Iterative image reconstruction algorithms have been widely used in the field of positron emission tomography (PET). However, such algorithms are sensitive to noise artifacts so that the reconstruction begins to degrade when the number of iterations is high. In this paper, we propose a new algorithm to reconstruct an image from the PET emission projection data by using the conditional entropy maximization and the adaptive mesh model. In a traditional tomography reconstruction method, the reconstructed image is directly computed in the pixel domain. Unlike this kind of methods, the proposed approach is performed by estimating the nodal values from the observed projection data in a mesh domain. In our method, the initial Delaunay triangulation mesh is generated from a set of randomly selected pixel points, and it is then modified according to the pixel intensity value of the estimated image at each iteration step in which the conditional entropy maximization is used. The advantage of using the adaptive mesh model for image reconstruction is that it provides a natural spatially adaptive smoothness mechanism. In experiments using the synthetic and clinical data, it is found that the proposed algorithm is more robust to noise compared to the common pixel-based MLEM algorithm and mesh-based MLEM with a fixed mesh structure.