ALL-PET: A Low-resource and Low-shot PET Foundation Model in Projection Domain

Building large-scale foundation model for PET imaging is hindered by limited access to labeled data and insufficient computational resources. To overcome data scarcity and efficiency limitations, we propose ALL-PET, a low-resource, low-shot PET foundation model operating directly in projection domain. ALL-PET leverages a latent diffusion model (LDM) with three key innovations. First, we design a Radon mask augmentation strategy (RMAS) that generates over 200,000 structurally diverse training samples by projecting randomized image-domain masks into sinogram space, significantly improving generalization with minimal data. This is extended by a dynamic multi-mask (DMM) mechanism that varies mask quantity and distribution, enhancing data diversity without added model complexity. Second, we implement positive/negative mask constraints to embed strict geometric consistency, reducing parameter burden while preserving generation quality. Third, we introduce transparent medical attention (TMA), a parameter-free, geometry-driven mechanism that enhances lesion-related regions in raw projection data. Lesion-focused attention maps are derived from coarse segmentation, covering both hypermetabolic and hypometabolic areas, and projected into sinogram space for physically consistent guidance. The system supports clinician-defined ROI adjustments, ensuring flexible, interpretable, and task-adaptive emphasis aligned with PET acquisition physics. Experimental results show that ALL-PET achieves high-quality sinogram generation using only 500 samples, with performance comparable to models trained on larger datasets. ALL-PET generalizes across tasks including low-dose reconstruction, attenuation correction, delayed-frame prediction, and tracer separation, operating efficiently with memory use under 24GB.