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Axel Rominger

Publications and source records attributed to Axel Rominger.

At least 19 recordsLinked to original sources

Voxel-wise Bayesian Estimation for Multi-Population Positronium Lifetime Imaging

Positronium lifetime imaging (PLI) provides local annihilation environment data beyond conventional activity imaging. Existing approaches, however, often estimate lifetime parameters over predefined regions, neglecting multiple lifetime populations within the same location. We present a 3D, population-specific Bayesian framework for fast voxel-wise PLI. A partial system matrix describes the spatial probability of detected events, while measured lifetimes provide soft assignments to slow, fast, and noise populations. These event responsibilities are used to estimate a decay-rate posterior independently for each voxel, preserving local lifetime variation and statistical uncertainty. In simulations, our formulation recovered spatially varying slow-population decay rates and a common fast-population rate, whereas a single-population model produced systematic bias. Slow-population two-standard-deviation coverage ranged from 93.8% to 98.1%. Experimental validation using 124I triple-coincidence data from a Siemens Biograph Vision Quadra scanner produced separate slow- and fast-population maps for aluminum, nickel, copper, and quartz. The long-lived quartz component matched ortho-positronium, while the fast population showed material-dependent differences among metals. Fast-population coverage was lower (69.1%), indicating underestimated uncertainty. The method is highly efficient, requiring only seconds to minutes per population on a single CPU core. This framework provides fast, population-specific PLI with Bayesian uncertainty quantification, making spatially resolved statistical inference feasible and practical for volumetric applications.

stat.AP

VLM- and LLM-Driven Multi-Agent System for PET Image Denoising

Positron emission tomography (PET) imaging suffers from limited spatial resolution and low signal-to-noise ratio, which can compromise quantitative accuracy and lesion detectability. Deep learning-based denoising methods have demonstrated strong potential for improving PET image quality. However, their practical deployment in real-world settings remains challenging, often requiring multiple specialized models and expert interventions, such as identifying motion-induced misregistration artifacts, estimating noise levels to select an appropriate denoiser, and performing lesion-focused quantitative assessment after denoising. Recent advances in vision-language models (VLMs) for image quality understanding and large language models (LLMs) for contextual reasoning provide new opportunities for automated, decision-driven workflows. Inspired by expert workflows for PET image quality enhancement, we propose an VLM- and LLM-driven multi-agent PET denoising framework that dynamically assesses image quality and lesion status, autonomously selects optimal denoising models and parameters, and enables closed-loop feedback with rollback mechanisms. Experiments were conducted on Siemens Biograph Vision Quadra PET/CT data with 1/20 and 1/50 low-dose settings. Individual module evaluations demonstrated the reliability of the agentic components, while the complete framework achieved higher PSNR and SSIM than UNet, GAN, and DDPM baselines at both dose levels. These preliminary results demonstrate the feasibility of using a closed-loop multi-agent framework to adapt PET denoising strategies to different image conditions.

eess.IV

TheraAgent: Multi-Agent Framework with Self-Evolving Memory and Evidence-Calibrated Reasoning for PET Theranostics

PET theranostics is transforming precision oncology, yet treatment response varies substantially; many patients receiving 177Lu-PSMA radioligand therapy (RLT) for metastatic castration-resistant prostate cancer (mCRPC) fail to respond, demanding reliable pre-therapy prediction. While LLM-based agents have shown remarkable potential in complex medical diagnosis, their application to PET theranostic outcome prediction remains unexplored, which faces three key challenges: (1) data and knowledge scarcity: RLT was only FDA-approved in 2022, yielding few training cases and insufficient domain knowledge in general LLMs; (2) heterogeneous information integration: robust prediction hinges on structured knowledge extraction from PET/CT, laboratory tests, and free-text clinical documentation; (3) evidence-grounded reasoning: clinical decisions must be anchored in trial evidence rather than LLM hallucinations. In this paper, we present TheraAgent, to our knowledge, the first agentic framework for PET theranostics, with three core innovations: (1) Multi-Expert Feature Extraction with Confidence-Weighted Consensus, where three specialized experts process heterogeneous inputs with uncertainty quantification; (2) Self-Evolving Agentic Memory (SEA-Mem), which learns prognostic patterns from accumulated cases, enabling case-based reasoning from limited data; (3) Evidence-Calibrated Reasoning, integrating a curated theranostics knowledge base to ground predictions in VISION/TheraP trial evidence. Evaluated on 35 real patients and 400 synthetic cases, TheraAgent achieves 75.7% overall accuracy on real patients and 87.0% on synthetic cases, outperforming MDAgents and MedAgent-Pro by over 20%. These results highlight a promising blueprint for trustworthy AI agents in PET theranostics, enabling trial-calibrated, multi-source decision support. Code will be released upon acceptance.

