I'm a PAL user in the USA. As has been said you need, or rather I have, a 40GB PS3 (or any PS3) bought in the US connected to my 32" Sharp HD TV with a HDMI cable (the key, otherwise you need a PAL convertor box/cable for your NTSC TV, but HDMI solves it). Back in the old days you'd also need a PAL Playstation (or NTSC-J, etc) along with a PAL TV or convertor cable. Now-a-days it is so simple
The game saves are totally different. You need both a PAL and NTSC game save and which one the system uses is determined by which disc you have in the PS3. Game saves for all version can be found on this site.
95% of my racing is with the PAL disc and everything game related works just fine though none of the GTTV works for me. I need to pop in my NTSC disc if i want to watch anything on GTTV, not that I do often.
Also keep in mind;
-When updates come to the game (like Spec II and III) it can take a while to download the update from European servers. When Spec II came out it took me over a week to update during which time I was stuck slumming it on NTSC. Spec III I got lucky and was up at like 2am when the update hit the servers and took about 3 tries to connect and about 10mins to download the update. Keep that in mind that when game updates come you might not be able to get them right away.
-Depending on where you are in the US/CA you need to keep in mind Europe is 6-9 hours ahead of you so you need to plan accordingly to race the fast guys in Europe. I'm lucky as I work a few blocks from home and can run home at 2pm and race for an hour or so with the fast guys. When I'm on at night my time (say 8pm EST) it is 2am in Europe generally and you often have a fragment of players you do during the afternoons. So just because you sit down to race at 8pm EST doesn't mean you'll get the fastest Euro guys.
-I have noticed connecting to races can take a longtime and lag is sometimes an issue, which makes sense given I'm in New York City and playing off of servers in Europe. This might be an issue with the NTSC game now, I've seen threads here complaining it takes forever to connect to races, but I've not raced a NTSC race in months so I have no idea.
-PD seems to be offering more "World Events" which might negate the fact you need a PAL/NTSC disc at some point (which makes sense).
-Technically by doing this you are voiding you terms of service with your PS3, not that importing a PAl or NTSC-J system back in the day wasn't doing the same thing.
lastly...
-The download version DOES work on any PS3. But there are two problems. The first, is small, you can only have one version of the game per account. So if you want to race the same screenname in PAL/NTSC you need to get the discs (the other option is to setup different screennames). The bigger issue is that you physically need your PS3 connected in region to download that version. So if you want to download the PAL version...you need to plan a vacation to Europe for you and your PS3 so you can download the PAL version from the European store (which you can't access in the US, you will only get the NTSC version). We tested this at my company and I know it works. There might be some hack somewhere to mask your US IP address and hit European one to get access to the Euro store...but that is a bit beyond most people's skill level and could get your PSN account yanked (again we tested this at my company, I work for a interactive studio that is worldwide, and when Sony saw one account hitting multiple stores it suspended it and eventually killed it). The old trick of signing up for a PSN account with a Euro address no longer works for any of this.
I hope this helps someone as it was a total PITA for me to figure out along the way.