Deep-JASC: joint attenuation and scatter correction in whole-body 18F-FDG PET using a deep residual network

Abstract

We demonstrate the feasibility of direct generation of attenuation and scatter-corrected images from uncorrected images (PET-nonASC) using deep residual networks in whole-body 18F-FDG PET imaging. Two- and three-dimensional deep residual networks using 2D successive slices (DL-2DS), 3D slices (DL-3DS) and 3D patches (DL-3DP) as input were constructed to perform joint attenuation and scatter correction on uncorrected whole-body images in an end-to-end fashion. We included 1150 clinical whole-body 18F-FDG PET/CT studies, among which 900, 100 and 150 patients were randomly partitioned into training, validation and independent validation sets, respectively. The images generated by the proposed approach were assessed using various evaluation metrics, including the root-mean-squared-error (RMSE) and absolute relative error (ARE %) using CT-based attenuation and scatter-corrected (CTAC) PET images as reference. PET image quantification variability was also assessed through voxel-wise standardized uptake value (SUV) bias calculation in different regions of the body (head, neck, chest, liver-lung, abdomen and pelvis). Our proposed attenuation and scatter correction (Deep-JASC) algorithm provided good image quality, comparable with those produced by CTAC. Across the 150 patients of the independent external validation set, the voxel-wise REs (%) were - 1.72 ± 4.22%, 3.75 ± 6.91% and - 3.08 ± 5.64 for DL-2DS, DL-3DS and DL-3DP, respectively. Overall, the DL-2DS approach led to superior performance compared with the other two 3D approaches. The brain and neck regions had the highest and lowest RMSE values between Deep-JASC and CTAC images, respectively. However, the largest ARE was observed in the chest (15.16 ± 3.96%) and liver/lung (11.18 ± 3.23%) regions for DL-2DS. DL-3DS and DL-3DP performed slightly better in the chest region, leading to AREs of 11.16 ± 3.42% and 11.69 ± 2.71%, respectively (p value < 0.05). The joint histogram analysis resulted in correlation coefficients of 0.985, 0.980 and 0.981 for DL-2DS, DL-3DS and DL-3DP approaches, respectively. This work demonstrated the feasibility of direct attenuation and scatter correction of whole-body 18F-FDG PET images using emission-only data via a deep residual network. The proposed approach achieved accurate attenuation and scatter correction without the need for anatomical images, such as CT and MRI. The technique is applicable in a clinical setting on standalone PET or PET/MRI systems. Nevertheless, Deep-JASC showing promising quantitative accuracy, vulnerability to noise was observed, leading to pseudo hot/cold spots and/or poor organ boundary definition in the resulting PET images.