An imaging method and corresponding system (10) account for cascade gammas. Event data describing detected gamma rays emitted from a target volume of a subject are received. The detected gamma rays include cascade gammas emitted from a radionuclide within the target volume. Cascade and annihilation gamma emissions from the target volume and coincidence detection of the imaging system (10) are simulated using a Monte Carlo (MC) simulation technique to generate a cascade dataset comprised of annihilation coincidence events and cascade coincidence events. The event data is reconstructed into an image representation of the target volume with correction of cascade coincidence using the relationship between the annihilation coincidence events and the cascade coincidence events in the cascade data set.