Positron emission tomography (PET) and computed tomography (CT) together are a powerful diagnostic tool, but
imperfect image quality allows false positive and false negative diagnoses to be made by any observer despite experience
and training. This work investigates PET acquisition mode, reconstruction method and a standard uptake value (SUV)
correction scheme on the classification of lesions as benign or malignant in PET/CT images, in an anthropomorphic
phantom. The scheme accounts for partial volume effect (PVE) and PET resolution. The observer draws a region of
interest (ROI) around the lesion using the CT dataset. A simulated homogenous PET lesion of the same shape as the
drawn ROI is blurred with the point spread function (PSF) of the PET scanner to estimate the PVE, providing a scaling
factor to produce a corrected SUV. Computer simulations showed that the accuracy of the corrected PET values depends
on variations in the CT-drawn boundary and the position of the lesion with respect to the PET image matrix, especially
for smaller lesions. Correction accuracy was affected slightly by mismatch of the simulation PSF and the actual scanner
PSF. The receiver operating characteristic (ROC) study resulted in several observations. Using observer drawn ROIs,
scaled tumor-background ratios (TBRs) more accurately represented actual TBRs than unscaled TBRs. For the PET
images, 3D OSEM outperformed 2D OSEM, 3D OSEM outperformed 3D FBP, and 2D OSEM outperformed 2D FBP.
The correction scheme significantly increased sensitivity and slightly increased accuracy for all acquisition and
reconstruction modes at the cost of a small decrease in specificity.