The spatial resolution in a reconstructed SPECT image is obviously inf
luenced by the intrinsic resolution of the detector, but it is not gen
erally recognized that the photon-counting efficiency of SPECT systems
is also determined by the intrinsic resolution. In fact, it is often
stated that increased intrinsic detector resolution is of little use s
ince the overall resolution is limited by the collimator rather than t
he detector, and that collimator resolution cannot be increased withou
t an unacceptable sacrifice in efficiency. In this paper we attempt to
demonstrate that improvements in detector resolution can lead to both
improved spatial resolution in the image and improved counting effici
ency compared to conventional systems. This paradoxical conclusion res
ults from optimizing the geometry of a multiple-pinhole coded-aperture
system when detectors of very high resolution are available. Suitable
semiconductor detectors, with sub-millimeter pixels, are currently un
der development in our laboratory and are discussed elsewhere in this
volume. In this paper we report simulation studies that demonstrate th
e image quality that is attainable with such detectors. Reconstruction
s were performed using an iterative search algorithm on a custom-desig
ned parallel computer. The imaging system was described by a calculate
d system matrix relating all voxels in the object space to all pixels
on the detector. We found a resolution close to 2 mm on the reconstruc
ted images obtained from these computer simulations with clinically re
asonable exposure times. This resolution may be even further improved
by optimization of the multiple-pinhole aperture. Thus the novel semic
onductor modular gamma-camera design should provide a large improvemen
t not only in detector resolution but also in reconstructed resolution
.