Design and utilisation of protocols to characterise dynamic PET uptake of two tracers using basis pursuit

Kinetic model-informed deep learning for multiplexed PET image separation

BACKGROUND

Multiplexed positron emission tomography (mPET) imaging can measure physiological and pathological information from different tracers simultaneously in a single scan. Separation of the multiplexed PET signals within a single PET scan is challenging due to the fact that each tracer gives rise to indistinguishable 511 keV photon pairs, and thus no unique energy information for differentiating the source of each photon pair.

METHODS

Recently, many applications of deep learning for mPET image separation have been concentrated on pure data-driven methods, e.g., training a neural network to separate mPET images into single-tracer dynamic/static images. These methods use over-parameterized networks with only a very weak inductive prior. In this work, we improve the inductive prior of the deep network by incorporating a general kinetic model based on spectral analysis. The model is incorporated, along with deep networks, into an unrolled image-space version of an iterative fully 4D PET reconstruction algorithm.

RESULTS

The performance of the proposed method was evaluated on a simulated brain image dataset for dual-tracer [18 F]FDG+[11 C]MET PET image separation. The results demonstrate that the proposed method can achieve separation performance comparable to that obtained with single-tracer imaging. In addition, the proposed method outperformed the model-based separation methods (the conventional voxel-wise multi-tracer compartment modeling method (v-MTCM) and the image-space dual-tracer version of the fully 4D PET image reconstruction algorithm (IS-F4D)), as well as a pure data-driven separation [using a convolutional encoder-decoder (CED)], with fewer training examples.

CONCLUSIONS

This work proposes a kinetic model-informed unrolled deep learning method for mPET image separation. In simulation studies, the method proved able to outperform both the conventional v-MTCM method and a pure data-driven CED with less training data.

Machine Learning-Based Noninvasive Quantification of Single-Imaging Session Dual-Tracer 18F-FDG and 68Ga-DOTATATE Dynamic PET-CT in Oncology

⁶⁸Ga-DOTATATE PET-CT is routinely used for imaging neuroendocrine tumor (NET) somatostatin receptor subtype 2 (SSTR2) density in patients, and is complementary to FDG PET-CT for improving the accuracy of NET detection, characterization, grading, staging, and predicting/monitoring NET responses to treatment. Performing sequential ¹⁸F-FDG and ⁶⁸Ga-DOTATATE PET scans would require 2 or more days and can delay patient care. To align temporal and spatial measurements of ¹⁸F-FDG and ⁶⁸Ga-DOTATATE PET, and to reduce scan time and CT radiation exposure to patients, we propose a single-imaging session dual-tracer dynamic PET acquisition protocol in the study. A recurrent extreme gradient boosting (rXGBoost) machine learning algorithm was proposed to separate the mixed ¹⁸F-FDG and ⁶⁸Ga-DOTATATE time activity curves (TACs) for the region of interest (ROI) based quantification with tracer kinetic modeling. A conventional parallel multi-tracer compartment modeling method was also implemented for reference. Single-scan dual-tracer dynamic PET was simulated from 12 NET patient studies with ¹⁸F-FDG and ⁶⁸Ga-DOTATATE 45-min dynamic PET scans separately obtained within 2 days. Our experimental results suggested an ¹⁸F-FDG injection first followed by ⁶⁸Ga-DOTATATE with a minimum 5 min delayed injection protocol for the separation of mixed ¹⁸F-FDG and ⁶⁸Ga-DOTATATE TACs using rXGBoost algorithm followed by tracer kinetic modeling is highly feasible.

