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Myocardial perfusion imaging using SPECT is widely utilized to diagnose coronary artery diseases, but image quality can be negatively affected in low-dose and few-view acquisition settings. Although various deep learning methods have been introduced to improve image quality from low-dose or few-view SPECT data, previous approaches often fail to generalize across different acquisition settings, limiting their applicability in reality. This work introduced DiffSPECT-3D, a diffusion framework for 3D cardiac SPECT imaging that effectively adapts to different acquisition settings without requiring further network re-training or fine-tuning. Using both image and projection data, a consistency strategy is proposed to ensure that diffusion sampling at each step aligns with the low-dose/few-view projection measurements, the image data, and the scanner geometry, thus enabling generalization to different low-dose/few-view settings. Incorporating anatomical spatial information from CT and total variation constraint, we proposed a 2.5D conditional strategy to allow the DiffSPECT-3D to observe 3D contextual information from the entire image volume, addressing the 3D memory issues in diffusion model. We extensively evaluated the proposed method on 1,325 clinical 99mTc tetrofosmin stress/rest studies from 795 patients. Each study was reconstructed into 5 different low-count and 5 different few-view levels for model evaluations, ranging from 1% to 50% and from 1 view to 9 view, respectively. Validated against cardiac catheterization results and diagnostic comments from nuclear cardiologists, the presented results show the potential to achieve low-dose and few-view SPECT imaging without compromising clinical performance. Additionally, DiffSPECT-3D could be directly applied to full-dose SPECT images to further improve image quality, especially in a low-dose stress-first cardiac SPECT imaging protocol., Comment: 13 pages, 6 figures, 2 tables. Paper under review. Oral presentation at IEEE MIC 2024

Rb-82 is a radioactive isotope widely used for cardiac PET imaging. Despite numerous benefits of 82-Rb, there are several factors that limits its image quality and quantitative accuracy. First, the short half-life of 82-Rb results in noisy dynamic frames. Low signal-to-noise ratio would result in inaccurate and biased image quantification. Noisy dynamic frames also lead to highly noisy parametric images. The noise levels also vary substantially in different dynamic frames due to radiotracer decay and short half-life. Existing denoising methods are not applicable for this task due to the lack of paired training inputs/labels and inability to generalize across varying noise levels. Second, 82-Rb emits high-energy positrons. Compared with other tracers such as 18-F, 82-Rb travels a longer distance before annihilation, which negatively affect image spatial resolution. Here, the goal of this study is to propose a self-supervised method for simultaneous (1) noise-aware dynamic image denoising and (2) positron range correction for 82-Rb cardiac PET imaging. Tested on a series of PET scans from a cohort of normal volunteers, the proposed method produced images with superior visual quality. To demonstrate the improvement in image quantification, we compared image-derived input functions (IDIFs) with arterial input functions (AIFs) from continuous arterial blood samples. The IDIF derived from the proposed method led to lower AUC differences, decreasing from 11.09% to 7.58% on average, compared to the original dynamic frames. The proposed method also improved the quantification of myocardium blood flow (MBF), as validated against 15-O-water scans, with mean MBF differences decreased from 0.43 to 0.09, compared to the original dynamic frames. We also conducted a generalizability experiment on 37 patient scans obtained from a different country using a different scanner., Comment: 15 Pages, 10 Figures, 5 tables. Paper Under review. Oral Presentation at IEEE MIC 2023

Positron Emission Tomography (PET) is an important clinical imaging tool but inevitably introduces radiation hazards to patients and healthcare providers. Reducing the tracer injection dose and eliminating the CT acquisition for attenuation correction can reduce the overall radiation dose, but often results in PET with high noise and bias. Thus, it is desirable to develop 3D methods to translate the non-attenuation-corrected low-dose PET (NAC-LDPET) into attenuation-corrected standard-dose PET (AC-SDPET). Recently, diffusion models have emerged as a new state-of-the-art deep learning method for image-to-image translation, better than traditional CNN-based methods. However, due to the high computation cost and memory burden, it is largely limited to 2D applications. To address these challenges, we developed a novel 2.5D Multi-view Averaging Diffusion Model (MADM) for 3D image-to-image translation with application on NAC-LDPET to AC-SDPET translation. Specifically, MADM employs separate diffusion models for axial, coronal, and sagittal views, whose outputs are averaged in each sampling step to ensure the 3D generation quality from multiple views. To accelerate the 3D sampling process, we also proposed a strategy to use the CNN-based 3D generation as a prior for the diffusion model. Our experimental results on human patient studies suggested that MADM can generate high-quality 3D translation images, outperforming previous CNN-based and Diffusion-based baseline methods., Comment: 15 pages, 7 figures

