Chi Liu

Bo Zhou, Jo Schlemper, Neel Dey et al. · mit

While enabling accelerated acquisition and improved reconstruction accuracy, current deep MRI reconstruction networks are typically supervised, require fully sampled data, and are limited to Cartesian sampling patterns. These factors limit their practical adoption as fully-sampled MRI is prohibitively time-consuming to acquire clinically. Further, non-Cartesian sampling patterns are particularly desirable as they are more amenable to acceleration and show improved motion robustness. To this end, we present a fully self-supervised approach for accelerated non-Cartesian MRI reconstruction which leverages self-supervision in both k-space and image domains. In training, the undersampled data are split into disjoint k-space domain partitions. For the k-space self-supervision, we train a network to reconstruct the input undersampled data from both the disjoint partitions and from itself. For the image-level self-supervision, we enforce appearance consistency obtained from the original undersampled data and the two partitions. Experimental results on our simulated multi-coil non-Cartesian MRI dataset demonstrate that DDSS can generate high-quality reconstruction that approaches the accuracy of the fully supervised reconstruction, outperforming previous baseline methods. Finally, DDSS is shown to scale to highly challenging real-world clinical MRI reconstruction acquired on a portable low-field (0.064 T) MRI scanner with no data available for supervised training while demonstrating improved image quality as compared to traditional reconstruction, as determined by a radiologist study.

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.

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.

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.

Chi Liu, Derek Li, Yan Shu et al.

While large language models show promise in medical applications, achieving expert-level clinical reasoning remains challenging due to the need for both accurate answers and transparent reasoning processes. To address this challenge, we introduce Fleming-R1, a model designed for verifiable medical reasoning through three complementary innovations. First, our Reasoning-Oriented Data Strategy (RODS) combines curated medical QA datasets with knowledge-graph-guided synthesis to improve coverage of underrepresented diseases, drugs, and multi-hop reasoning chains. Second, we employ Chain-of-Thought (CoT) cold start to distill high-quality reasoning trajectories from teacher models, establishing robust inference priors. Third, we implement a two-stage Reinforcement Learning from Verifiable Rewards (RLVR) framework using Group Relative Policy Optimization, which consolidates core reasoning skills while targeting persistent failure modes through adaptive hard-sample mining. Across diverse medical benchmarks, Fleming-R1 delivers substantial parameter-efficient improvements: the 7B variant surpasses much larger baselines, while the 32B model achieves near-parity with GPT-4o and consistently outperforms strong open-source alternatives. These results demonstrate that structured data design, reasoning-oriented initialization, and verifiable reinforcement learning can advance clinical reasoning beyond simple accuracy optimization. We release Fleming-R1 publicly to promote transparent, reproducible, and auditable progress in medical AI, enabling safer deployment in high-stakes clinical environments.

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.

Bo Zhou, Zachary Augenfeld, Julius Chapiro et al.

Multimodal image registration has many applications in diagnostic medical imaging and image-guided interventions, such as Transcatheter Arterial Chemoembolization (TACE) of liver cancer guided by intraprocedural CBCT and pre-operative MR. The ability to register peri-procedurally acquired diagnostic images into the intraprocedural environment can potentially improve the intra-procedural tumor targeting, which will significantly improve therapeutic outcomes. However, the intra-procedural CBCT often suffers from suboptimal image quality due to lack of signal calibration for Hounsfield unit, limited FOV, and motion/metal artifacts. These non-ideal conditions make standard intensity-based multimodal registration methods infeasible to generate correct transformation across modalities. While registration based on anatomic structures, such as segmentation or landmarks, provides an efficient alternative, such anatomic structure information is not always available. One can train a deep learning-based anatomy extractor, but it requires large-scale manual annotations on specific modalities, which are often extremely time-consuming to obtain and require expert radiological readers. To tackle these issues, we leverage annotated datasets already existing in a source modality and propose an anatomy-preserving domain adaptation to segmentation network (APA2Seg-Net) for learning segmentation without target modality ground truth. The segmenters are then integrated into our anatomy-guided multimodal registration based on the robust point matching machine. Our experimental results on in-house TACE patient data demonstrated that our APA2Seg-Net can generate robust CBCT and MR liver segmentation, and the anatomy-guided registration framework with these segmenters can provide high-quality multimodal registrations. Our code is available at https://github.com/bbbbbbzhou/APA2Seg-Net.

