Advancing Positron Emission Tomography Image Quantification: Artificial Intelligence-Driven Methods, Clinical Challenges, and Emerging Opportunities in Long-Axial Field-of-View Positron Emission Tomography/Computed Tomography Imaging

MTV is increasingly recognized as an accurate estimate of disease burden, which has prognostic value, but its implementation has been hindered by the time-consuming need for manual segmentation of images. Automated quantitation using AI-driven approaches is promising. AI-driven automated quantification significantly reduces labor-intensive manual segmentation, improving consistency, reproducibility, and feasibility for routine clinical practice. AI-enhanced radiomics provides comprehensive characterization of tumor biology, capturing intratumoral and intertumoral heterogeneity beyond what conventional volumetric metrics alone offer, supporting improved patient stratification and therapy planning. AI-driven segmentation of normal organs improves radioligand therapy planning by enabling accurate dose predictions and comprehensive organ-based radiomics analysis, further refining personalized patient management.