Reducing scan times, radiation dose, and enhancing image quality, especially for lower-performance scanners, are critical in low-count/low-dose PET imaging. Deep learning (DL) techniques have been investigated for PET image denoising. However, existing models have often resulted in compromised image quality when achieving low-dose PET and have limited generalizability to different image noise-levels, acquisition protocols, and patient populations. Recently, diffusion models have emerged as the new state-of-the-art generative model to generate high-quality samples and have demonstrated strong potential for medical imaging tasks. However, for low-dose PET imaging, existing diffusion models failed to generate consistent 3D reconstructions, unable to generalize across varying noise-levels, often produced visually-appealing but distorted image details, and produced images with biased tracer uptake. Here, we develop DDPET-3D, a dose-aware diffusion model for 3D low-dose PET imaging to address these challenges. Collected from 4 medical centers globally with different scanners and clinical protocols, we extensively evaluated the proposed model using a total of 9,783 18F-FDG studies (1,596 patients) with low-dose/low-count levels ranging from 1% to 50%. With a cross-center, cross-scanner validation, the proposed DDPET-3D demonstrated its potential to generalize to different low-dose levels, different scanners, and different clinical protocols. As confirmed with reader studies performed by nuclear medicine physicians, experienced readers judged the images to be similar to or superior to the full-dose images and previous DL baselines based on qualitative visual impression. The presented results show the potential of achieving low-dose PET while maintaining image quality. Lastly, a group of real low-dose scans was also included for evaluation to demonstrate the clinical potential of DDPET-3D., Comment: 15 Pages, 15 Figures, 5 Tables. Paper under review. First-place Freek J. Beekman Young Investigator Award at SNMMI 2024. arXiv admin note: substantial text overlap with arXiv:2311.04248

Inter-frame motion in dynamic cardiac positron emission tomography (PET) using rubidium-82 (82-Rb) myocardial perfusion imaging impacts myocardial blood flow (MBF) quantification and the diagnosis accuracy of coronary artery diseases. However, the high cross-frame distribution variation due to rapid tracer kinetics poses a considerable challenge for inter-frame motion correction, especially for early frames where intensity-based image registration techniques often fail. To address this issue, we propose a novel method called Temporally and Anatomically Informed Generative Adversarial Network (TAI-GAN) that utilizes an all-to-one mapping to convert early frames into those with tracer distribution similar to the last reference frame. The TAI-GAN consists of a feature-wise linear modulation layer that encodes channel-wise parameters generated from temporal information and rough cardiac segmentation masks with local shifts that serve as anatomical information. Our proposed method was evaluated on a clinical 82-Rb PET dataset, and the results show that our TAI-GAN can produce converted early frames with high image quality, comparable to the real reference frames. After TAI-GAN conversion, the motion estimation accuracy and subsequent myocardial blood flow (MBF) quantification with both conventional and deep learning-based motion correction methods were improved compared to using the original frames., Comment: Under revision at Medical Image Analysis

Low-dose PET offers a valuable means of minimizing radiation exposure in PET imaging. However, the prevalent practice of employing additional CT scans for generating attenuation maps (u-map) for PET attenuation correction significantly elevates radiation doses. To address this concern and further mitigate radiation exposure in low-dose PET exams, we propose POUR-Net - an innovative population-prior-aided over-under-representation network that aims for high-quality attenuation map generation from low-dose PET. First, POUR-Net incorporates an over-under-representation network (OUR-Net) to facilitate efficient feature extraction, encompassing both low-resolution abstracted and fine-detail features, for assisting deep generation on the full-resolution level. Second, complementing OUR-Net, a population prior generation machine (PPGM) utilizing a comprehensive CT-derived u-map dataset, provides additional prior information to aid OUR-Net generation. The integration of OUR-Net and PPGM within a cascade framework enables iterative refinement of $\mu$-map generation, resulting in the production of high-quality $\mu$-maps. Experimental results underscore the effectiveness of POUR-Net, showing it as a promising solution for accurate CT-free low-count PET attenuation correction, which also surpasses the performance of previous baseline methods., Comment: 10 pages, 5 figures