Huidong Xie, Hongming Shan, Wenxiang Cong et al.

Breast CT provides image volumes with isotropic resolution in high contrast, enabling detection of small calcification (down to a few hundred microns in size) and subtle density differences. Since breast is sensitive to x-ray radiation, dose reduction of breast CT is an important topic, and for this purpose, few-view scanning is a main approach. In this article, we propose a Deep Efficient End-to-end Reconstruction (DEER) network for few-view breast CT image reconstruction. The major merits of our network include high dose efficiency, excellent image quality, and low model complexity. By the design, the proposed network can learn the reconstruction process with as few as O(N) parameters, where N is the side length of an image to be reconstructed, which represents orders of magnitude improvements relative to the state-of-the-art deep-learning-based reconstruction methods that map raw data to tomographic images directly. Also, validated on a cone-beam breast CT dataset prepared by Koning Corporation on a commercial scanner, our method demonstrates a competitive performance over the state-of-the-art reconstruction networks in terms of image quality. The source code of this paper is available at: https://github.com/HuidongXie/DEER.

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.

Zhengquan Luo, Chi Liu, Dongfu Xiao et al.

The integration of AI with medical images enables the extraction of implicit image-derived biomarkers for a precise health assessment. Recently, retinal age, a biomarker predicted from fundus images, is a proven predictor of systemic disease risks, behavioral patterns, aging trajectory and even mortality. However, the capability to infer such sensitive biometric data raises significant privacy risks, where unauthorized use of fundus images could lead to bioinformation leakage, breaching individual privacy. In response, we formulate a new research problem of biometric privacy associated with medical images and propose RetinaGuard, a novel privacy-enhancing framework that employs a feature-level generative adversarial masking mechanism to obscure retinal age while preserving image visual quality and disease diagnostic utility. The framework further utilizes a novel multiple-to-one knowledge distillation strategy incorporating a retinal foundation model and diverse surrogate age encoders to enable a universal defense against black-box age prediction models. Comprehensive evaluations confirm that RetinaGuard successfully obfuscates retinal age prediction with minimal impact on image quality and pathological feature representation. RetinaGuard is also flexible for extension to other medical image derived biomarkers. RetinaGuard is also flexible for extension to other medical image biomarkers.

Yinchi Zhou, Huidong Xie, Menghua Xia et al.

Low-count positron emission tomography (LCPET) imaging can reduce patients' exposure to radiation but often suffers from increased image noise and reduced lesion detectability, necessitating effective denoising techniques. Diffusion models have shown promise in LCPET denoising for recovering degraded image quality. However, training such models requires large and diverse datasets, which are challenging to obtain in the medical domain. To address data scarcity and privacy concerns, we combine diffusion models with federated learning -- a decentralized training approach where models are trained individually at different sites, and their parameters are aggregated on a central server over multiple iterations. The variation in scanner types and image noise levels within and across institutions poses additional challenges for federated learning in LCPET denoising. In this study, we propose a novel noise-embedded federated learning diffusion model (Fed-NDIF) to address these challenges, leveraging a multicenter dataset and varying count levels. Our approach incorporates liver normalized standard deviation (NSTD) noise embedding into a 2.5D diffusion model and utilizes the Federated Averaging (FedAvg) algorithm to aggregate locally trained models into a global model, which is subsequently fine-tuned on local datasets to optimize performance and obtain personalized models. Extensive validation on datasets from the University of Bern, Ruijin Hospital in Shanghai, and Yale-New Haven Hospital demonstrates the superior performance of our method in enhancing image quality and improving lesion quantification. The Fed-NDIF model shows significant improvements in PSNR, SSIM, and NMSE of the entire 3D volume, as well as enhanced lesion detectability and quantification, compared to local diffusion models and federated UNet-based models.

