Direct synthetic computed tomography (CT) generation from positron emission tomography (PET) plays a crucial role in PET attenuation correction, yet providing detailed structural information to compensate for functional imaging. Compared to the widely used PET/CT and indirect PET/MR-CT, the direct PET-to-CT translation method (denoted as PET-to-CT) offers several advantages: 1) The CT required for PET-to-CT is directly obtained from PET, thereby avoiding the intermediate errors generated in the inter-step processes of multimodal scanning in PET/CT and PET/MR-CT. 2) Furthermore, direct PET-to-CT eliminates the requirement for supplementary imaging equipment, thereby reducing complexity and scan duration in contrast to PET/CT and PET/MR-CT imaging. Thus, direct PET-to-CT is highly promising for clinical applications. However, it faces challenges, including spatial resolution mismatches between PET and CT, as well as voxel-wise semantic differences arising from functional and structural imaging. To address these challenges, this paper proposes a 2D hierarchical method called S2SCT (Slice-to-Slice Continual Transformer)-SA (Segmentation-aware) Network. It uses a slice-continual network to acquire semantic transformation knowledge from each PET slice to a CT slice, facilitating the conversion between functional and structural imaging domains. Subsequently, the segmentation-aware network is designed to futher capture spatial correlations both between slices and within slice, resulting in improved CT spatial resolution. The experiment results demonstrate that our proposed method outperforms mainstream methods in both CT generation and attenuation correction, as evidenced by both visual results and metric values.
Ge et al. (Thu,) studied this question.