Single-Photon Emission Computed Tomography (SPECT) is widely applied for the diagnosis of coronary artery diseases. Low-dose (LD) SPECT aims to minimize radiation exposure but leads to increased image noise. Limited-view (LV) SPECT, such as the latest GE MyoSPECT ES system, enables accelerated scanning and reduces hardware expenses but degrades reconstruction accuracy. Additionally, Computed Tomography (CT) is commonly used to derive attenuation maps ($\mu$-maps) for attenuation correction (AC) of cardiac SPECT, but it will introduce additional radiation exposure and SPECT-CT misalignments. Although various methods have been developed to solely focus on LD denoising, LV reconstruction, or CT-free AC in SPECT, the solution for simultaneously addressing these tasks remains challenging and under-explored. Furthermore, it is essential to explore the potential of fusing cross-domain and cross-modality information across these interrelated tasks to further enhance the accuracy of each task. Thus, we propose a Dual-Domain Coarse-to-Fine Progressive Network (DuDoCFNet), a multi-task learning method for simultaneous LD denoising, LV reconstruction, and CT-free $\mu$-map generation of cardiac SPECT. Paired dual-domain networks in DuDoCFNet are cascaded using a multi-layer fusion mechanism for cross-domain and cross-modality feature fusion. Two-stage progressive learning strategies are applied in both projection and image domains to achieve coarse-to-fine estimations of SPECT projections and CT-derived $\mu$-maps. Our experiments demonstrate DuDoCFNet's superior accuracy in estimating projections, generating $\mu$-maps, and AC reconstructions compared to existing single- or multi-task learning methods, under various iterations and LD levels. The source code of this work is available at https://github.com/XiongchaoChen/DuDoCFNet-MultiTask., Comment: 11 Pages, 10 figures, 4 tables

As PET imaging is accompanied by substantial radiation exposure and cancer risk, reducing radiation dose in PET scans is an important topic. Recently, diffusion models have emerged as the new state-of-the-art generative model to generate high-quality samples and have demonstrated strong potential for various tasks in medical imaging. However, it is difficult to extend diffusion models for 3D image reconstructions due to the memory burden. Directly stacking 2D slices together to create 3D image volumes would results in severe inconsistencies between slices. Previous works tried to either applying a penalty term along the z-axis to remove inconsistencies or reconstructing the 3D image volumes with 2 pre-trained perpendicular 2D diffusion models. Nonetheless, these previous methods failed to produce satisfactory results in challenging cases for PET image denoising. In addition to administered dose, the noise-levels in PET images are affected by several other factors in clinical settings, such as scan time, patient size, and weight, etc. Therefore, a method to simultaneously denoise PET images with different noise-levels is needed. Here, we proposed a dose-aware diffusion model for 3D low-dose PET imaging (DDPET) to address these challenges. The proposed DDPET method was tested on 295 patients from three different medical institutions globally with different low-dose levels. These patient data were acquired on three different commercial PET scanners, including Siemens Vision Quadra, Siemens mCT, and United Imaging Healthcare uExplorere. The proposed method demonstrated superior performance over previously proposed diffusion models for 3D imaging problems as well as models proposed for noise-aware medical image denoising. Code is available at: xxx., Comment: Paper under review. 12 pages, 7 figures

The rapid tracer kinetics of rubidium-82 ($^{82}$Rb) and high variation of cross-frame distribution in dynamic cardiac positron emission tomography (PET) raise significant challenges for inter-frame motion correction, particularly for the early frames where conventional intensity-based image registration techniques are not applicable. Alternatively, a promising approach utilizes generative methods to handle the tracer distribution changes to assist existing registration methods. To improve frame-wise registration and parametric quantification, we propose a Temporally and Anatomically Informed Generative Adversarial Network (TAI-GAN) to transform the early frames into the late reference frame using an all-to-one mapping. Specifically, a feature-wise linear modulation layer encodes channel-wise parameters generated from temporal tracer kinetics information, and rough cardiac segmentations with local shifts serve as the anatomical information. We validated our proposed method on a clinical $^{82}$Rb PET dataset and found that our TAI-GAN can produce converted early frames with high image quality, comparable to the real reference frames. After TAI-GAN conversion, motion estimation accuracy and clinical myocardial blood flow (MBF) quantification were improved compared to using the original frames. Our code is published at https://github.com/gxq1998/TAI-GAN., Comment: Accepted by Simulation and Synthesis in Medical Imaging (SASHIMI 2023, MICCAI workshop), preprint version

