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A maximum likelihood (ML) estimation method, called the ML-ROI algorithm, is presented for the calculation of region-of-interest (ROI) values from emission tomography scans. The EM algorithm is used to directly estimate ROI values from tomographic projection data given the location, size, and shape of all ROIs. The algorithm requires the specification of a detailed model of the physical factors contributing to projection measurements including resolution and attenuation. The ML-ROI algorithm also provides an estimate of the variability of the ROI estimator (covariance matrix). The algorithm was tested with simulation and phantom data and compared with ROI estimation strategies using filtered back projection (FBP) images. The ML-ROI estimates were unbiased, i.e., the partial volume effect was eliminated. Except for regions smaller than the detector resolution, the variability of the ML estimates was comparable to or less than the biased FBP estimators. Computation time for the ML-ROI algorithm was between 5 and 10 s/iteration. An evaluation of the sensitivity of the algorithm to misdefinition of the location and size of the ROIs was also performed.