cs.AI

Feasibility study of the positronium lifetime imaging with the Biograph Vision Quadra and J-PET tomographs

Background: After its first ex-vivo and in-vivo demonstration, Positronium Lifetime Imaging (PLI) has received considerable interest as a potential new diagnostic biomarker. High sensitivity Positron Emission Tomography (PET) systems are needed for PLI since it requires simultaneous registration of annihilation photons and prompt gamma. In this simulation-based study, a~feasibility of PLI with the long axial field-of-view Biograph Vision Quadra (Quadra) and the Total Body J-PET scanner was investigated. Methods: The study was performed using the GATE software. Background radiation, present within the Quadra tomograph, was added to the simulation. First, the optimal placement of the energy window for the registration of the prompt gamma was investigated. Next, the organ-wise sensitivity of Quadra was calculated for the $^{68}$Ga, $^{44}$Sc, $^{22}$Na and $^{124}$I radioisotopes. Finally, the sensitivity for the scandium isotope was compared to the sensitivities obtainable with the Total Body J-PET scanner, as well as with the modular J-PET prototype. Results: The PLI sensitivities for the Quadra with the background radiation are estimated to 9.22(3), 10.46(4), 5.91(3), and 15.39(4) cps/kBq for the $^{44}$Sc, $^{68}$Ga, $^{22}$Na and $^{124}$I radioisotopes, respectively. The highest sensitivity was obtained when the energy window for the deexcitation photon is adjacent to the energy window for the annihilation photons. The determined PLI sensitivities with Quadra and the Total Body J-PET are in the order of sensitivities of standard PET imaging with the short axial field-of-view ($\sim$20 cm) PET scanners. Conclusion: The organ-wise PLI sensitivity of Quadra has been computed for the $^{68}$Ga, $^{44}$Sc, $^{22}$Na and $^{124}$I radioisotopes. A sensitivity gain by a factor of 150 was estimated relative to the modular J-PET system previously used for the first in-vivo PLI.

physics.med-ph

First Positronium Lifetime Imaging using $^{52}$Mn and $^{55}$Co with a plastic-based PET scanner

Positronium Lifetime Imaging (PLI) extends positron emission tomography by using the lifetime of positronium atoms as a probe of tissue molecular architecture. In this work, we report the first PLI measurements performed with $^{52}$Mn and $^{55}$Co using the modular J-PET. Four samples were studied in each experiment: two Certified Reference Materials (polycarbonate and fused silica) and two human tissues (cardiac myxoma and adipose). The selection of PLI events was based on the registration of two 511~keV annihilation photons and one prompt gamma in triple coincidence. From the resulting lifetime spectra we extracted the mean ortho-positronium lifetime $\tau_{\text{oPs}}$ and the mean positron lifetime $\Delta T_{\text{mean}}$ for each sample. The measured values of $\tau_{\text{oPs}}$ in polycarbonate using both isotopes matches well with the certified reference values. Furthermore, $^{55}$Co reproduced identical results for fused-silica measurements at their respective uncertainty levels. In contrast, measurements with $^{52}$Mn in fused silica show a minor deviation, which could be caused by the Parafilm spacer. In myxoma and adipose tissue, the reduced $\tau_{\text{oPs}}$ values are mainly linked to the long storage history of the samples rather than to the choice of isotope. Comparing peak-to-background ratios and spectral purity, $^{55}$Co provides cleaner PLI data under the same experimental conditions. Although $^{52}$Mn offers a longer half-life and a multi gamma cascade enhancing $\beta^{+}$ + $\gamma$ coincidences, but at the expense of higher background. In this study, we demonstrate that the applied selection criteria on the data measured with the modular J-PET can be used for PLI studies even with radionuclides with complex decay patterns.

physics.med-ph

Patient-specific AI for generation of 3D dosimetry imaging from two 2D-planar measurements