Positron range-free and multi-isotope tomography of positron emitters

Despite improvements in small animal PET instruments, many tracers cannot be imaged at sufficiently high resolutions due to positron range, while multi-tracer PET is hampered by the fact that all annihilation photons have equal energies. Here we realize multi-isotope and sub-mm resolution PET of isotopes with several mm positron range by utilizing prompt gamma photons that are commonly neglected. A PET-SPECT-CT scanner (VECTor/CT, MILabs, The Netherlands) equipped with a high-energy cluster-pinhole collimator was used to image ¹²⁴I and a mix of ¹²⁴I and ¹⁸F in phantoms and mice. In addition to positrons (mean range 3.4 mm) ¹²⁴I emits large amounts of 603 keV prompt gammas that-aided by excellent energy discrimination of NaI-were selected to reconstruct ¹²⁴I images that are unaffected by positron range. Photons detected in the 511 keV window were used to reconstruct ¹⁸F images. Images were reconstructed iteratively using an energy dependent matrix for each isotope. Correction of ¹⁸F images for contamination with ¹²⁴I annihilation photons was performed by Monte Carlo based range modelling and scaling of the ¹²⁴I prompt gamma image before subtracting it from the ¹⁸F image. Additionally, prompt gamma imaging was tested for ⁸⁹Zr that emits very high-energy prompts (909 keV). In Derenzo resolution phantoms 0.75 mm rods were clearly discernable for ¹²⁴I, ⁸⁹Zr and for simultaneously acquired ¹²⁴I and ¹⁸F imaging. Image quantification in phantoms with reservoirs filled with both ¹²⁴I and ¹⁸F showed excellent separation of isotopes and high quantitative accuracy. Mouse imaging showed uptake of ¹²⁴I in tiny thyroid parts and simultaneously injected ¹⁸F-NaF in bone structures. The ability to obtain PET images at sub-mm resolution both for isotopes with several mm positron range and for multi-isotope PET adds to many other unique capabilities of VECTor's clustered pinhole imaging, including simultaneous sub-mm PET-SPECT and theranostic high energy SPECT.

PET Parametric Imaging: Past, Present, and Future

Positron emission tomography (PET) is actively used in a diverse range of applications in oncology, cardiology, and neurology. The use of PET in the clinical setting focuses on static (single time frame) imaging at a specific time-point post radiotracer injection and is typically considered as semi-quantitative; e.g. standardized uptake value (SUV) measures. In contrast, dynamic PET imaging requires increased acquisition times but has the advantage that it measures the full spatiotemporal distribution of a radiotracer and, in combination with tracer kinetic modeling, enables the generation of multiparametric images that more directly quantify underlying biological parameters of interest, such as blood flow, glucose metabolism, and receptor binding. Parametric images have the potential for improved detection and for more accurate and earlier therapeutic response assessment. Parametric imaging with dynamic PET has witnessed extensive research in the past four decades. In this paper, we provide an overview of past and present activities and discuss emerging opportunities in the field of parametric imaging for the future.

Three-dimensional convolutional neural networks for simultaneous dual-tracer PET imaging

Dual-tracer positron emission tomography (PET) is a promising technique to measure the distribution of two tracers in the body by a single scan, which can improve the clinical accuracy of disease diagnosis and can also serve as a research tool for scientists. Most current research on dual-tracer PET reconstruction is based on mixed images pre-reconstructed by algorithms, which restricts the further improvement of the precision of reconstruction. In this study, we present a hybrid loss-guided deep learning based framework for dual-tracer PET imaging using sinogram data, which can achieve reconstruction by naturally unifying two functions: the reconstruction of the mixed images and the separation for individual tracers. Combined with volumetric dual-tracer images, we adopted a three-dimensional (3D) convolutional neural network (CNN) to learn full features, including spatial information and temporal information simultaneously. In addition, an auxiliary loss layer was introduced to guide the reconstruction of the dual tracers. We used Monte Carlo simulations with data augmentation to generate sufficient datasets for training and testing. The results were analyzed by the bias and variance both spatially (different regions of interest) and temporally (different frames). The analysis verified the feasibility of the 3D CNN framework for dual-tracer reconstruction. Furthermore, we compared the reconstruction results with a deep belief network (DBN), which is another deep learning based technique for the separation of dual-tracer images based on time-activity curves (TACs). The comparison results provide insights into the superior features and performance of the 3D CNN. Furthermore, we tested the [¹¹C]FMZ-[¹¹C]DTBZ images with three total-counts levels ([Formula: see text], [Formula: see text], [Formula: see text]), which indicate different noise ratios. The analysis results demonstrate that our method can successfully recover the respective distribution of lower total counts with nearly the same accuracy as that of the higher total counts in the total counts range we applied, which also also indicates the proposed 3D CNN framework is more robust to noise compared with DBN.