Xueqi Guo

Xueqi Guo, Luyao Shi, Xiongchao Chen et al.

The rapid tracer kinetics of rubidium-82 ($^{82}$Rb) and high variation of cross-frame distribution in dynamic cardiac positron emission tomography (PET) raise significant challenges for inter-frame motion correction, particularly for the early frames where conventional intensity-based image registration techniques are not applicable. Alternatively, a promising approach utilizes generative methods to handle the tracer distribution changes to assist existing registration methods. To improve frame-wise registration and parametric quantification, we propose a Temporally and Anatomically Informed Generative Adversarial Network (TAI-GAN) to transform the early frames into the late reference frame using an all-to-one mapping. Specifically, a feature-wise linear modulation layer encodes channel-wise parameters generated from temporal tracer kinetics information, and rough cardiac segmentations with local shifts serve as the anatomical information. We validated our proposed method on a clinical $^{82}$Rb PET dataset and found that our TAI-GAN can produce converted early frames with high image quality, comparable to the real reference frames. After TAI-GAN conversion, motion estimation accuracy and clinical myocardial blood flow (MBF) quantification were improved compared to using the original frames. Our code is published at https://github.com/gxq1998/TAI-GAN.

Xiongchao Chen, Bo Zhou, Huidong Xie et al.

Single-photon emission computed tomography (SPECT) is a widely applied imaging approach for diagnosis of coronary artery diseases. Attenuation maps (u-maps) derived from computed tomography (CT) are utilized for attenuation correction (AC) to improve diagnostic accuracy of cardiac SPECT. However, SPECT and CT are obtained sequentially in clinical practice, which potentially induces misregistration between the two scans. Convolutional neural networks (CNN) are powerful tools for medical image registration. Previous CNN-based methods for cross-modality registration either directly concatenated two input modalities as an early feature fusion or extracted image features using two separate CNN modules for a late fusion. These methods do not fully extract or fuse the cross-modality information. Besides, deep-learning-based rigid registration of cardiac SPECT and CT-derived u-maps has not been investigated before. In this paper, we propose a Dual-Branch Squeeze-Fusion-Excitation (DuSFE) module for the registration of cardiac SPECT and CT-derived u-maps. DuSFE fuses the knowledge from multiple modalities to recalibrate both channel-wise and spatial features for each modality. DuSFE can be embedded at multiple convolutional layers to enable feature fusion at different spatial dimensions. Our studies using clinical data demonstrated that a network embedded with DuSFE generated substantial lower registration errors and therefore more accurate AC SPECT images than previous methods.

Xueqi Guo, Bo Zhou, David Pigg et al.

Subject motion in whole-body dynamic PET introduces inter-frame mismatch and seriously impacts parametric imaging. Traditional non-rigid registration methods are generally computationally intense and time-consuming. Deep learning approaches are promising in achieving high accuracy with fast speed, but have yet been investigated with consideration for tracer distribution changes or in the whole-body scope. In this work, we developed an unsupervised automatic deep learning-based framework to correct inter-frame body motion. The motion estimation network is a convolutional neural network with a combined convolutional long short-term memory layer, fully utilizing dynamic temporal features and spatial information. Our dataset contains 27 subjects each under a 90-min FDG whole-body dynamic PET scan. With 9-fold cross-validation, compared with both traditional and deep learning baselines, we demonstrated that the proposed network obtained superior performance in enhanced qualitative and quantitative spatial alignment between parametric $K_{i}$ and $V_{b}$ images and in significantly reduced parametric fitting error. We also showed the potential of the proposed motion correction method for impacting downstream analysis of the estimated parametric images, improving the ability to distinguish malignant from benign hypermetabolic regions of interest. Once trained, the motion estimation inference time of our proposed network was around 460 times faster than the conventional registration baseline, showing its potential to be easily applied in clinical settings.

Huidong Xie, Bo Zhou, Xiongchao Chen et al.

