# Score-based Generative Diffusion Models to Synthesize Full-dose FDG Brain PET from MRI in Epilepsy Patients

arXiv: https://arxiv.org/abs/2506.11297 · HTML: https://mlsanity.com/paper/2506.11297/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical imaging and segmentation, one of 14 directions in Diffusion models.
- Builds on 12 of its 39 references that are in the map.
- First posted on arXiv 12 Jun 2025.

## Placed in

- Diffusion models / [Medical imaging and segmentation](https://mlsanity.com/diffusion/medical-imaging-and-segmentation/)

## Builds on (most cited first, 12 of 12)

- [Score-Based Generative Modeling through Stochastic Differential Equations](https://mlsanity.com/paper/2011.13456/) (2020)
- [Elucidating the Design Space of Diffusion-Based Generative Models](https://mlsanity.com/paper/2206.00364/) (2022)
- [DPM-Solver: A Fast ODE Solver for Diffusion Probabilistic Model Sampling in Around 10 Steps](https://mlsanity.com/paper/2206.00927/) (2022)
- [Consistency Models](https://mlsanity.com/paper/2303.01469/) (2023)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [MedGAN: Medical Image Translation using GANs](https://mlsanity.com/paper/1806.06397/) (2018)
- [Conversion Between CT and MRI Images Using Diffusion and Score-Matching Models](https://mlsanity.com/paper/2209.12104/) (2022)
- [PET image denoising based on denoising diffusion probabilistic models](https://mlsanity.com/paper/2209.06167/) (2022)
- [Fast-DDPM: Fast Denoising Diffusion Probabilistic Models for Medical Image-to-Image Generation](https://mlsanity.com/paper/2405.14802/) (2024)
- [Score-Based Generative Models for PET Image Reconstruction](https://mlsanity.com/paper/2308.14190/) (2023)
- [Slice-Consistent 3D Volumetric Brain CT-to-MRI Translation with 2D Brownian Bridge Diffusion Model](https://mlsanity.com/paper/2407.05059/) (2024)
- [MRI to FDG-PET: Cross-Modal Synthesis Using 3D U-Net For Multi-Modal Alzheimer's Classification](https://mlsanity.com/paper/1807.10111/) (2018)

## Abstract (arXiv)

Fluorodeoxyglucose (FDG) PET to evaluate patients with epilepsy is one of the most common applications for simultaneous PET/MRI, given the need to image both brain structure and metabolism, but is suboptimal due to the radiation dose in this young population. Little work has been done synthesizing diagnostic quality PET images from MRI data or MRI data with ultralow-dose PET using advanced generative AI methods, such as diffusion models, with attention to clinical evaluations tailored for the epilepsy population. Here we compared the performance of diffusion- and non-diffusion-based deep learning models for the MRI-to-PET image translation task for epilepsy imaging using simultaneous PET/MRI in 52 subjects (40 train/2 validate/10 hold-out test). We tested three different models: 2 score-based generative diffusion models (SGM-Karras Diffusion [SGM-KD] and SGM-variance preserving [SGM-VP]) and a Transformer-Unet. We report results on standard image processing metrics as well as clinically relevant metrics, including congruency measures (Congruence Index and Congruency Mean Absolute Error) that assess hemispheric metabolic asymmetry, which is a key part of the clinical analysis of these images. The SGM-KD produced the best qualitative and quantitative results when synthesizing PET purely from T1w and T2 FLAIR images with the least mean absolute error in whole-brain specific uptake value ratio (SUVR) and highest intraclass correlation coefficient. When 1% low-dose PET images are included in the inputs, all models improve significantly and are interchangeable for quantitative performance and visual quality. In summary, SGMs hold great potential for pure MRI-to-PET translation, while all 3 model types can synthesize full-dose FDG-PET accurately using MRI and ultralow-dose PET.