Deep-Learning Generation of Synthetic Intermediate Projections Improves ¹⁷⁷Lu SPECT Images Reconstructed with...

The aims of this study were to decrease the ¹⁷⁷Lu-SPECT acquisition time by reducing the number of projections and to circumvent image degradation by adding deep-learning-generated synthesized projections. Methods: We constructed a deep convolutional U-net-shaped neural network for generation of synthetic intermediate projections (CUSIPs). The number of SPECT investigations was 352 for training, 37 for validation, and 15 for testing. The input was every fourth projection of 120 acquired SPECT projections, that is, 30 projections. The output was 30 synthetic intermediate projections (SIPs) per CUSIP. SPECT images were reconstructed with 120 or 30 projections, or with 120 projections when 90 SIPs were generated from 30 projections (30-120SIPs), using 3 CUSIPs. The reconstructions were performed with 2 ordered-subset expectation maximization (OSEM) algorithms: attenuation-corrected (AC) OSEM, and attenuation, scatter, and collimator response-corrected (ASCC) OSEM. The quality of the SIPs and SPECT images was quantitatively evaluated with root-mean-square error, peak signal-to-noise ratio (PSNR), and structural similarity (SSIM) index metrics. From a Jaszczak SPECT phantom, the recovery and signal-to-noise ratio (SNR) were determined. In addition, an experienced observer qualitatively assessed the SPECT image quality of the test set. Kidney activity concentrations, as determined from the different SPECT images, were compared. Results: The generated SIPs had a mean SSIM value of 0.926 (SD, 0.061). For AC-OSEM, the reconstruction with 30-120SIPs had higher SSIM (0.993 vs. 0.989, P < 0.001) and PSNR (49.5 vs. 47.2, P < 0.001) values than the reconstruction with 30 projections. ASCC-OSEM had higher SSIM and PSNR values than AC-OSEM (P < 0.001). There was a minor loss in recovery for 30-120SIPs, but SNR was clearly improved compared with 30 projections. The observer assessed 27 of 30 images reconstructed with 30 projections as having unacceptable noise levels, whereas the corresponding values were 2 of 60 for 30-120SIPs and 120 projections. Image quality did not differ significantly between 30-120SIPs and 120 projections. The kidney activity concentration was similar between the different projection sets, excepting a minor reduction of 2.5% for ASCC-OSEM 30-120SIPs. Conclusion: Adopting SIPs for sparsely acquired projections considerably recovers image quality and could allow a reduced SPECT acquisition time in clinical dosimetry protocols.