End-to-End PET Image Reconstruction via a Posterior-Mean Diffusion Model

Positron Emission Tomography (PET) is a functional imaging modality that enables the visualization of biochemical and physiological processes across various tissues. Recently, deep learning (DL)-based methods have demonstrated significant progress in directly mapping sinograms to PET images. However, regression-based DL models often yield overly smoothed reconstructions lacking of details (i.e., low distortion, low perceptual quality), whereas GAN-based and likelihood-based posterior sampling models tend to introduce undesirable artifacts in predictions (i.e., high distortion, high perceptual quality), limiting their clinical applicability. To achieve a robust perception-distortion tradeoff, we propose Posterior-Mean Denoising Diffusion Model (PMDM-PET), a novel approach that builds upon a recently established mathematical theory to explore the closed-form expression of perception-distortion function in diffusion model space for PET image reconstruction from sinograms. Specifically, PMDM-PET first obtained posterior-mean PET predictions under minimum mean square error (MSE), then optimally transports the distribution of them to the ground-truth PET images distribution. Experimental results demonstrate that PMDM-PET not only generates realistic PET images with possible minimum distortion and optimal perceptual quality but also outperforms five recent state-of-the-art (SOTA) DL baselines in both qualitative visual inspection and quantitative pixel-wise metrics PSNR (dB)/SSIM/NRMSE.