Cardiovascular disease (CVD) is the leading cause of death worldwide, and myocardial perfusion imaging using SPECT has been widely used in the diagnosis of CVDs. The GE 530/570c dedicated cardiac SPECT scanners adopt a stationary geometry to simultaneously acquire 19 projections to increase sensitivity and achieve dynamic imaging. However, the limited amount of angular sampling negatively affects image quality. Deep learning methods can be implemented to produce higher-quality images from stationary data. This is essentially a few-view imaging problem. In this work, we propose a novel 3D transformer-based dual-domain network, called TIP-Net, for high-quality 3D cardiac SPECT image reconstructions. Our method aims to first reconstruct 3D cardiac SPECT images directly from projection data without the iterative reconstruction process by proposing a customized projection-to-image domain transformer. Then, given its reconstruction output and the original few-view reconstruction, we further refine the reconstruction using an image-domain reconstruction network. Validated by cardiac catheterization images, diagnostic interpretations from nuclear cardiologists, and defect size quantified by an FDA 510(k)-cleared clinical software, our method produced images with higher cardiac defect contrast on human studies compared with previous baseline methods, potentially enabling high-quality defect visualization using stationary few-view dedicated cardiac SPECT scanners., Comment: Early accepted by MICCAI 2023 in Vancouver, Canada

Myocardial perfusion imaging (MPI) by single-photon emission computed tomography (SPECT) is widely applied for the diagnosis of cardiovascular diseases. Reducing the dose of the injected tracer is essential for lowering the patient's radiation exposure, but it will lead to increased image noise. Additionally, the latest dedicated cardiac SPECT scanners typically acquire projections in fewer angles using fewer detectors to reduce hardware expenses, potentially resulting in lower reconstruction accuracy. To overcome these challenges, we propose a dual-domain iterative network for end-to-end joint denoising and reconstruction from low-dose and few-angle projections of cardiac SPECT. The image-domain network provides a prior estimate for the projection-domain networks. The projection-domain primary and auxiliary modules are interconnected for progressive denoising and few-angle reconstruction. Adaptive Data Consistency (ADC) modules improve prediction accuracy by efficiently fusing the outputs of the primary and auxiliary modules. Experiments using clinical MPI data show that our proposed method outperforms existing image-, projection-, and dual-domain techniques, producing more accurate projections and reconstructions. Ablation studies confirm the significance of the image-domain prior estimate and ADC modules in enhancing network performance., Comment: 13 pages, 8 figures, 3 tables

Single-Photon Emission Computed Tomography (SPECT) is widely applied for the diagnosis of ischemic heart diseases. Low-dose (LD) SPECT aims to minimize radiation exposure but leads to increased image noise. Limited-angle (LA) SPECT enables faster scanning and reduced hardware costs but results in lower reconstruction accuracy. Additionally, computed tomography (CT)-derived attenuation maps ($\mu$-maps) are commonly used for SPECT attenuation correction (AC), but it will cause extra radiation exposure and SPECT-CT misalignments. In addition, the majority of SPECT scanners in the market are not hybrid SPECT/CT scanners. Although various deep learning methods have been introduced to separately address these limitations, the solution for simultaneously addressing these challenges still remains highly under-explored and challenging. To this end, we propose a Cross-domain Iterative Network (CDI-Net) for simultaneous denoising, LA reconstruction, and CT-free AC in cardiac SPECT. In CDI-Net, paired projection- and image-domain networks are end-to-end connected to fuse the emission and anatomical information across domains and iterations. Adaptive Weight Recalibrators (AWR) adjust the multi-channel input features to enhance prediction accuracy. Our experiments using clinical data showed that CDI-Net produced more accurate $\mu$-maps, projections, and reconstructions compared to existing approaches that addressed each task separately. Ablation studies demonstrated the significance of cross-domain and cross-iteration connections, as well as AWR, in improving the reconstruction performance., Comment: 12 pages, 7 figures, 4 tables

