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An accidental coincidence is defined as the erroneous registration of two photons, originating from separate positron annihilations, as having originated from the same positron annihilation. Previous analyses which did not consider accidental coincidences indicated that for a certain radioactivity distribution a gain in image signal-to-noise ratio of about 5 dB is achieved by the time-of-flight method over the conventional method. Subsequent experiments have validated this prediction in low counting rate situations. For higher, typical counting rates these experiments showed a significantly larger gain of about 9 dB, which was attributed to the way in which the time-of-flight method suppresses the degrading effects of accidental coincidences. We present an analytical model, extended from a previous model, which considers accidental coincidences. Calculations of signal-to-noise ratio, using this model, compare well with the experiments and show that the additional gain is indeed due to the treatment of accidental coincidences. An understanding of the model leads to an intuitive explanation of the gain mechanism and a determination of an effective coincidence-timing window that is achieved by the time-of-flight method.

The physical characteristics and some imaging capabilities of Super PETT I, a positron emission tomograph utilizing time-of-flight (TOF) in its image reconstruction process were assessed experimentally by means of measurements carried out in phantoms and clinical imaging studies. The performance characteristics assessed included sensitivity, spatial resolution, image improvements resulting from time-of-flight information utilization, system dead time, and linearity. The clinical examples included imaging of the brain, the heart, the liver, and a demonstration of Super PETT I's capability of achieving cardiac gating.

The gain achieved in image quality by utilizing, in the image forming process, the time-of-flight information (TOF) of positron annihilation photons between their inception and detection was measured experimentally by means of a positron emission tomograph (PET)-Super PETT I. The measurements were carried out by imaging a 35 cm cylindrical uniform phantom containing different positron activity concentrations. The gain achieved through the incorporation of TOF information, defined as the ratio of variances in images reconstructed with and without TOF information, was found to be approximately 3 at the lowest activity concentration and 5-8 in the activity concentration range typically encountered in clinical studies especially in fast or dynamic studies. This increase in gain with activity was interpreted as resulting from the reduction of random coincidences when TOF information is used. Further image improvement is yielded by incorporating TOF information into the PET attenuation correction provided by the measurement of transmission of annihilation photons in the object imaged.