Not yet reviewed by Pith; the record is open.

[Objective] This study aims to introduce a novel back projection-induced U-Net-shaped architecture, called ReconU-Net, for deep learning-based direct positron emission tomography (PET) image reconstruction. Additionally, our objective is to analyze the behavior of direct PET image reconstruction and gain deeper insights by comparing the proposed ReconU-Net architecture with other encoder-decoder architectures without skip connections. [Approach] The proposed ReconU-Net architecture uniquely integrates the physical model of the back projection operation into the skip connection. This distinctive feature facilitates the effective transfer of intrinsic spatial information from the input sinogram to the reconstructed image via an embedded physical model. The proposed ReconU-Net was trained using Monte Carlo simulation data from the Brainweb phantom and tested on both simulated and real Hoffman brain phantom data. [Main results] The proposed ReconU-Net method generated a reconstructed image with a more accurate structure compared to other deep learning-based direct reconstruction methods. Further analysis showed that the proposed ReconU-Net architecture has the ability to transfer features of multiple resolutions, especially non-abstract high-resolution information, through skip connections. Despite limited training on simulated data, the proposed ReconU-Net successfully reconstructed the real Hoffman brain phantom, unlike other deep learning-based direct reconstruction methods, which failed to produce a reconstructed image. [Significance] The proposed ReconU-Net can improve the fidelity of direct PET image reconstruction, even when dealing with small training datasets, by leveraging the synergistic relationship between data-driven modeling and the physics model of the imaging process.