Cardiovascular disease (CVD) is the leading cause of death worldwide, and myocardial perfusion imaging using SPECT has been widely used in the diagnosis of CVDs. The GE 530/570c dedicated cardiac SPECT scanners adopt a stationary geometry to simultaneously acquire 19 projections to increase sensitivity and achieve dynamic imaging. However, the limited amount of angular sampling negatively affects image quality. Deep learning methods can be implemented to produce higher-quality images from stationary data. This is essentially a few-view imaging problem. In this work, we propose a novel 3D transformer-based dual-domain network, called TIP-Net, for high-quality 3D cardiac SPECT image reconstructions. Our method aims to first reconstruct 3D cardiac SPECT images directly from projection data without the iterative reconstruction process by proposing a customized projection-to-image domain transformer. Then, given its reconstruction output and the original few-view reconstruction, we further refine the reconstruction using an image-domain reconstruction network. Validated by cardiac catheterization images, diagnostic interpretations from nuclear cardiologists, and defect size quantified by an FDA 510(k)-cleared clinical software, our method produced images with higher cardiac defect contrast on human studies compared with previous baseline methods, potentially enabling high-quality defect visualization using stationary few-view dedicated cardiac SPECT scanners.

Bo Zhou, Yu-Jung Tsai, Jiazhen Zhang et al.

Patient motion during PET is inevitable. Its long acquisition time not only increases the motion and the associated artifacts but also the patient's discomfort, thus PET acceleration is desirable. However, accelerating PET acquisition will result in reconstructed images with low SNR, and the image quality will still be degraded by motion-induced artifacts. Most of the previous PET motion correction methods are motion type specific that require motion modeling, thus may fail when multiple types of motion present together. Also, those methods are customized for standard long acquisition and could not be directly applied to accelerated PET. To this end, modeling-free universal motion correction reconstruction for accelerated PET is still highly under-explored. In this work, we propose a novel deep learning-aided motion correction and reconstruction framework for accelerated PET, called Fast-MC-PET. Our framework consists of a universal motion correction (UMC) and a short-to-long acquisition reconstruction (SL-Reon) module. The UMC enables modeling-free motion correction by estimating quasi-continuous motion from ultra-short frame reconstructions and using this information for motion-compensated reconstruction. Then, the SL-Recon converts the accelerated UMC image with low counts to a high-quality image with high counts for our final reconstruction output. Our experimental results on human studies show that our Fast-MC-PET can enable 7-fold acceleration and use only 2 minutes acquisition to generate high-quality reconstruction images that outperform/match previous motion correction reconstruction methods using standard 15 minutes long acquisition data.

Bo Zhou, Huidong Xie, Qiong Liu et al.

Low-count PET is an efficient way to reduce radiation exposure and acquisition time, but the reconstructed images often suffer from low signal-to-noise ratio (SNR), thus affecting diagnosis and other downstream tasks. Recent advances in deep learning have shown great potential in improving low-count PET image quality, but acquiring a large, centralized, and diverse dataset from multiple institutions for training a robust model is difficult due to privacy and security concerns of patient data. Moreover, low-count PET data at different institutions may have different data distribution, thus requiring personalized models. While previous federated learning (FL) algorithms enable multi-institution collaborative training without the need of aggregating local data, addressing the large domain shift in the application of multi-institutional low-count PET denoising remains a challenge and is still highly under-explored. In this work, we propose FedFTN, a personalized federated learning strategy that addresses these challenges. FedFTN uses a local deep feature transformation network (FTN) to modulate the feature outputs of a globally shared denoising network, enabling personalized low-count PET denoising for each institution. During the federated learning process, only the denoising network's weights are communicated and aggregated, while the FTN remains at the local institutions for feature transformation. We evaluated our method using a large-scale dataset of multi-institutional low-count PET imaging data from three medical centers located across three continents, and showed that FedFTN provides high-quality low-count PET images, outperforming previous baseline FL reconstruction methods across all low-count levels at all three institutions.

Xueqi Guo, Halid Ziya Yerebakan, Yoshihisa Shinagawa et al.

