MR-Guided Kernel EM Reconstruction for Reduced Dose PET Imaging.

PET image reconstruction is highly susceptible to the impact of Poisson noise, and if shorter acquisition times or reduced injected doses are used, the noisy PET data become even more limiting. The recent development of kernel expectation maximisation (KEM) is a simple way to reduce noise in PET images, and we show in this work that impressive dose reduction can be achieved when the kernel method is used with MR-derived kernels. The kernel method is shown to surpass maximum likelihood expectation maximisation (MLEM) for the reconstruction of low-count datasets (corresponding to those obtained at reduced injected doses) producing visibly clearer reconstructions for unsmoothed and smoothed images, at all count levels. The kernel EM reconstruction of 10% of the data had comparable whole brain voxel-level error measures to the MLEM reconstruction of 100% of the data (for simulated data, at 100 iterations). For regional metrics, the kernel method at reduced dose levels attained a reduced coefficient of variation and more accurate mean values compared to MLEM. However, the advances provided by the kernel method are at the expense of possible over-smoothing of features unique to the PET data. Further assessment on clinical data is required to determine the level of dose reduction that can be routinely achieved using the kernel method, whilst maintaining the diagnostic utility of the scan.