In this work we explored the use of patient specific reinforced learning to generate 3D activity maps from two 2D planar images (anterior and posterior). The solution of this problem remains unachievable using conventional methodologies and is of particular interest for dosimetry in nuclear medicine where approaches for post-therapy distribution of radiopharmaceuticals such as 177Lu-PSMA are typically done via either expensive and long 3D SPECT acquisitions or fast, yet only 2D, planar scintigraphy. Being able to generate 3D activity maps from planar scintigraphy opens the gate for new dosimetry applications removing the need for SPECT and facilitating multi-time point dosimetry studies. Our solution comprises the generation of a patient specific dataset with possible 3D uptake maps of the radiopharmaceuticals withing the anatomy of the individual followed by an AI approach (we explored both the use of 3DUnet and diffusion models) able to generate 3D activity maps from 2D planar images. We have validated our method both in simulation and real planar acquisitions. We observed enhanced results using patient specific reinforcement learning (~20% reduction on MAE and ~5% increase in SSIM) and better organ delineation and patient anatomy especially when combining diffusion models with patient specific training yielding a SSIM=0.89 compared to the ground truth for simulations and 0.73 when compared to a SPECT acquisition performed half an hour after the planar. We believe that our methodology can set a change of paradigm for nuclear medicine dosimetry allowing for 3D quantification using only planar scintigraphy without the need of expensive and time-consuming SPECT leveraging the pre-therapy information of the patients.

physics.med-ph

Artificial intelligence for simplified patient-centered dosimetry in radiopharmaceutical therapies

KEY WORDS: Artificial Intelligence (AI), Theranostics, Dosimetry, Radiopharmaceutical Therapy (RPT), Patient-friendly dosimetry KEY POINTS - The rapid evolution of radiopharmaceutical therapy (RPT) highlights the growing need for personalized and patient-centered dosimetry. - Artificial Intelligence (AI) offers solutions to the key limitations in current dosimetry calculations. - The main advances on AI for simplified dosimetry toward patient-friendly RPT are reviewed. - Future directions on the role of AI in RPT dosimetry are discussed.

physics.med-ph

First Positronium Lifetime Imaging with Scandium-44 on a Long Axial Field-of-view PET/CT

Purpose: 44Sc has been successfully produced, synthesized, labeled and first-in-human studies were conducted some years ago. The decay properties of 44Sc, together with being close to a clinical implementation, make it an ideal candidate for in vivo positronium lifetime measurements. In this study, we investigate the count statistics for ortho-positronium (oPs) measurements with 44Sc. Method: A NEMA image quality phantom was filled with 41.7 MBq of 44Sc dissolved in water and scanned on a commercial long-axial field-of-view PET/CT. Three-photon events were identified using a prototype feature of the scanner and dedicated software. The lifetime of oPs was determined in the phantom spheres and in 4x4x4 mm^3 voxels. Results: All measured oPs lifetimes are compatible, within the uncertainties, with the literature values for water. The oPs lifetime is 2.65+-0.50, 1.39+-0.20 and 1.76+-0.18 ns in the three smallest spheres of the phantom and 1.79+-0.57 ns for a single voxel in the central region of the largest sphere. The relative standard deviation in the background regions of the time difference distributions, i.e., for time differences smaller than -2.7 ns, is above 20% - even for voxels inside the phantom spheres. Conclusions: Despite the favorable physical properties of 44Sc, the count statistics of three-photon events remains a challenge. The high prompt-photon energy causes a significant amount of random three-photon coincidences with the given methodology and, therefore, increases the statistical uncertainties on the measured oPs lifetime.

physics.med-ph

First positronium imaging using $^{44}$Sc with the J-PET scanner: a case study on the NEMA-Image Quality phantom

Positronium Lifetime Imaging (PLI), an emerging extension of conventional positron emission tomography (PET) imaging, offers a novel window for probing the submolecular properties of biological tissues by imaging the mean lifetime of the positronium atom. Currently, the method is under rapid development in terms of reconstruction and detection systems. Recently, the first in vivo PLI of the human brain was performed using the J-PET scanner utilizing the $^{68}$Ga isotope. However, this isotope has limitations due to its comparatively low prompt gamma yields, which is crucial for positronium lifetime measurement. Among alternative radionuclides, $^{44}$Sc stands out as a promising isotope for PLI, characterized by a clinically suitable half-life (4.04 hours) emitting 1157 keV prompt gamma in 100% cases after the emission of the positron. This study reports the first experimental demonstration of PLI with $^{44}$Sc, carried out on a NEMA-Image Quality (IQ) phantom using the Modular J-PET tomograph-the first plastic scintillators-based PET scanner.

physics.med-ph

Fed-NDIF: A Noise-Embedded Federated Diffusion Model For Low-Count Whole-Body PET Denoising

