Abstract

PurposeTo enhance the image quality of oncology [18F]-FDG PET scans acquired in shorter times and reconstructed by faster algorithms using deep neural networks.MethodsList-mode data from 277 [18F]-FDG PET/CT scans, from six centres using GE Discovery PET/CT scanners, were split into ¾-, ½- and ¼-duration scans. Full-duration datasets were reconstructed using the convergent block sequential regularised expectation maximisation (BSREM) algorithm. Short-duration datasets were reconstructed with the faster OSEM algorithm. The 277 examinations were divided into training (n = 237), validation (n = 15) and testing (n = 25) sets. Three deep learning enhancement (DLE) models were trained to map full and partial-duration OSEM images into their target full-duration BSREM images. In addition to standardised uptake value (SUV) evaluations in lesions, liver and lungs, two experienced radiologists scored the quality of testing set images and BSREM in a blinded clinical reading (175 series).ResultsOSEM reconstructions demonstrated up to 22% difference in lesion SUVmax, for different scan durations, compared to full-duration BSREM. Application of the DLE models reduced this difference significantly for full-, ¾- and ½-duration scans, while simultaneously reducing the noise in the liver. The clinical reading showed that the standard DLE model with full- or ¾-duration scans provided an image quality substantially comparable to full-duration scans with BSREM reconstruction, yet in a shorter reconstruction time.ConclusionDeep learning–based image enhancement models may allow a reduction in scan time (or injected activity) by up to 50%, and can decrease reconstruction time to a third, while maintaining image quality.

Highlights

  • Positron emission tomography (PET) is a quantitative imaging modality that is used to study functional processes using specific radiotracers (e.g. metabolism using ­[18F]-fluorodeoxyglucose (FDG), prostate cancer detection using ­[68 Ga]-PSMA)

  • The results show liver noise in OSEM is increased as scan duration is decreased, while smooth, standard and sharp deep learning enhancement (DLE) show consistently reduced noise

  • We report the results for DLE-standard

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Summary

Introduction

Positron emission tomography (PET) is a quantitative imaging modality that is used to study functional processes using specific radiotracers (e.g. metabolism using ­[18F]-fluorodeoxyglucose (FDG), prostate cancer detection using ­[68 Ga]-PSMA). The quality and quantitative accuracy of PET images are influenced by several factors such as scanner specifications (e.g. sensitivity, spatial resolution, timing resolution), patient demographics, imaging protocol (e.g. radiotracer, injected dose, post-injection delay, scan duration) and image reconstruction technique (e.g. pointspread-function modelling—PSF, convergence criteria, regularisation) [1]. Advances in Bayesian iterative reconstruction techniques have led to improved quality of PET images by ensuring the reconstruction process considers all the statistical and physical processes involved during data acquisition. As a result, these reconstruction methods (e.g. ordered subsets expectation maximisation—OSEM and block sequential regularised expectation maximisation—BSREM [4]) have mostly superseded the analytic techniques in emission tomography—despite their computational burden. GE Healthcare’s commercial implementation of BSREM (Q.Clear) has found widespread clinical use [5]

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