Multi-organ segmentation of 3D medical images is fundamental with meaningful applications in various clinical automation pipelines. Although deep learning has achieved superior performance, the time and memory consumption of segmenting the entire 3D volume voxel by voxel using neural networks can be huge. Classifiers have been developed as an alternative in cases with certain points of interest, but the trade-off between speed and accuracy remains an issue. Thus, we propose a novel fast multi-organ segmentation framework with the usage of hierarchical sparse sampling and a Residual Transformer. Compared with whole-volume analysis, the hierarchical sparse sampling strategy could successfully reduce computation time while preserving a meaningful hierarchical context utilizing multiple resolution levels. The architecture of the Residual Transformer segmentation network could extract and combine information from different levels of information in the sparse descriptor while maintaining a low computational cost. In an internal data set containing 10,253 CT images and the public dataset TotalSegmentator, the proposed method successfully improved qualitative and quantitative segmentation performance compared to the current fast organ classifier, with fast speed at the level of ~2.24 seconds on CPU hardware. The potential of achieving real-time fine organ segmentation is suggested.

Xiongchao Chen, Bo Zhou, Xueqi Guo et al.

Single-Photon Emission Computed Tomography (SPECT) is widely applied for the diagnosis of coronary artery diseases. Low-dose (LD) SPECT aims to minimize radiation exposure but leads to increased image noise. Limited-view (LV) SPECT, such as the latest GE MyoSPECT ES system, enables accelerated scanning and reduces hardware expenses but degrades reconstruction accuracy. Additionally, Computed Tomography (CT) is commonly used to derive attenuation maps ($μ$-maps) for attenuation correction (AC) of cardiac SPECT, but it will introduce additional radiation exposure and SPECT-CT misalignments. Although various methods have been developed to solely focus on LD denoising, LV reconstruction, or CT-free AC in SPECT, the solution for simultaneously addressing these tasks remains challenging and under-explored. Furthermore, it is essential to explore the potential of fusing cross-domain and cross-modality information across these interrelated tasks to further enhance the accuracy of each task. Thus, we propose a Dual-Domain Coarse-to-Fine Progressive Network (DuDoCFNet), a multi-task learning method for simultaneous LD denoising, LV reconstruction, and CT-free $μ$-map generation of cardiac SPECT. Paired dual-domain networks in DuDoCFNet are cascaded using a multi-layer fusion mechanism for cross-domain and cross-modality feature fusion. Two-stage progressive learning strategies are applied in both projection and image domains to achieve coarse-to-fine estimations of SPECT projections and CT-derived $μ$-maps. Our experiments demonstrate DuDoCFNet's superior accuracy in estimating projections, generating $μ$-maps, and AC reconstructions compared to existing single- or multi-task learning methods, under various iterations and LD levels. The source code of this work is available at https://github.com/XiongchaoChen/DuDoCFNet-MultiTask.

Peiyu Duan, Xueqi Guo, Sepehr Farhand et al.

Accurate 3D brain MRI subtype classification benefits from both localized anatomical cues and long-range contextual reasoning. We present AGA3DNet, a report-grounded framework that incorporates brief anatomical phrases extracted from radiology reports as a soft anatomical prior channel and fuses it with a lightweight 3D CNN and multi-view xLSTM aggregation. Specifically, extracted anatomical phrases are mapped to atlas-defined regions and converted into smooth spatial priors using a signed-distance transform followed by Gaussian weighting, providing interpretable, anatomy-grounded guidance without requiring dense voxel annotations. We evaluate AGA3DNet on a retrospective institutional brain MRI cohort for abnormal subtype discrimination and compare against reproducible 3D classification baselines. AGA3DNet achieves improved overall balance across performance metrics and supports clinically interpretable localization through the prior channel. We discuss limitations related to single-cohort evaluation and the lack of large-scale public brain MRI datasets paired with radiology reports under broadly usable terms.

Xueqi Guo, Luyao Shi, Xiongchao Chen et al.

