Artificial intelligence for tumor [18F]FDG-PET imaging: Advancement and future trends—part I

Abstract

The advent of sophisticated image analysis techniques has facilitated the extraction of increasingly complex data, such as radiomic features, from various imaging modalities, including [¹⁸F]FDG PET/CT, a well-established cornerstone of oncological imaging. Furthermore, the use of artificial intelligence (AI) algorithms has shown considerable promise in enhancing the interpretation of these quantitative parameters. Additionally, AI-driven models enable the integration of parameters from multiple imaging modalities along with clinical data, facilitating the development of comprehensive models with significant clinical impact.

However, challenges remain regarding standardization and validation of the AI-powered models, as well as their implementation in real-world clinical practice. The variability in imaging acquisition protocols, segmentation methods, and feature extraction approaches across different institutions necessitates robust harmonization efforts to ensure reproducibility and clinical utility. Moreover, the successful translation of AI models into clinical practice requires prospective validation in large cohorts, as well as seamless integration into existing workflows to assess their ability to enhance clinicians’ performance.

This review aims to provide an overview of the literature and highlight three key applications: diagnostic impact, prediction of treatment response, and long-term patient prognostication. In the first part, we will focus on head and neck, lung, breast, gastroesophageal, colorectal, and gynecological malignancies.