calculated. Quantitative parameters of each beta factor of BSREM were compared with OSEM and OSEM + PSF, using the Wilcoxon sign rank test with Bonferroni correction, a value of P < 0.002 was considered statistically significant. Visual scoring by two readers was also evaluated.

Thirty lesions of mean size 1.91 ± 0.58 cm range (0.7–3.6 cm) were identified. Liver noise and SBR were reduced, whereas SNR was increased with an increasing β value of BSREM. In comparison with OSEM, liver noise was not significantly different from β200 and β250. SNR of OSEM was significantly lower than any other β factors and SBR of β factor less than 500 was significantly higher than OSEM. In comparison with OSEM + PSF, liver noise was not significantly different from β400 and β350–500 do not show a significant difference in SNR and SBR compared with OSEM + PSF. β350 scored highest under visual scoring with a moderate agreement.

The study quantitatively indicates the optimum beta range of β250–450 and the qualitative evaluation indicates that β350 is an optimum beta factor of BSREM in breast cancer cases for 18F-FDG WB-PET CT.