Inter-frame motion in dynamic cardiac positron emission tomography (PET) using rubidium-82 (82-Rb) myocardial perfusion imaging impacts myocardial blood flow (MBF) quantification and the diagnosis accuracy of coronary artery diseases. However, the high cross-frame distribution variation due to rapid tracer kinetics poses a considerable challenge for inter-frame motion correction, especially for early frames where intensity-based image registration techniques often fail. To address this issue, we propose a novel method called Temporally and Anatomically Informed Generative Adversarial Network (TAI-GAN) that utilizes an all-to-one mapping to convert early frames into those with tracer distribution similar to the last reference frame. The TAI-GAN consists of a feature-wise linear modulation layer that encodes channel-wise parameters generated from temporal information and rough cardiac segmentation masks with local shifts that serve as anatomical information. Our proposed method was evaluated on a clinical 82-Rb PET dataset, and the results show that our TAI-GAN can produce converted early frames with high image quality, comparable to the real reference frames. After TAI-GAN conversion, the motion estimation accuracy and subsequent myocardial blood flow (MBF) quantification with both conventional and deep learning-based motion correction methods were improved compared to using the original frames.

Halid Ziya Yerebakan, Kritika Iyer, Xueqi Guo et al.

We introduce a new type of foundational model for parsing human anatomy in medical images that works for different modalities. It supports supervised or unsupervised training and can perform matching, registration, classification, or segmentation with or without user interaction. We achieve this by training a neural network estimator that maps query locations to atlas coordinates via regression. Efficiency is improved by sparsely sampling the input, enabling response times of less than 1 ms without additional accelerator hardware. We demonstrate the utility of the algorithm in both CT and MRI modalities.

Tianqi Chen, Jun Hou, Yinchi Zhou et al.

Positron Emission Tomography (PET) is an important clinical imaging tool but inevitably introduces radiation hazards to patients and healthcare providers. Reducing the tracer injection dose and eliminating the CT acquisition for attenuation correction can reduce the overall radiation dose, but often results in PET with high noise and bias. Thus, it is desirable to develop 3D methods to translate the non-attenuation-corrected low-dose PET (NAC-LDPET) into attenuation-corrected standard-dose PET (AC-SDPET). Recently, diffusion models have emerged as a new state-of-the-art deep learning method for image-to-image translation, better than traditional CNN-based methods. However, due to the high computation cost and memory burden, it is largely limited to 2D applications. To address these challenges, we developed a novel 2.5D Multi-view Averaging Diffusion Model (MADM) for 3D image-to-image translation with application on NAC-LDPET to AC-SDPET translation. Specifically, MADM employs separate diffusion models for axial, coronal, and sagittal views, whose outputs are averaged in each sampling step to ensure the 3D generation quality from multiple views. To accelerate the 3D sampling process, we also proposed a strategy to use the CNN-based 3D generation as a prior for the diffusion model. Our experimental results on human patient studies suggested that MADM can generate high-quality 3D translation images, outperforming previous CNN-based and Diffusion-based baseline methods.

Bo Zhou, Jun Hou, Tianqi Chen et al.

Low-dose PET offers a valuable means of minimizing radiation exposure in PET imaging. However, the prevalent practice of employing additional CT scans for generating attenuation maps (u-map) for PET attenuation correction significantly elevates radiation doses. To address this concern and further mitigate radiation exposure in low-dose PET exams, we propose POUR-Net - an innovative population-prior-aided over-under-representation network that aims for high-quality attenuation map generation from low-dose PET. First, POUR-Net incorporates an over-under-representation network (OUR-Net) to facilitate efficient feature extraction, encompassing both low-resolution abstracted and fine-detail features, for assisting deep generation on the full-resolution level. Second, complementing OUR-Net, a population prior generation machine (PPGM) utilizing a comprehensive CT-derived u-map dataset, provides additional prior information to aid OUR-Net generation. The integration of OUR-Net and PPGM within a cascade framework enables iterative refinement of $μ$-map generation, resulting in the production of high-quality $μ$-maps. Experimental results underscore the effectiveness of POUR-Net, showing it as a promising solution for accurate CT-free low-count PET attenuation correction, which also surpasses the performance of previous baseline methods.

