Feasibility of Deep Learning–Based PET/MR Attenuation Correction in the Pelvis Using Only Diagnostic MR Images

This study evaluated the feasibility of using only diagnostically relevant magnetic resonance (MR) images together with deep learning for positron emission tomography (PET)/MR attenuation correction (deepMRAC) in the pelvis. Such an approach could eliminate dedicated MRAC sequences that have limited diagnostic utility but can substantially lengthen acquisition times for multibed position scans. We used axial T2 and T1 LAVA Flex magnetic resonance imaging images that were acquired for diagnostic purposes as inputs to a 3D deep convolutional neural network. The network was trained to produce a discretized (air, water, fat, and bone) substitute computed tomography (CT) (CT(sub)). Discretized (CT(ref-discrete)) and continuously valued (CT(ref)) reference CT images were created to serve as ground truth for network training and attenuation correction, respectively. Training was performed with data from 12 subjects. CT(sub), CT(ref), and the system MRAC were used for PET/MR attenuation correction, and quantitative PET values of the resulting images were compared in 6 test subjects. Overall, the network produced CT(sub) with Dice coefficients of 0.79 ± 0.03 for cortical bone, 0.98 ± 0.01 for soft tissue (fat: 0.94 ± 0.0; water: 0.88 ± 0.02), and 0.49 ± 0.17 for bowel gas when compared with CT(ref-discrete). The root mean square error of the whole PET image was 4.9% by using deepMRAC and 11.6% by using the system MRAC. In evaluating 16 soft tissue lesions, the distribution of errors for maximum standardized uptake value was significantly narrower using deepMRAC (−1.0% ± 1.3%) than using system MRAC method (0.0% ± 6.4%) according to the Brown–Forsy the test (P < .05). These results indicate that improved PET/MR attenuation correction can be achieved in the pelvis using only diagnostically relevant MR images.