Flow Matching-Based PET Image Reconstruction

Deep generative models have recently emerged as powerful priors for solving ill-posed inverse problems in CT, with diffusion-based approaches achieving state-of-the-art reconstruction performance. However, diffusion models typically rely on stochastic sampling procedures, long inference trajectories, and carefully tuned noise schedules, which can limit computational efficiency and numerical stability, especially at high spatial resolutions. In this work, we investigate Flow Matching as an alternative generative prior for CT reconstruction. We train a high-resolution Rectified Flow Matching model on 256x256 chest images from the Mayo Clinic Low-Dose CT dataset. To mitigate overfitting and limited anatomical variability, we employ a two-stage training strategy consisting of an initial phase with strong, anatomically informed data augmentation, followed by a fine-tuning phase with reduced or no augmentation to refine structural fidelity. The resulting model is capable of generating high-quality and anatomically coherent CT-like images, serving as a strong learned prior. We then evaluate multiple reconstruction methods specifically designed for Flow Matching models, including Plug-and-Play Flow, FlowDPS, Flower, and Flow-Priors (ICTM), and compare them against state-of-the-art diffusion-based reconstruction algorithms such as DDRM, DPS, and DiffPIR. Experimental results across several CT inverse problem settings show that Flow Matching-based approaches consistently outperform diffusion-based methods in terms of PSNR, SSIM, and perceptual quality, while requiring fewer sampling steps. Finally, we publicly release the trained Flow Matching model and accompanying code to facilitate reproducibility and future research. Overall, this work demonstrates that Flow Matching provides a stable, efficient, and effective alternative to diffusion models for high-resolution CT image reconstruction.

Low-count Positron Emission Tomography (PET) reconstruction is severely hindered by the dissipative nature of prevailing generative models, where the inherent phase-space contraction leads to the numerical extinction (``wash-out'') of weak but diagnostically critical lesion signals. To overcome this geometric limitation, we propose FlowPET, a physics-informed framework that reformulates reconstruction as volume-preserving transport in a symplectic phase space. By parameterizing the posterior dynamics via a Separable Hamiltonian System, our approach guarantees a divergence-free vector field by construction, theoretically immunizing weak signals against probability mass collapse. To steer this conservative flow, we introduce conjugate boundary conditions based on the Range-Null space decomposition of the PET operator; this strictly enforces data consistency in the range space while confining stochastic uncertainty injection to the unobserved null space. We train the model via symplectic flow matching and perform inference using a symplectic leapfrog integrator. Extensive experiments on BrainWeb, clinical pediatric, and UDPET datasets demonstrate that FlowPET not only surpasses state-of-the-art deterministic and stochastic baselines in SSIM and PSNR but, more crucially, exhibits superior recovery of low-contrast lesions. The results confirm that imposing Hamiltonian structural constraints offers a robust geometric safeguard for medical inverse problems in high-noise regimes.

Generative models, particularly Diffusion Models (DM), have shown strong potential for Computed Tomography (CT) reconstruction serving as expressive priors for solving ill-posed inverse problems. However, diffusion-based reconstruction relies on Stochastic Differential Equations (SDEs) for forward diffusion and reverse denoising, where such stochasticity can interfere with repeated data consistency corrections in CT reconstruction. Since CT reconstruction is often time-critical in clinical and interventional scenarios, improving reconstruction efficiency is essential. In contrast, Flow Matching (FM) models sampling as a deterministic Ordinary Differential Equation (ODE), yielding smooth trajectories without stochastic noise injection. This deterministic formulation is naturally compatible with repeated data consistency operations. Furthermore, we observe that FM-predicted velocity fields exhibit strong correlations across adjacent steps. Motivated by this, we propose an FM-based CT reconstruction framework (FMCT) and an efficient variant (EFMCT) that reuses previously predicted velocity fields over consecutive steps to substantially reduce the number of Neural network Function Evaluations (NFEs), thereby improving inference efficiency. We provide theoretical analysis showing that the error introduced by velocity reuse is bounded when combined with data consistency operations. Extensive experiments demonstrate that FMCT/EFMCT achieve competitive reconstruction quality while significantly improving computational efficiency compared with diffusion-based methods. The codebase is open-sourced at https://github.com/EFMCT/EFMCT.