Low-count positron emission tomography (LCPET) imaging can reduce patients' exposure to radiation but often suffers from increased image noise and reduced lesion detectability, necessitating effective denoising techniques. Diffusion models have shown promise in LCPET denoising for recovering degraded image quality. However, training such models requires large and diverse datasets, which are challenging to obtain in the medical domain. To address data scarcity and privacy concerns, we combine diffusion models with federated learning -- a decentralized training approach where models are trained individually at different sites, and their parameters are aggregated on a central server over multiple iterations. The variation in scanner types and image noise levels within and across institutions poses additional challenges for federated learning in LCPET denoising. In this study, we propose a novel noise-embedded federated learning diffusion model (Fed-NDIF) to address these challenges, leveraging a multicenter dataset and varying count levels. Our approach incorporates liver normalized standard deviation (NSTD) noise embedding into a 2.5D diffusion model and utilizes the Federated Averaging (FedAvg) algorithm to aggregate locally trained models into a global model, which is subsequently fine-tuned on local datasets to optimize performance and obtain personalized models. Extensive validation on datasets from the University of Bern, Ruijin Hospital in Shanghai, and Yale-New Haven Hospital demonstrates the superior performance of our method in enhancing image quality and improving lesion quantification. The Fed-NDIF model shows significant improvements in PSNR, SSIM, and NMSE of the entire 3D volume, as well as enhanced lesion detectability and quantification, compared to local diffusion models and federated UNet-based models.

eess.IV

Positronium Imaging: History, Current Status, and Future Perspectives

Positronium imaging was recently proposed to image the properties of positronium atoms in the patient body. Positronium properties depend on the size of intramolecular voids and oxygen concentration; therefore, they deliver information different and complementary to the anatomic, morphological, and metabolic images. Thus far, the mean ortho-positronium lifetime imaging has been at the center of research interest. The first ex vivo and in vivo positronium lifetime images of humans have been demonstrated with the dedicated J-PET scanner enabling simultaneous registration of annihilation photons and prompt gamma from ${\beta^{+} \gamma}$ emitters. Annihilation photons are used to reconstruct the annihilation place and time while prompt gamma is used to reconstruct the time of positronium formation. This review describes recent achievements in the translation of positronium imaging into clinics. The first measurements of positronium lifetime in humans with commercial PET scanners modernized to register triple coincidences are reported. The in vivo observations of differences in ortho-positronium lifetime between tumor and healthy tissues and between different oxygen concentrations are discussed. So far, the positronium lifetime measurements in humans were completed with clinically available ${^{68}\text{Ga}}$, ${^{82}\text{Rb}}$, and ${^{124}\text{I}}$ radionuclides. Status and challenges in developing positronium imaging on a way to a clinically useful procedure are presented and discussed.

physics.med-ph

Developing a PET/CT Foundation Model for Cross-Modal Anatomical and Functional Imaging

In oncology, Positron Emission Tomography-Computed Tomography (PET/CT) is widely used in cancer diagnosis, staging, and treatment monitoring, as it combines anatomical details from CT with functional metabolic activity and molecular marker expression information from PET. However, existing artificial intelligence-driven PET/CT analyses rely predominantly on task-specific models trained from scratch or on limited datasets, limiting their generalizability and robustness. To address this, we propose a foundation model approach specifically designed for multimodal PET/CT imaging. We introduce the Cross-Fraternal Twin Masked Autoencoder (FratMAE), a novel framework that effectively integrates whole-body anatomical and functional or molecular information. FratMAE employs separate Vision Transformer (ViT) encoders for PET and CT scans, along with cross-attention decoders that enable synergistic interactions between modalities during masked autoencoder training. Additionally, it incorporates textual metadata to enhance PET representation learning. By pre-training on PET/CT datasets, FratMAE captures intricate cross-modal relationships and global uptake patterns, achieving superior performance on downstream tasks and demonstrating its potential as a generalizable foundation model.

