openSSS: an open-source implementation of scatter estimation for 3D TOF-PET

Background: Scatter correction is essential for quantitative and accurate time-of-flight (TOF) PET imaging. It is implemented by an accurate scatter estimation algorithm, to calculate the statistical distribution of scattered photons among the measured coincidences. However, to our knowledge, scatter estimation algorithms that account for TOF and that are compatible with custom geometries are not available in open-source reconstruction libraries, such as CASToR and STIR. To this end, we have developed an open-source implementation of the TOF-aware single-scatter-simulation (SSS) algorithm: openSSS. Results: openSSS is validated on NEMA phantoms and patient data, for three PET geometries, compared to Monte-Carlo simulations and two proprietary vendor-specific reconstruction platforms. The reconstructed images have similar contrast recovery and background variability, deviating by up to 3.7%-point on contrast recovery and 1.8 on background variability and looking visually similar. Conclusion: We have developed and validated an open-source scatter estimation library to complement reconstruction frameworks. By enabling vendor-independent clinical-grade reconstructions on custom scanner geometries, openSSS represents a crucial step in transparent research on quantitative PET and novel PET scanner designs.