Albert J. Sinusas

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.

Huidong Xie, Zhao Liu, Luyao Shi et al.

In nuclear imaging, limited resolution causes partial volume effects (PVEs) that affect image sharpness and quantitative accuracy. Partial volume correction (PVC) methods incorporating high-resolution anatomical information from CT or MRI have been demonstrated to be effective. However, such anatomical-guided methods typically require tedious image registration and segmentation steps. Accurately segmented organ templates are also hard to obtain, particularly in cardiac SPECT imaging, due to the lack of hybrid SPECT/CT scanners with high-end CT and associated motion artifacts. Slight mis-registration/mis-segmentation would result in severe degradation in image quality after PVC. In this work, we develop a deep-learning-based method for fast cardiac SPECT PVC without anatomical information and associated organ segmentation. The proposed network involves a densely-connected multi-dimensional dynamic mechanism, allowing the convolutional kernels to be adapted based on the input images, even after the network is fully trained. Intramyocardial blood volume (IMBV) is introduced as an additional clinical-relevant loss function for network optimization. The proposed network demonstrated promising performance on 28 canine studies acquired on a GE Discovery NM/CT 570c dedicated cardiac SPECT scanner with a 64-slice CT using Technetium-99m-labeled red blood cells. This work showed that the proposed network with densely-connected dynamic mechanism produced superior results compared with the same network without such mechanism. Results also showed that the proposed network without anatomical information could produce images with statistically comparable IMBV measurements to the images generated by anatomical-guided PVC methods, which could be helpful in clinical translation.

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.

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.

Yinchi Zhou, Liang Guo, Huidong Xie et al.

Rb-82 dynamic cardiac PET imaging is widely used for the clinical diagnosis of coronary artery disease (CAD), but its short half-life results in high noise levels that degrade dynamic frame quality and parametric imaging. The lack of paired clean-noisy training data, rapid tracer kinetics, and frame-dependent noise variations further limit the effectiveness of existing deep learning denoising methods. We propose DECADE (A Temporally-Consistent Unsupervised Diffusion model for Enhanced Rb-82 CArdiac PET DEnoising), an unsupervised diffusion framework that generalizes across early- to late-phase dynamic frames. DECADE incorporates temporal consistency during both training and iterative sampling, using noisy frames as guidance to preserve quantitative accuracy. The method was trained and evaluated on datasets acquired from Siemens Vision 450 and Siemens Biograph Vision Quadra scanners. On the Vision 450 dataset, DECADE consistently produced high-quality dynamic and parametric images with reduced noise while preserving myocardial blood flow (MBF) and myocardial flow reserve (MFR). On the Quadra dataset, using 15%-count images as input and full-count images as reference, DECADE outperformed UNet-based and other diffusion models in image quality and K1/MBF quantification. The proposed framework enables effective unsupervised denoising of Rb-82 dynamic cardiac PET without paired training data, supporting clearer visualization while maintaining quantitative integrity.

Anne-Marie Rickmann, Stephanie L. Thorn, Shawn S. Ahn et al.

Cardiac image segmentation is an important step in many cardiac image analysis and modeling tasks such as motion tracking or simulations of cardiac mechanics. While deep learning has greatly advanced segmentation in clinical settings, there is limited work on pre-clinical imaging, notably in porcine models, which are often used due to their anatomical and physiological similarity to humans. However, differences between species create a domain shift that complicates direct model transfer from human to pig data. Recently, foundation models trained on large human datasets have shown promise for robust medical image segmentation; yet their applicability to porcine data remains largely unexplored. In this work, we investigate whether foundation models can generate sufficiently accurate pseudo-labels for pig cardiac CT and propose a simple self-training approach to iteratively refine these labels. Our method requires no manually annotated pig data, relying instead on iterative updates to improve segmentation quality. We demonstrate that this self-training process not only enhances segmentation accuracy but also smooths out temporal inconsistencies across consecutive frames. Although our results are encouraging, there remains room for improvement, for example by incorporating more sophisticated self-training strategies and by exploring additional foundation models and other cardiac imaging technologies.

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.

Allen Lu, Nripesh Parajuli, Maria Zontak et al.

Reliable motion estimation and strain analysis using 3D+time echocardiography (4DE) for localization and characterization of myocardial injury is valuable for early detection and targeted interventions. However, motion estimation is difficult due to the low-SNR that stems from the inherent image properties of 4DE, and intelligent regularization is critical for producing reliable motion estimates. In this work, we incorporated the notion of domain adaptation into a supervised neural network regularization framework. We first propose an unsupervised autoencoder network with biomechanical constraints for learning a latent representation that is shown to have more physiologically plausible displacements. We extended this framework to include a supervised loss term on synthetic data and showed the effects of biomechanical constraints on the network's ability for domain adaptation. We validated both the autoencoder and semi-supervised regularization method on in vivo data with implanted sonomicrometers. Finally, we showed the ability of our semi-supervised learning regularization approach to identify infarcted regions using estimated regional strain maps with good agreement to manually traced infarct regions from postmortem excised hearts.

Nripesh Parajuli, Allen Lu, Kevinminh Ta et al.

The accurate quantification of left ventricular (LV) deformation/strain shows significant promise for quantitatively assessing cardiac function for use in diagnosis and therapy planning (Jasaityte et al., 2013). However, accurate estimation of the displacement of myocardial tissue and hence LV strain has been challenging due to a variety of issues, including those related to deriving tracking tokens from images and following tissue locations over the entire cardiac cycle. In this work, we propose a point matching scheme where correspondences are modeled as flow through a graphical network. Myocardial surface points are set up as nodes in the network and edges define neighborhood relationships temporally. The novelty lies in the constraints that are imposed on the matching scheme, which render the correspondences one-to-one through the entire cardiac cycle, and not just two consecutive frames. The constraints also encourage motion to be cyclic, which is an important characteristic of LV motion. We validate our method by applying it to the estimation of quantitative LV displacement and strain estimation using 8 synthetic and 8 open-chested canine 4D echocardiographic image sequences, the latter with sonomicrometric crystals implanted on the LV wall. We were able to achieve excellent tracking accuracy on the synthetic dataset and observed a good correlation with crystal-based strains on the in-vivo data.