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Two major challenges in time-of-flight positron emission tomography (TOF-PET)are low spatial resolution and high radioactive dose to the patient, both ofwhich result from limitations in detection technology rather than fundamentalphysics. A new type of TOF-PET detector employing low-atomic number (low-Z)scintillation media and large-area, high-resolution photodetectors to recordCompton scattering locations in the detector has been proposed as a promisingalternative, but the minimum technical requirements for such a system have notyet been established. Here we present a simulation study evaluating thepotential of a proposed low-Z detection medium, linear alkylbenzene (LAB) dopedwith a switchable molecular recorder, for next-generation TOF-PET detection. Wedeveloped a custom Monte Carlo simulation of full-body TOF-PET using the TOPASGeant4 software package. By quantifying contributions and tradeoffs for energy,spatial, and timing resolution of the detector, we show that at reasonablecombination of specifications, our likelihood-based identification of pairs offirst interaction locations in the simulated detector identifies 87.1% of pairswith zero or negligible error, and correctly rejects 90% of all in-patientscatters. The same specifications give TOF-PET sensitivity of ~66.7% and PSFwidth 4.6 mm with clear contrast. A detector with these specifications providesa clear image of a brain phantom simulated at less than 1% of a standardradiotracer dose.

Simulation of a Compton-based detector for low-dose high-resolution time-of-flight positron emission tomography