MED-PHCVLGOct 15, 2025

Steerable Conditional Diffusion for Domain Adaptation in PET Image Reconstruction

arXiv:2510.13441v11 citationsh-index: 22025 IEEE Nuclear Science Symposium (NSS), Medical Imaging Conference (MIC) and Room Temperature Semiconductor Detector Conference (RTSD)
Originality Incremental advance
AI Analysis

This addresses domain adaptation for clinical PET reconstruction, but it is incremental as it builds on prior diffusion methods and is limited to synthetic data.

The authors tackled domain shift in diffusion-based PET image reconstruction by integrating steerable conditional diffusion with a likelihood-scheduled framework, which suppressed hallucinated artefacts and outperformed baselines on synthetic 2D brain phantoms.

Diffusion models have recently enabled state-of-the-art reconstruction of positron emission tomography (PET) images while requiring only image training data. However, domain shift remains a key concern for clinical adoption: priors trained on images from one anatomy, acquisition protocol or pathology may produce artefacts on out-of-distribution data. We propose integrating steerable conditional diffusion (SCD) with our previously-introduced likelihood-scheduled diffusion (PET-LiSch) framework to improve the alignment of the diffusion model's prior to the target subject. At reconstruction time, for each diffusion step, we use low-rank adaptation (LoRA) to align the diffusion model prior with the target domain on the fly. Experiments on realistic synthetic 2D brain phantoms demonstrate that our approach suppresses hallucinated artefacts under domain shift, i.e. when our diffusion model is trained on perturbed images and tested on normal anatomy, our approach suppresses the hallucinated structure, outperforming both OSEM and diffusion model baselines qualitatively and quantitatively. These results provide a proof-of-concept that steerable priors can mitigate domain shift in diffusion-based PET reconstruction and motivate future evaluation on real data.

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