Magnetic resonance imaging (MRI) is widely employed for diagnostic tests in neurology. However, the utility of MRI is largely limited by its long acquisition time. Acquiring fewer k-space data in a sparse manner is a potential solution to reducing the acquisition time, but it can lead to severe aliasing reconstruction artifacts. In this paper, we present a novel Dual-Domain Cross-Iteration Squeeze and Excitation Network (DD-CISENet) for accelerated sparse MRI reconstruction. The information of k-spaces and MRI images can be iteratively fused and maintained using the Cross-Iteration Residual connection (CIR) structures. This study included 720 multi-coil brain MRI cases adopted from the open-source fastMRI Dataset. Results showed that the average reconstruction error by DD-CISENet was 2.28 $\pm$ 0.57%, which outperformed existing deep learning methods including image-domain prediction (6.03 $\pm$ 1.31, p < 0.001), k-space synthesis (6.12 $\pm$ 1.66, p < 0.001), and dual-domain feature fusion approaches (4.05 $\pm$ 0.88, p < 0.001)., Comment: Accepted at MIDL 2023

As PET imaging is accompanied by substantial radiation exposure and cancer risk, reducing radiation dose in PET scans is an important topic. However, low-count PET scans often suffer from high image noise, which can negatively impact image quality and diagnostic performance. Recent advances in deep learning have shown great potential for recovering underlying signal from noisy counterparts. However, neural networks trained on a specific noise level cannot be easily generalized to other noise levels due to different noise amplitude and variances. To obtain optimal denoised results, we may need to train multiple networks using data with different noise levels. But this approach may be infeasible in reality due to limited data availability. Denoising dynamic PET images presents additional challenge due to tracer decay and continuously changing noise levels across dynamic frames. To address these issues, we propose a Unified Noise-aware Network (UNN) that combines multiple sub-networks with varying denoising power to generate optimal denoised results regardless of the input noise levels. Evaluated using large-scale data from two medical centers with different vendors, presented results showed that the UNN can consistently produce promising denoised results regardless of input noise levels, and demonstrate superior performance over networks trained on single noise level data, especially for extremely low-count data., Comment: 10 Pages, 6 Figures, 1 table. Paper under review

Low-count PET is an efficient way to reduce radiation exposure and acquisition time, but the reconstructed images often suffer from low signal-to-noise ratio (SNR), thus affecting diagnosis and other downstream tasks. Recent advances in deep learning have shown great potential in improving low-count PET image quality, but acquiring a large, centralized, and diverse dataset from multiple institutions for training a robust model is difficult due to privacy and security concerns of patient data. Moreover, low-count PET data at different institutions may have different data distribution, thus requiring personalized models. While previous federated learning (FL) algorithms enable multi-institution collaborative training without the need of aggregating local data, addressing the large domain shift in the application of multi-institutional low-count PET denoising remains a challenge and is still highly under-explored. In this work, we propose FedFTN, a personalized federated learning strategy that addresses these challenges. FedFTN uses a local deep feature transformation network (FTN) to modulate the feature outputs of a globally shared denoising network, enabling personalized low-count PET denoising for each institution. During the federated learning process, only the denoising network's weights are communicated and aggregated, while the FTN remains at the local institutions for feature transformation. We evaluated our method using a large-scale dataset of multi-institutional low-count PET imaging data from three medical centers located across three continents, and showed that FedFTN provides high-quality low-count PET images, outperforming previous baseline FL reconstruction methods across all low-count levels at all three institutions., Comment: 13 pages, 6 figures, Accepted at Medical Image Analysis Journal (MedIA)

Patient motion during PET is inevitable. Its long acquisition time not only increases the motion and the associated artifacts but also the patient's discomfort, thus PET acceleration is desirable. However, accelerating PET acquisition will result in reconstructed images with low SNR, and the image quality will still be degraded by motion-induced artifacts. Most of the previous PET motion correction methods are motion type specific that require motion modeling, thus may fail when multiple types of motion present together. Also, those methods are customized for standard long acquisition and could not be directly applied to accelerated PET. To this end, modeling-free universal motion correction reconstruction for accelerated PET is still highly under-explored. In this work, we propose a novel deep learning-aided motion correction and reconstruction framework for accelerated PET, called Fast-MC-PET. Our framework consists of a universal motion correction (UMC) and a short-to-long acquisition reconstruction (SL-Reon) module. The UMC enables modeling-free motion correction by estimating quasi-continuous motion from ultra-short frame reconstructions and using this information for motion-compensated reconstruction. Then, the SL-Recon converts the accelerated UMC image with low counts to a high-quality image with high counts for our final reconstruction output. Our experimental results on human studies show that our Fast-MC-PET can enable 7-fold acceleration and use only 2 minutes acquisition to generate high-quality reconstruction images that outperform/match previous motion correction reconstruction methods using standard 15 minutes long acquisition data., Comment: Accepted at Information Processing in Medical Imaging (IPMI 2023)