cs.CV

Positronium Lifetime Imaging with the Biograph Vision Quadra using 124I

Purpose: Measuring the ortho-positronium (oPs) lifetime in human tissue bears the potential of adding clinically relevant information about the tissue microenvironment to conventional positron emission tomography (PET). Through phantom measurements, we investigate the voxel-wise measurement of oPs lifetime using a commercial long-axial field-of-view (LAFOV) PET scanner. Methods: We prepared four samples with mixtures of Amberlite XAD4, a porous polymeric adsorbent, and water and added between 1.12 MBq and 1.44 MBq of $^{124}$I. The samples were scanned in two different setups: once with a couple of centimeters between each sample (15 minutes scan time) and once with all samples taped together (40 minutes scan time). For each scan, we determine the oPs lifetime for the full samples and at the voxel level. The voxel sizes under consideration are $10.0^3$ mm$^3$, $7.1^3$ mm$^3$ and $4.0^3$ mm$^3$. Results: Amberlite XAD4 allows the preparation of samples with distinct oPs lifetime. Using a Bayesian fitting procedure, the oPs lifetimes in the whole samples are $2.52 \pm 0.03$ ns, $2.37\pm 0.03$ ns, $2.27\pm0.04$ ns and $1.82\pm 0.02$ ns, respectively. The voxel-wise oPs lifetime fits showed that even with $4.0^3$ mm$^3$ voxels the samples are clearly distinguishable and a central voxels have good count statistics. However, the situation with the samples close together remains challenging with respect to the spatial distinction of regions with different oPs lifetimes. Conclusion: Our study shows that positronium lifetime imaging on a commercial LAFOV PET/CT should be feasible under clinical conditions using $^{124}$I.

physics.med-ph

Evaluation of Deep Learning-based Scatter Correction on a Long-axial Field-of-view PET scanner

Objective: Long-axial field-of-view (LAFOV) positron emission tomography (PET) systems allow higher sensitivity, with an increased number of detected lines of response induced by a larger angle of acceptance. However, this extended angle increases the number of multiple scatters and the scatter contribution within oblique planes. As scattering affects both quality and quantification of the reconstructed image, it is crucial to correct this effect with more accurate methods than the state-of-the-art single scatter simulation (SSS) that can reach its limits with such an extended field-of-view (FOV). In this work, which is an extension of our previous assessment of deep learning-based scatter estimation (DLSE) carried out on a conventional PET system, we aim to evaluate the DLSE method performance on LAFOV total-body PET. Approach: The proposed DLSE method based on a convolutional neural network (CNN) U-Net architecture uses emission and attenuation sinograms to estimate scatter sinogram. The network was trained from Monte-Carlo (MC) simulations of XCAT phantoms [18F]-FDG PET acquisitions using a Siemens Biograph Vision Quadra scanner model, with multiple morphologies and dose distributions. We firstly evaluated the method performance on simulated data in both sinogram and image domain by comparing it to the MC ground truth and SSS scatter sinograms. We then tested the method on seven [18F]-FDG and seven [18F]-PSMA clinical datasets, and compare it to SSS estimations. Results: DLSE showed superior accuracy on phantom data, greater robustness to patient size and dose variations compared to SSS, and better lesion contrast recovery. It also yielded promising clinical results, improving lesion contrasts in [18F]-FDG datasets and performing consistently with [18F]-PSMA datasets despite no training with [18F]-PSMA.

physics.med-ph

Dose-aware Diffusion Model for 3D PET Image Denoising: Multi-institutional Validation with Reader Study and Real Low-dose Data

Reducing scan times, radiation dose, and enhancing image quality for lower-performance scanners, are critical in low-dose PET imaging. Deep learning techniques have been investigated for PET image denoising. However, existing models have often resulted in compromised image quality when achieving low-count/low-dose PET and have limited generalizability to different image noise-levels, acquisition protocols, and patient populations. Recently, diffusion models have emerged as the new state-of-the-art generative model to generate high-quality samples and have demonstrated strong potential for medical imaging tasks. However, for low-dose PET imaging, existing diffusion models failed to generate consistent 3D reconstructions, unable to generalize across varying noise-levels, often produced visually-appealing but distorted image details, and produced images with biased tracer uptake. Here, we develop DDPET-3D, a dose-aware diffusion model for 3D low-dose PET imaging to address these challenges. Collected from 4 medical centers globally with different scanners and clinical protocols, we evaluated the proposed model using a total of 9,783 18F-FDG studies with low-dose levels ranging from 1% to 50%. With a cross-center, cross-scanner validation, the proposed DDPET-3D demonstrated its potential to generalize to different low-dose levels, different scanners, and different clinical protocols. As confirmed with reader studies performed by board-certified nuclear medicine physicians, experienced readers judged the images to be similar or superior to the full-dose images and previous DL baselines based on qualitative visual impression. Lesion-level quantitative accuracy was evaluated using a Monte Carlo simulation study and a lesion segmentation network. The presented results show the potential to achieve low-dose PET while maintaining image quality. Real low-dose scans was also included for evaluation.

