Dose-aware Diffusion Model for 3D Ultra Low-dose PET Imaging

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.