Magnetic resonance imaging (MRI) is one of the most commonly applied tests in neurology and neurosurgery. However, the utility of MRI is largely limited by its long acquisition time, which might induce many problems including patient discomfort and motion artifacts. Acquiring fewer k-space sampling is a potential solution to reducing the total scanning time. However, it can lead to severe aliasing reconstruction artifacts and thus affect the clinical diagnosis. Nowadays, deep learning has provided new insights into the sparse reconstruction of MRI. In this paper, we present a new approach to this problem that iteratively fuses the information of k-space and MRI images using novel dual Squeeze-Excitation Networks and Cross-Iteration Residual Connections. This study included 720 clinical multi-coil brain MRI cases adopted from the open-source deidentified fastMRI Dataset. 8-folder downsampling rate was applied to generate the sparse k-space. Results showed that the average reconstruction error over 120 testing cases by our proposed method was 2.28%, which outperformed the existing image-domain prediction (6.03%, p<0.001), k-space synthesis (6.12%, p<0.001), and dual-domain feature fusion (4.05%, p<0.001)., Comment: 4 pages, 5 figures, 2 tables

In nuclear imaging, limited resolution causes partial volume effects (PVEs) that affect image sharpness and quantitative accuracy. Partial volume correction (PVC) methods incorporating high-resolution anatomical information from CT or MRI have been demonstrated to be effective. However, such anatomical-guided methods typically require tedious image registration and segmentation steps. Accurately segmented organ templates are also hard to obtain, particularly in cardiac SPECT imaging, due to the lack of hybrid SPECT/CT scanners with high-end CT and associated motion artifacts. Slight mis-registration/mis-segmentation would result in severe degradation in image quality after PVC. In this work, we develop a deep-learning-based method for fast cardiac SPECT PVC without anatomical information and associated organ segmentation. The proposed network involves a densely-connected multi-dimensional dynamic mechanism, allowing the convolutional kernels to be adapted based on the input images, even after the network is fully trained. Intramyocardial blood volume (IMBV) is introduced as an additional clinical-relevant loss function for network optimization. The proposed network demonstrated promising performance on 28 canine studies acquired on a GE Discovery NM/CT 570c dedicated cardiac SPECT scanner with a 64-slice CT using Technetium-99m-labeled red blood cells. This work showed that the proposed network with densely-connected dynamic mechanism produced superior results compared with the same network without such mechanism. Results also showed that the proposed network without anatomical information could produce images with statistically comparable IMBV measurements to the images generated by anatomical-guided PVC methods, which could be helpful in clinical translation., Comment: 12 pages, 11 figures. Accepted for publication at IEEE Transactions on Medical Imaging

Single-photon emission computed tomography (SPECT) is a widely applied imaging approach for diagnosis of coronary artery diseases. Attenuation maps (u-maps) derived from computed tomography (CT) are utilized for attenuation correction (AC) to improve diagnostic accuracy of cardiac SPECT. However, SPECT and CT are obtained sequentially in clinical practice, which potentially induces misregistration between the two scans. Convolutional neural networks (CNN) are powerful tools for medical image registration. Previous CNN-based methods for cross-modality registration either directly concatenated two input modalities as an early feature fusion or extracted image features using two separate CNN modules for a late fusion. These methods do not fully extract or fuse the cross-modality information. Besides, deep-learning-based rigid registration of cardiac SPECT and CT-derived u-maps has not been investigated before. In this paper, we propose a Dual-Branch Squeeze-Fusion-Excitation (DuSFE) module for the registration of cardiac SPECT and CT-derived u-maps. DuSFE fuses the knowledge from multiple modalities to recalibrate both channel-wise and spatial features for each modality. DuSFE can be embedded at multiple convolutional layers to enable feature fusion at different spatial dimensions. Our studies using clinical data demonstrated that a network embedded with DuSFE generated substantial lower registration errors and therefore more accurate AC SPECT images than previous methods., Comment: 10 pages, 4 figures, accepted at MICCAI 2022