Is Automatic Tumor Segmentation on Whole-Body ¹⁸F-FDG PET Images a Clinical Reality?

The integration of automated whole-body tumor segmentation using ¹⁸F-FDG PET/CT images represents a pivotal shift in oncologic diagnostics, enhancing the precision and efficiency of tumor burden assessment. This editorial examines the transition toward automation, propelled by advancements in artificial intelligence, notably through deep learning techniques. We highlight the current availability of commercial tools and the academic efforts that have set the stage for these developments. Further, we comment on the challenges of data diversity, validation needs, and regulatory barriers. The role of metabolic tumor volume and total lesion glycolysis as vital metrics in cancer management underscores the significance of this evaluation. Despite promising progress, we call for increased collaboration across academia, clinical users, and industry to better realize the clinical benefits of automated segmentation, thus helping to streamline workflows and improve patient outcomes in oncology.