Paper detail

Patient-specific mean teacher UNet for enhancing PET image and low-dose PET reconstruction on RefleXion X1 biology-guided radiotherapy system

The RefleXion X1 is the first biology-guided radiotherapy (BgRT) system. Its dual 90-degree PET detector collects fewer pair production events compared to a full-ring diagnostic PET system. In the proposed BgRT workflow, a short scan is acquired before treatment delivery to ensure image quality and consistency. The shorter scan time, a quarter of the simulation scan time, also leads to fewer coincidence events and hence reduced image quality. In this study, we proposed a patient-specific mean teacher UNet (MT-UNet) to enhance PET image quality and low-dose PET reconstruction on RefleXion X1. PET/CT scans of nine cancer patients were acquired using RefleXion X1. Every patient had one simulation scan. Five patients had additional scans acquired during the first and the final treatment fractions. Treatment scans were acquired using the same imaging protocol as the simulation scan. For each scan, we reconstructed a full-dose image and evenly split coincidence events into four sessions to reconstruct four quarter-dose PET images. For each patient, our proposed MT-UNet was trained using quarter-dose and full-dose images of the simulation scan. For the image quality enhancement task, we applied nine trained MT-UNets to full-dose simulation PET images of the nine patients to generate enhanced images, respectively. The enhanced images were compared with the original full-dose images using CNR and SNR. For the low-dose image reconstruction task, we applied five trained MT-UNets to ten quarter-dose treatment images of five patients to predict full-dose images, respectively. The predicted and ground truth full-dose images were compared using SSIM and PSNR. We also trained and evaluated patient-specific UNets for model comparison. Our proposed patient-specific MT-UNet achieved better performance in improving the quality of RefleXion low-dose and full-dose images compared to the patient-specific UNet.