Training end-to-end unrolled iterative neural networks for SPECT image reconstruction requires a memory-efficient forward-backward projector for efficient backpropagation. This paper describes an open-source, high performance Julia implementation of a SPECT forward-backward projector that supports memory-efficient backpropagation with an exact adjoint. Our Julia projector uses only ~5% of the memory of an existing Matlab-based projector. We compare unrolling a CNN-regularized expectation-maximization (EM) algorithm with end-to-end training using our Julia projector with other training methods such as gradient truncation (ignoring gradients involving the projector) and sequential training, using XCAT phantoms and virtual patient (VP) phantoms generated from SIMIND Monte Carlo (MC) simulations. Simulation results with two different radionuclides (90Y and 177Lu) show that: 1) For 177Lu XCAT phantoms and 90Y VP phantoms, training unrolled EM algorithm in end-to-end fashion with our Julia projector yields the best reconstruction quality compared to other training methods and OSEM, both qualitatively and quantitatively. For VP phantoms with 177Lu radionuclide, the reconstructed images using end-to-end training are in higher quality than using sequential training and OSEM, but are comparable with using gradient truncation. We also find there exists a trade-off between computational cost and reconstruction accuracy for different training methods. End-to-end training has the highest accuracy because the correct gradient is used in backpropagation; sequential training yields worse reconstruction accuracy, but is significantly faster and uses much less memory.
Image reconstruction in low-count PET is particularly challenging because gammas from natural radioactivity in Lu-based crystals cause high random fractions that lower the measurement signal-to-noise-ratio (SNR). In model-based image reconstruction (MBIR), using more iterations of an unregularized method may increase the noise, so incorporating regularization into the image reconstruction is desirable to control the noise. New regularization methods based on learned convolutional operators are emerging in MBIR. We modify the architecture of a variational neural network, BCD-Net, for PET MBIR, and demonstrate the efficacy of the trained BCD-Net using XCAT phantom data that simulates the low true coincidence count-rates with high random fractions typical for Y-90 PET patient imaging after Y-90 microsphere radioembolization. Numerical results show that the proposed BCD-Net significantly improves PET reconstruction performance compared to MBIR methods using non-trained regularizers, total variation (TV) and non-local means (NLM), and a non-MBIR method using a single forward pass deep neural network, U-Net. BCD-Net improved activity recovery for a hot sphere significantly and reduced noise, whereas non-trained regularizers had a trade-off between noise and quantification. BCD-Net improved CNR and RMSE by 43.4% (85.7%) and 12.9% (29.1%) compared to TV (NLM) regularized MBIR. Moreover, whereas the image reconstruction results show that the non-MBIR U-Net over-fits the training data, BCD-Net successfully generalizes to data that differs from training data. Improvements were also demonstrated for the clinically relevant phantom measurement data where we used training and testing datasets having very different activity distribution and count-level.