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Background  The digital cadmium–zinc–telluride (CZT)-based SPECT system has many advantages, including better spatial and energy resolution. However, the impacts of different acquisition and reconstruction parameters on CZT SPECT quantification might still need to be validated. This study aimed to evaluate the impacts of acquisition parameters (the main energy window and acquisition time per frame) and reconstruction parameters (the number of iterations, subsets in iterative reconstruction, post-filter, and image correction methods) on the technetium quantification of CZT SPECT/CT.    Methods  A phantom (PET NEMA/IEC image quality, USA) was filled with four target-to-background (T/B) ratios (32:1, 16:1, 8:1, and 4:1) of technetium. Mean uptake values (the calculated mean concentrations for spheres) were measured to evaluate the recovery coefficient (RC) changes under different acquisition and reconstruction parameters. The corresponding standard deviations of mean uptake values were also measured to evaluate the quantification error. Image quality was evaluated using the National Electrical Manufacturers Association (NEMA) NU 2–2012 standard.    Results  For all T/B ratios, significant correlations were found between iterations and RCs ( r  = 0.62–0.96 for 1–35 iterations,  r  = 0.94–0.99 for 35–90 iterations) as well as between the full width at half maximum (FWHM) of the Gaussian filter and RCs ( r  = − 0.86 to − 1.00, all  P  values < 0.05). The regression coefficients of 1–35 iterations were higher than those of 35–90 iterations (0.51–1.60 vs. 0.02–0.19). RCs calculated with AC (attenuation correction) + SC (scatter correction) + RR (resolution recovery correction) combination were more accurate (53.82–106.70%) than those calculated with other combinations (all  P  values < 0.05). No significant statistical differences (all  P  values > 0.05) were found between the 15% and 20% energy windows except for the 32:1 T/B ratio ( P  value = 0.023) or between the 10 s/frame and 120 s/frame acquisition times except for the 4:1 T/B ratio ( P  value = 0.015) in terms of RCs.    Conclusions  CZT-SPECT/CT of technetium resulted in good quantification accuracy. The favourable acquisition parameters might be a 15% energy window and 40 s/frame of acquisition time. The favourable reconstruction parameters might be 35 iterations, 20 subsets, the AC + SC + RR correction combination, and no filter.    Supplementary Information  The online version contains supplementary material available at 10.1186/s40658-021-00412-4.

ejnmmi physics

Impacts of acquisition and reconstruction parameters on the absolute technetium quantification of the cadmium–zinc–telluride-based SPECT/CT system: a phantom study