Using deep learning methods to shorten acquisition time in children's renal cortical imaging

Purpose This study evaluates the capability of diffusion-based generative models to reconstruct diagnostic-quality renal cortical images from reduced-acquisition-time pediatric 99mTc-DMSA scintigraphy. Materials and Methods A prospective study was conducted on 99mTc-DMSA scintigraphic data from consecutive pediatric patients with suspected urinary tract infections (UTIs) acquired between November 2023 and October 2024. A diffusion model SR3 was trained to reconstruct standard-quality images from simulated reduced-count data. Performance was benchmarked against U-Net, U2-Net, Restormer, and a Poisson-based variant of SR3 (PoissonSR3). Quantitative assessment employed peak signal-to-noise ratio (PSNR), structural similarity index (SSIM), Fr&eacutechet inception distance (FID), and learned perceptual image patch similarity (LPIPS). Renal contrast and anatomic fidelity were assessed using the target-to-background ratio (TBR) and the Dice similarity coefficient respectively. Wilcoxon signed-rank tests were used for statistical analysis. Results The training cohort comprised 94 participants (mean age 5.16±3.90 years; 48 male) with corresponding Poisson-downsampled images, while the test cohort included 36 patients (mean age 6.39 ± 3.16 years; 14 male). SR3 outperformed all models, achieving the highest PSNR (30.976 ± 2.863, P < .0001), FID(25.687 ± 16.223, P < .001), and LPIPS (0.055 ± 0.022, P < .001). Further, SR3 maintained excellent renal contrast (TBR: left kidney 7.33 ± 2.176; right kidney 7.156 ± 1.808) and anatomical consistency (Dice coefficient: left kidney 0.749 ± 0.200; right kidney 0.745 ± 0.176), representing significant improvements over the fast scan (all P < .001). While Restormer, U-Net, and PoissonSR3 showed statistically significant improvements accross all metrics, U2-Net exhibited limited improvement restricted to SSIM and left kidney TBR (P < .001). Conclusion SR3 enables high-quality reconstruction of 99mTc-DMSA images from 4-fold accelerated acquisitions, demonstrating potential for substantial reduction in imaging duration while preserving both diagnostic image quality and renal anatomical integrity.