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.

Yinchi Zhou, Tianqi Chen, Jun Hou et al.

Image-to-image translation is a vital component in medical imaging processing, with many uses in a wide range of imaging modalities and clinical scenarios. Previous methods include Generative Adversarial Networks (GANs) and Diffusion Models (DMs), which offer realism but suffer from instability and lack uncertainty estimation. Even though both GAN and DM methods have individually exhibited their capability in medical image translation tasks, the potential of combining a GAN and DM to further improve translation performance and to enable uncertainty estimation remains largely unexplored. In this work, we address these challenges by proposing a Cascade Multi-path Shortcut Diffusion Model (CMDM) for high-quality medical image translation and uncertainty estimation. To reduce the required number of iterations and ensure robust performance, our method first obtains a conditional GAN-generated prior image that will be used for the efficient reverse translation with a DM in the subsequent step. Additionally, a multi-path shortcut diffusion strategy is employed to refine translation results and estimate uncertainty. A cascaded pipeline further enhances translation quality, incorporating residual averaging between cascades. We collected three different medical image datasets with two sub-tasks for each dataset to test the generalizability of our approach. Our experimental results found that CMDM can produce high-quality translations comparable to state-of-the-art methods while providing reasonable uncertainty estimations that correlate well with the translation error.

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.

Bo Zhou, Neel Dey, Jo Schlemper et al.

Multi-contrast MRI (MC-MRI) captures multiple complementary imaging modalities to aid in radiological decision-making. Given the need for lowering the time cost of multiple acquisitions, current deep accelerated MRI reconstruction networks focus on exploiting the redundancy between multiple contrasts. However, existing works are largely supervised with paired data and/or prohibitively expensive fully-sampled MRI sequences. Further, reconstruction networks typically rely on convolutional architectures which are limited in their capacity to model long-range interactions and may lead to suboptimal recovery of fine anatomical detail. To these ends, we present a dual-domain self-supervised transformer (DSFormer) for accelerated MC-MRI reconstruction. DSFormer develops a deep conditional cascade transformer (DCCT) consisting of several cascaded Swin transformer reconstruction networks (SwinRN) trained under two deep conditioning strategies to enable MC-MRI information sharing. We further present a dual-domain (image and k-space) self-supervised learning strategy for DCCT to alleviate the costs of acquiring fully sampled training data. DSFormer generates high-fidelity reconstructions which experimentally outperform current fully-supervised baselines. Moreover, we find that DSFormer achieves nearly the same performance when trained either with full supervision or with our proposed dual-domain self-supervision.

Bo Zhou, Rui Wang, Ming-Kai Chen et al.

Positron Emission Tomography (PET) is an important tool for studying Alzheimer's disease (AD). PET scans can be used as diagnostics tools, and to provide molecular characterization of patients with cognitive disorders. However, multiple tracers are needed to measure glucose metabolism (18F-FDG), synaptic vesicle protein (11C-UCB-J), and $β$-amyloid (11C-PiB). Administering multiple tracers to patient will lead to high radiation dose and cost. In addition, access to PET scans using new or less-available tracers with sophisticated production methods and short half-life isotopes may be very limited. Thus, it is desirable to develop an efficient multi-tracer PET synthesis model that can generate multi-tracer PET from single-tracer PET. Previous works on medical image synthesis focus on one-to-one fixed domain translations, and cannot simultaneously learn the feature from multi-tracer domains. Given 3 or more tracers, relying on previous methods will also create a heavy burden on the number of models to be trained. To tackle these issues, we propose a 3D unified anatomy-aware cyclic adversarial network (UCAN) for translating multi-tracer PET volumes with one unified generative model, where MR with anatomical information is incorporated. Evaluations on a multi-tracer PET dataset demonstrate the feasibility that our UCAN can generate high-quality multi-tracer PET volumes, with NMSE less than 15% for all PET tracers.