eess.IV

LeqMod: Adaptable Lesion-Quantification-Consistent Modulation for Deep Learning Low-Count PET Image Denoising

Deep learning-based positron emission tomography (PET) image denoising offers the potential to reduce radiation exposure and scanning time by transforming low-count images into high-count equivalents. However, existing methods typically blur crucial details, leading to inaccurate lesion quantification. This paper proposes a lesion-perceived and quantification-consistent modulation (LeqMod) strategy for enhanced PET image denoising, via employing downstream lesion quantification analysis as auxiliary tools. The LeqMod is a plug-and-play design adaptable to a wide range of model architectures, modulating the sampling and optimization procedures of model training without adding any computational burden to the inference phase. Specifically, the LeqMod consists of two components, the lesion-perceived modulation (LeMod) and the multiscale quantification-consistent modulation (QuMod). The LeMod enhances lesion contrast and visibility by allocating higher sampling weights and stricter loss criteria to lesion-present samples determined by an auxiliary segmentation network than lesion-absent ones. The QuMod further emphasizes quantification accuracy for both the mean and maximum standardized uptake value (SUVmean and SUVmax) across multiscale sub-regions throughout the entire image, thereby reducing biases of denoised results relative to high-count references. Experiments conducted on large PET datasets from multiple centers and vendors, and varying noise levels demonstrated the LeqMod efficacy across various denoising frameworks. Compared to frameworks without LeqMod, the integration of LeqMod reduces the lesion SUVmax bias by 5.92% on average and increases the peak signal-to-noise ratio (PSNR) by 0.36 on average, when denoising images across participating sites.

eess.IV

Phantom study for 90Y post-treatment dosimetry with a long axial field-of-view PET/CT

Purpose: The physical properties of yttrium-90 (90Y) allow for imaging with positron emission tomography/computed tomography (PET/CT). The increased sensitivity of long axial field-of-view (LAFOV) PET/CT scanners possibly allows to overcome the small branching ratio for positron production from 90Y decays and to improve for the post-treatment dosimetry of 90Y of selective internal radiation therapy. Methods: For the challenging case of an image quality body phantom, we compare a full Monte Carlo (MC) dose calculation with the results from the two commercial software packages Simplicit90Y and Hermes. The voxel dosimetry module of Hermes relies on the 90Y images taken with a LAFOV PET/CT, while the MC and Simplicit90Y dose calculations are image independent. Results: The resulting doses from the MC calculation and Simplicit90Y agree well within the error margins. The image-based dose calculation with Hermes, however, consistently underestimates the dose. This is due to the mismatch of the activity distribution in the PET images and the size of the volume of interest. Furthermore, there are likely limitations of Hermes' dose calculation algorithm for 90Y. We found that only for the smallest phantom sphere there is a statistically significant dependence of the Hermes dose on the image reconstruction parameters and scan time. Conclusion: Our study shows that Simplicit90Y's local deposition model can provide a reliable dose estimate. On the other hand, the image based dose calculation requires further benchmarks and verification in order to take full advantage of LAFOV PET/CT systems.

physics.med-ph

FedFTN: Personalized Federated Learning with Deep Feature Transformation Network for Multi-institutional Low-count PET Denoising

Low-count PET is an efficient way to reduce radiation exposure and acquisition time, but the reconstructed images often suffer from low signal-to-noise ratio (SNR), thus affecting diagnosis and other downstream tasks. Recent advances in deep learning have shown great potential in improving low-count PET image quality, but acquiring a large, centralized, and diverse dataset from multiple institutions for training a robust model is difficult due to privacy and security concerns of patient data. Moreover, low-count PET data at different institutions may have different data distribution, thus requiring personalized models. While previous federated learning (FL) algorithms enable multi-institution collaborative training without the need of aggregating local data, addressing the large domain shift in the application of multi-institutional low-count PET denoising remains a challenge and is still highly under-explored. In this work, we propose FedFTN, a personalized federated learning strategy that addresses these challenges. FedFTN uses a local deep feature transformation network (FTN) to modulate the feature outputs of a globally shared denoising network, enabling personalized low-count PET denoising for each institution. During the federated learning process, only the denoising network's weights are communicated and aggregated, while the FTN remains at the local institutions for feature transformation. We evaluated our method using a large-scale dataset of multi-institutional low-count PET imaging data from three medical centers located across three continents, and showed that FedFTN provides high-quality low-count PET images, outperforming previous baseline FL reconstruction methods across all low-count levels at all three institutions.

eess.IV