Impact of patient weight on tumor visibility based on human-shaped phantom simulation study in PET imaging system

Energy window technique has been implemented in all positron emission tomography (PET) imaging protocol, with the aim to remove the unwanted low energy photons. Current practices in our institution however are performed by using default energy threshold level regardless of the weight of the patient. Phantom size, which represents the size of the patient's body, is the factor that determined the level of scatter fraction during PET imaging. Thus, the motivation of this study is to determine the optimum energy threshold level for different sizes of human-shaped phantom, to represent underweight, normal, overweight and obese patients. In this study, the scanner was modeled by using Monte Carlo code, version MCNP5. Five different sizes of elliptical-cylinder shaped of human-sized phantoms with diameter ranged from 15 to 30 cm were modeled. The tumor was modeled by a cylindrical line source filled with 1.02 MeV positron emitters at the center of the phantom. Various energy window widths, in the ranged of 10-50% were implemented to the data. In conclusion, the phantom mass volume did influence the scatter fraction within the volume. Bigger phantom caused more scattering events and thus led to coincidence counts lost. We evaluated the impact of phantom sizes on the sensitivity and visibility of the simulated models. Implementation of wider energy window improved the sensitivity of the system and retained the coincidence photons lost. Visibility of the tumor improved as an appropriate energy window implemented for the different sizes of phantom.