MAP-Diff: Multi-Anchor Guided Diffusion for Progressive 3D Whole-Body Low-Dose PET Denoising

Low-dose Positron Emission Tomography (PET) reduces radiation exposure but suffers from severe noise and quantitative degradation. Diffusion-based denoising models achieve strong final reconstructions, yet their reverse trajectories are typically unconstrained and not aligned with the progressive nature of PET dose formation. We propose MAP-Diff, a multi-anchor guided diffusion framework for progressive 3D whole-body PET denoising. MAP-Diff introduces clinically observed intermediate-dose scans as trajectory anchors and enforces timestep-dependent supervision to regularize the reverse process toward dose-aligned intermediate states. Anchor timesteps are calibrated via degradation matching between simulated diffusion corruption and real multi-dose PET pairs, and a timestep-weighted anchor loss stabilizes stage-wise learning. At inference, the model requires only ultra-low-dose input while enabling progressive, dose-consistent intermediate restoration. Experiments on internal (Siemens Biograph Vision Quadra) and cross-scanner (United Imaging uEXPLORER) datasets show consistent improvements over strong CNN-, Transformer-, GAN-, and diffusion-based baselines. On the internal dataset, MAP-Diff improves PSNR from 42.48 dB to 43.71 dB (+1.23 dB), increases SSIM to 0.986, and reduces NMAE from 0.115 to 0.103 (-0.012) compared to 3D DDPM. Performance gains generalize across scanners, achieving 34.42 dB PSNR and 0.141 NMAE on the external cohort, outperforming all competing methods.

3D Wavelet-Based Structural Priors for Controlled Diffusion in Whole-Body Low-Dose PET Denoising

Low-dose Positron Emission Tomography (PET) imaging reduces patient radiation exposure but suffers from increased noise that degrades image quality and diagnostic reliability. Although diffusion models have demonstrated strong denoising capability, their stochastic nature makes it challenging to enforce anatomically consistent structures, particularly in low signal-to-noise regimes and volumetric whole-body imaging. We propose Wavelet-Conditioned ControlNet (WCC-Net), a fully 3D diffusion-based framework that introduces explicit frequency-domain structural priors via wavelet representations to guide volumetric PET denoising. By injecting wavelet-based structural guidance into a frozen pretrained diffusion backbone through a lightweight control branch, WCC-Net decouples anatomical structure from noise while preserving generative expressiveness and 3D structural continuity. Extensive experiments demonstrate that WCC-Net consistently outperforms CNN-, GAN-, and diffusion-based baselines. On the internal 1/20-dose test set, WCC-Net improves PSNR by +1.21 dB and SSIM by +0.008 over a strong diffusion baseline, while reducing structural distortion (GMSD) and intensity error (NMAE). Moreover, WCC-Net generalizes robustly to unseen dose levels (1/50 and 1/4), achieving superior quantitative performance and improved volumetric anatomical consistency.