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Minimizing the need for pixel-level annotated data for training PET anomaly segmentation networks is crucial, particularly due to time and cost constraints related to expert annotations. Current un-/weakly-supervised anomaly detection methods rely on autoencoder or generative adversarial networks trained only on healthy data, although these are more challenging to train. In this work, we present a weakly supervised and Implicitly guided COuNterfactual diffusion model for Detecting Anomalies in PET images, branded as IgCONDA-PET. The training is conditioned on image class labels (healthy vs. unhealthy) along with implicit guidance to generate counterfactuals for an unhealthy image with anomalies. The counterfactual generation process synthesizes the healthy counterpart for a given unhealthy image, and the difference between the two facilitates the identification of anomaly locations. The code is available at: https://github.com/igcondapet/IgCONDA-PET.git