Bo Zhou, Yu-Jung Tsai, Chi Liu

Gating is commonly used in PET imaging to reduce respiratory motion blurring and facilitate more sophisticated motion correction methods. In the applications of low dose PET, however, reducing injection dose causes increased noise and reduces signal-to-noise ratio (SNR), subsequently corrupting the motion estimation/correction steps, causing inferior image quality. To tackle these issues, we first propose a Siamese adversarial network (SAN) that can efficiently recover high dose gated image volume from low dose gated image volume. To ensure the appearance consistency between the recovered gated volumes, we then utilize a pre-trained motion estimation network incorporated into SAN that enables the constraint of gate-to-gate (G2G) consistency. With high-quality recovered gated volumes, gate-to-gate motion vectors can be simultaneously outputted from the motion estimation network. Comprehensive evaluations on a low dose gated PET dataset of 29 subjects demonstrate that our method can effectively recover the low dose gated PET volumes, with an average PSNR of 37.16 and SSIM of 0.97, and simultaneously generate robust motion estimation that could benefit subsequent motion corrections.

Bo Zhou, S. Kevin Zhou, James S. Duncan et al.

Limited view tomographic reconstruction aims to reconstruct a tomographic image from a limited number of sinogram or projection views arising from sparse view or limited angle acquisitions that reduce radiation dose or shorten scanning time. However, such a reconstruction suffers from high noise and severe artifacts due to the incompleteness of sinogram. To derive quality reconstruction, previous state-of-the-art methods use UNet-like neural architectures to directly predict the full view reconstruction from limited view data; but these methods leave the deep network architecture issue largely intact and cannot guarantee the consistency between the sinogram of the reconstructed image and the acquired sinogram, leading to a non-ideal reconstruction. In this work, we propose a novel recurrent reconstruction framework that stacks the same block multiple times. The recurrent block consists of a custom-designed residual dense spatial-channel attention network. Further, we develop a sinogram consistency layer interleaved in our recurrent framework in order to ensure that the sampled sinogram is consistent with the sinogram of the intermediate outputs of the recurrent blocks. We evaluate our methods on two datasets. Our experimental results on AAPM Low Dose CT Grand Challenge datasets demonstrate that our algorithm achieves a consistent and significant improvement over the existing state-of-the-art neural methods on both limited angle reconstruction (over 5dB better in terms of PSNR) and sparse view reconstruction (about 4dB better in term of PSNR). In addition, our experimental results on Deep Lesion datasets demonstrate that our method is able to generate high-quality reconstruction for 8 major lesion types.

Luyao Shi, John A. Onofrey, Enette Mae Revilla et al.

In PET/CT imaging, CT is used for PET attenuation correction (AC). Mismatch between CT and PET due to patient body motion results in AC artifacts. In addition, artifact caused by metal, beam-hardening and count-starving in CT itself also introduces inaccurate AC for PET. Maximum likelihood reconstruction of activity and attenuation (MLAA) was proposed to solve those issues by simultaneously reconstructing tracer activity ($λ$-MLAA) and attenuation map ($μ$-MLAA) based on the PET raw data only. However, $μ$-MLAA suffers from high noise and $λ$-MLAA suffers from large bias as compared to the reconstruction using the CT-based attenuation map ($μ$-CT). Recently, a convolutional neural network (CNN) was applied to predict the CT attenuation map ($μ$-CNN) from $λ$-MLAA and $μ$-MLAA, in which an image-domain loss (IM-loss) function between the $μ$-CNN and the ground truth $μ$-CT was used. However, IM-loss does not directly measure the AC errors according to the PET attenuation physics, where the line-integral projection of the attenuation map ($μ$) along the path of the two annihilation events, instead of the $μ$ itself, is used for AC. Therefore, a network trained with the IM-loss may yield suboptimal performance in the $μ$ generation. Here, we propose a novel line-integral projection loss (LIP-loss) function that incorporates the PET attenuation physics for $μ$ generation. Eighty training and twenty testing datasets of whole-body 18F-FDG PET and paired ground truth $μ$-CT were used. Quantitative evaluations showed that the model trained with the additional LIP-loss was able to significantly outperform the model trained solely based on the IM-loss function.