Background
Deep learning (DL)-based image quality improvement is a novel technique based on convolutional neural networks. The aim of this study was to compare the clinical value of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) images obtained with the DL method with those obtained using a Gaussian filter.
Methods
Fifty patients with a mean age of 64.4 (range, 19–88) years who underwent 18F-FDG PET/CT between April 2019 and May 2019 were included in the study. PET images were obtained with the DL method in addition to conventional images reconstructed with three-dimensional time of flight-ordered subset expectation maximization and filtered with a Gaussian filter as a baseline for comparison. The reconstructed images were reviewed by two nuclear medicine physicians and scored from 1 (poor) to 5 (excellent) for tumor delineation, overall image quality, and image noise. For the semi-quantitative analysis, standardized uptake values in tumors and healthy tissues were compared between images obtained using the DL method and those obtained with a Gaussian filter.
Results
Images acquired using the DL method scored significantly higher for tumor delineation, overall image quality, and image noise compared to baseline (P < 0.001). The Fleiss’ kappa value for overall inter-reader agreement was 0.78. The standardized uptake values in tumor obtained by DL were significantly higher than those acquired using a Gaussian filter (P < 0.001).
Conclusions
Deep learning method improves the quality of PET images.
Deep learning (DL) image quality improvement has been studied for application to 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). It is unclear, however, whether DL can increase the quality of images obtained with semiconductor-based PET/CT scanners. This study aimed to compare the quality of semiconductor-based PET/CT scanner images obtained by DL-based technology and conventional OSEM image with Gaussian postfilter. For DL-based data processing implementation, we used Advanced Intelligent Clear-IQ Engine (AiCE, Canon Medical Systems, Tochigi, Japan) and for OSEM images, Gaussian postfilter of 3 mm FWHM is used. Thirty patients who underwent semiconductor-based PET/CT scanner imaging between May 6, 2021, and May 19, 2021, were enrolled. We compared AiCE images and OSEM images and scored them for delineation, image noise, and overall image quality. We also measured standardized uptake values (SUVs) in tumors and healthy tissues and compared them between AiCE and OSEM. AiCE images scored significantly higher than OSEM images for delineation, image noise, and overall image quality. The Fleiss kappa value for the interobserver agreement was 0.57. Among the 21 SUV measurements in healthy organs, 11 (52.4%) measurements were significantly different between AiCE and OSEM images. More pathological lesions were detected in AiCE images as compared with OSEM images, with AiCE images showing higher SUVs for pathological lesions than OSEM images. AiCE can improve the quality of images acquired with semiconductor-based PET/CT scanners, including the noise level, contrast, and tumor detection capability.
We investigated whether 18F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography images restored via deep learning (DL) improved image quality and affected axillary lymph node (ALN) metastasis diagnosis in patients with breast cancer. Using a five-point scale, two readers compared the image quality of DL-PET and conventional PET (cPET) in 53 consecutive patients from September 2020 to October 2021. Visually analyzed ipsilateral ALNs were rated on a three-point scale. The standard uptake values SUVmax and SUVpeak were calculated for breast cancer regions of interest. For “depiction of primary lesion”, reader 2 scored DL-PET significantly higher than cPET. For “noise”, “clarity of mammary gland”, and “overall image quality”, both readers scored DL-PET significantly higher than cPET. The SUVmax and SUVpeak for primary lesions and normal breasts were significantly higher in DL-PET than in cPET (p < 0.001). Considering the ALN metastasis scores 1 and 2 as negative and 3 as positive, the McNemar test revealed no significant difference between cPET and DL-PET scores for either reader (p = 0.250, 0.625). DL-PET improved visual image quality for breast cancer compared with cPET. SUVmax and SUVpeak were significantly higher in DL-PET than in cPET. DL-PET and cPET exhibited comparable diagnostic abilities for ALN metastasis.
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