Investigation of PET image quality with acquisition time/bed and enhancement of lesion quantification accuracy through deep progressive learning.

Objective: To improve the PET image quality by a deep progressive learning (DPL) reconstruction algorithm and evaluate the DPL performance in lesion quantification.

Methods: We reconstructed PET images from 48 oncological patients using ordered subset expectation maximization (OSEM) and deep progressive learning (DPL) methods. The patients were enrolled into three overlapped studies: 11 patients for image quality assessment (study 1), 34 patients for sub-centimeter lesion quantification (study 2), and 28 patients for imaging of overweight or obese individuals (study 3). In study 1, we evaluated the image quality visually based on four criteria: overall score, image sharpness, image noise, and diagnostic confidence. We also measured the image quality quantitatively using the signal-to-background ratio (SBR), signal-to-noise ratio (SNR), contrast-to-background ratio (CBR), and contrast-to-noise ratio (CNR). To evaluate the performance of the DPL algorithm in quantifying lesions, we compared the maximum standardized uptake values (SUV_max), SBR, CBR, SNR and CNR of 63 sub-centimeter lesions in study 2 and 44 lesions in study 3.

Results: DPL produced better PET image quality than OSEM did based on the visual evaluation methods when the acquisition time was 0.5, 1.0 and 1.5 min/bed. However, no discernible differences were found between the two methods when the acquisition time was 2.0, 2.5 and 3.0 min/bed. Quantitative results showed that DPL had significantly higher values of SBR, CBR, SNR, and CNR than OSEM did for each acquisition time. For sub-centimeter lesion quantification, the SUV_max, SBR, CBR, SNR, and CNR of DPL were significantly enhanced, compared with OSEM. Similarly, for lesion quantification in overweight and obese patients, DPL significantly increased these parameters compared with OSEM.

Conclusion: The DPL algorithm dramatically enhanced the quality of PET images and enabled more accurate quantification of sub-centimeters lesions in patients and lesions in overweight or obese patients. This is particularly beneficial for overweight or obese patients who usually have lower image quality due to the increased attenuation.