Title: Pseudo-MRI-Guided PET Image Reconstruction Method Based on a Diffusion Probabilistic Model

Abstract: Anatomically guided PET reconstruction using MRI information has been shown to have the potential to improve PET image quality. However, these improvements are limited to PET scans with paired MRI information. In this work we employed a diffusion probabilistic model (DPM) to infer T1-weighted-MRI (deep-MRI) images from FDG-PET brain images. We then use the DPM-generated T1w-MRI to guide the PET reconstruction. The model was trained with brain FDG scans, and tested in datasets containing multiple levels of counts. Deep-MRI images appeared somewhat degraded than the acquired MRI images. Regarding PET image quality, volume of interest analysis in different brain regions showed that both PET reconstructed images using the acquired and the deep-MRI images improved image quality compared to OSEM. Same conclusions were found analysing the decimated datasets. A subjective evaluation performed by two physicians confirmed that OSEM scored consistently worse than the MRI-guided PET images and no significant differences were observed between the MRI-guided PET images. This proof of concept shows that it is possible to infer DPM-based MRI imagery to guide the PET reconstruction, enabling the possibility of changing reconstruction parameters such as the strength of the prior on anatomically guided PET reconstruction in the absence of MRI.