Xiongchao Chen, Bo Zhou, Huidong Xie et al.

Myocardial perfusion imaging (MPI) by single-photon emission computed tomography (SPECT) is widely applied for the diagnosis of cardiovascular diseases. Reducing the dose of the injected tracer is essential for lowering the patient's radiation exposure, but it will lead to increased image noise. Additionally, the latest dedicated cardiac SPECT scanners typically acquire projections in fewer angles using fewer detectors to reduce hardware expenses, potentially resulting in lower reconstruction accuracy. To overcome these challenges, we propose a dual-domain iterative network for end-to-end joint denoising and reconstruction from low-dose and few-angle projections of cardiac SPECT. The image-domain network provides a prior estimate for the projection-domain networks. The projection-domain primary and auxiliary modules are interconnected for progressive denoising and few-angle reconstruction. Adaptive Data Consistency (ADC) modules improve prediction accuracy by efficiently fusing the outputs of the primary and auxiliary modules. Experiments using clinical MPI data show that our proposed method outperforms existing image-, projection-, and dual-domain techniques, producing more accurate projections and reconstructions. Ablation studies confirm the significance of the image-domain prior estimate and ADC modules in enhancing network performance.

Xiongchao Chen, Bo Zhou, Huidong Xie et al.

Single-Photon Emission Computed Tomography (SPECT) is widely applied for the diagnosis of ischemic heart diseases. Low-dose (LD) SPECT aims to minimize radiation exposure but leads to increased image noise. Limited-angle (LA) SPECT enables faster scanning and reduced hardware costs but results in lower reconstruction accuracy. Additionally, computed tomography (CT)-derived attenuation maps ($μ$-maps) are commonly used for SPECT attenuation correction (AC), but it will cause extra radiation exposure and SPECT-CT misalignments. In addition, the majority of SPECT scanners in the market are not hybrid SPECT/CT scanners. Although various deep learning methods have been introduced to separately address these limitations, the solution for simultaneously addressing these challenges still remains highly under-explored and challenging. To this end, we propose a Cross-domain Iterative Network (CDI-Net) for simultaneous denoising, LA reconstruction, and CT-free AC in cardiac SPECT. In CDI-Net, paired projection- and image-domain networks are end-to-end connected to fuse the emission and anatomical information across domains and iterations. Adaptive Weight Recalibrators (AWR) adjust the multi-channel input features to enhance prediction accuracy. Our experiments using clinical data showed that CDI-Net produced more accurate $μ$-maps, projections, and reconstructions compared to existing approaches that addressed each task separately. Ablation studies demonstrated the significance of cross-domain and cross-iteration connections, as well as AWR, in improving the reconstruction performance.

Xueqi Guo, Sule Tinaz, Nicha C. Dvornek

Parkinson's disease (PD) is a common and complex neurodegenerative disorder with 5 stages in the Hoehn and Yahr scaling. Given the heterogeneity of PD, it is challenging to classify early stages 1 and 2 and detect brain function alterations. Functional magnetic resonance imaging (fMRI) is a promising tool in revealing functional connectivity (FC) differences and developing biomarkers in PD. Some machine learning approaches like support vector machine and logistic regression have been successfully applied in the early diagnosis of PD using fMRI data, which outperform classifiers based on manually selected morphological features. However, the early-stage characterization in FC changes has not been fully investigated. Given the complexity and non-linearity of fMRI data, we propose the use of a long short-term memory (LSTM) network to characterize the early stages of PD. The study included 84 subjects (56 in stage 2 and 28 in stage 1) from the Parkinson's Progression Markers Initiative (PPMI), the largest available public PD dataset. Under a repeated 10-fold stratified cross-validation, the LSTM model reached an accuracy of 71.63%, 13.52% higher than the best traditional machine learning method, indicating significantly better robustness and accuracy compared with other machine learning classifiers. We used the learned LSTM model weights to select the top brain regions that contributed to model prediction and performed FC analyses to characterize functional changes with disease stage and motor impairment to gain better insight into the brain mechanisms of PD.