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Dixon-VIBE Deep Learning (DIVIDE) Pseudo-CT Synthesis for Pelvis PET/MR Attenuation Correction.

ABSTRACT: Whole-body attenuation correction (AC) is still challenging in combined PET/MR scanners. We describe Dixon-VIBE Deep Learning (DIVIDE), a deep-learning network that allows synthesizing pelvis pseudo-CT maps based only on the standard Dixon volumetric interpolated breath-hold examination (Dixon-VIBE) images currently acquired for AC in some commercial scanners. Methods: We propose a network that maps between the four 2-dimensional (2D) Dixon MR images (water, fat, in-phase, and out-of-phase) and their corresponding 2D CT image. In contrast to previous methods, we used transposed convolutions to learn the up-sampling parameters, we used whole 2D slices to provide context information, and we pretrained the network with brain images. Twenty-eight datasets obtained from 19 patients who underwent PET/CT and PET/MR examinations were used to evaluate the proposed method. We assessed the accuracy of the ?-maps and reconstructed PET images by performing voxel- and region-based analysis comparing the SUVs (in g/mL) obtained after AC using the Dixon-VIBE (PET_Dixon), DIVIDE (PET_DIVIDE), and CT-based (PET_CT) methods. Additionally, the bias in quantification was estimated in synthetic lesions defined in the prostate, rectum, pelvis, and spine. Results: Absolute mean relative change values relative to CT AC were lower than 2% on average for the DIVIDE method in every region of interest except for bone tissue, where it was lower than 4% and 6.75 times smaller than the relative change of the Dixon method. There was an excellent voxel-by-voxel correlation between PET_CT and PET_DIVIDE (R ² = 0.9998, P < 0.01). The Bland-Altman plot between PET_CT and PET_DIVIDE showed that the average of the differences and the variability were lower (mean PET_CT-PET_DIVIDE SUV, 0.0003; PET_CT-PET_DIVIDE SD, 0.0094; 95% confidence interval, [-0.0180,0.0188]) than the average of differences between PET_CT and PET_Dixon (mean PET_CT-PET_Dixon SUV, 0.0006; PET_CT-PET_Dixon SD, 0.0264; 95% confidence interval, [-0.0510,0.0524]). Statistically significant changes in PET data quantification were observed between the 2 methods in the synthetic lesions, with the largest improvement in femur and spine lesions. Conclusion: The DIVIDE method can accurately synthesize a pelvis pseudo-CT scan from standard Dixon-VIBE images, allowing for accurate AC in combined PET/MR scanners. Additionally, our implementation allows rapid pseudo-CT synthesis, making it suitable for routine applications and even allowing retrospective processing of Dixon-VIBE data.

SUBMITTER: Torrado-Carvajal A

PROVIDER: S-EPMC6910626 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Project description:This study introduces a new hybrid ZTE/Dixon MR-based attenuation correction (MRAC) method including bone density estimation for PET/MRI and quantifies the effects of bone attenuation on metastatic lesion uptake in the pelvis.Six patients with pelvic lesions were scanned using fluorodeoxyglucose (18F-FDG) in an integrated time-of-flight (TOF) PET/MRI system. For PET attenuation correction, MR imaging consisted of two-point Dixon and zero echo-time (ZTE) pulse sequences. A continuous-value fat and water pseudoCT was generated from a two-point Dixon MRI. Bone was segmented from the ZTE images and converted to Hounsfield units (HU) using a continuous two-segment piecewise linear model based on ZTE MRI intensity. The HU values were converted to linear attenuation coefficients (LAC) using a bilinear model. The bone voxels of the Dixon-based pseudoCT were replaced by the ZTE-derived bone to produce the hybrid ZTE/Dixon pseudoCT. The three different AC maps (Dixon, hybrid ZTE/Dixon, CTAC) were used to reconstruct PET images using a TOF-ordered subset expectation maximization algorithm with a point-spread function model. Metastatic lesions were separated into two classes, bone lesions and soft tissue lesions, and analyzed. The MRAC methods were compared using a root-mean-squared error (RMSE), where the registered CTAC was taken as ground truth.The RMSE of the maximum standardized uptake values (SUVmax ) is 11.02% and 7.79% for bone (N = 6) and soft tissue lesions (N = 8), respectively, using Dixon MRAC. The RMSE of SUVmax for these lesions is significantly reduced to 3.28% and 3.94% when using the new hybrid ZTE/Dixon MRAC. Additionally, the RMSE for PET SUVs across the entire pelvis and all patients are 8.76% and 4.18%, for the Dixon and hybrid ZTE/Dixon MRAC methods, respectively.A hybrid ZTE/Dixon MRAC method was developed and applied to pelvic regions in an integrated TOF PET/MRI, demonstrating improved MRAC. This new method included bone density estimation, through which PET quantification is improved.

Project description:The authors evaluate the energy dependent noise and bias properties of monoenergetic images synthesized from dual-energy CT (DECT) acquisitions. These monoenergetic images can be used to estimate attenuation coefficients at energies suitable for positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging. This is becoming more relevant with the increased use of quantitative imaging by PET/CT and SPECT/CT scanners. There are, however, potential variations in the noise and bias of synthesized monoenergetic images as a function of energy.The authors used analytic approximations and simulations to estimate the noise and bias of synthesized monoenergetic images of water-filled cylinders with different shapes and the NURBS-based cardiac-torso (NCAT) phantom from 40 to 520 keV, the range of SPECT and PET energies. The dual-kVp spectra were based on the GE Lightspeed VCT scanner at 80 and 140 kVp with added filtration of 0.5 mm Cu. The authors evaluated strategies of noise suppression with sinogram smoothing and dose minimization with reduction of tube currents at the two kVp settings. The authors compared the impact of DECT-based attenuation correction with single-kVp CT-based attenuation correction on PET quantitation for the NCAT phantom for soft tissue and high-Z materials of bone and iodine contrast enhancement.Both analytic calculations and simulations displayed the expected minimum noise value for a synthesized monoenergetic image at an energy between the mean energies of the two spectra. In addition the authors found that the normalized coefficient of variation in the synthesized attenuation map increased with energy but reached a plateau near 160 keV, and then remained constant with increasing energy up to 511 keV and beyond. The bias was minimal, as the linear attenuation coefficients of the synthesized monoenergetic images were within 2.4% of the known true values across the entire energy range. Compared with no sinogram smoothing, sinogram smoothing can dramatically reduce noise in the DECT-derived attenuation map. Through appropriate selection of tube currents for high and low kVp scans, DECT can deliver roughly the same amount of radiation dose as that of a single kVp CT scan, but could be used for PET attenuation correction with reduced bias in contrast agent regions by a factor of ≈ 2.6 and slightly reduced RMSE for the total image.When DECT is used for attenuation correction at higher energies, there is a noise amplification that is dependent on the energy of the synthesized monoenergetic image of linear attenuation coefficients. Sinogram smoothing reduces the noise amplification in DECT-derived attenuation maps without increasing bias. With an appropriate selection of CT techniques, a DECT scan with the same radiation dose as a single CT scan can result in a PET image with improved quantitative accuracy.

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Dixon-VIBE Deep Learning (DIVIDE) Pseudo-CT Synthesis for Pelvis PET/MR Attenuation Correction.

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