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coPERCIST: AI-assisted PET-CT response assessment.

Elin Trägårdh1,2, Måns Larsson3, Olof Enqvist3,4

  • 1Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Inga Marie Nilssons G 49, 205 02, Malmö, Sweden. Elin.tragardh@med.lu.se.

European Journal of Nuclear Medicine and Molecular Imaging
|October 21, 2025
PubMed
Summary
This summary is machine-generated.

This study introduces coPERCIST, an AI tool that semi-automates [18F]FDG PET-CT analysis for cancer treatment response using PERCIST criteria. The AI system streamlines evaluation, offering accurate and reproducible results with reduced review times.

Keywords:
CancerPERCIST 1.0PET-CTTreatment response

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Area of Science:

  • Oncology
  • Medical Imaging
  • Artificial Intelligence

Background:

  • The PET Response Criteria in Solid Tumours (PERCIST) 1.0 standardizes [18F]fluorodeoxyglucose ([18F]FDG) PET-CT response assessment.
  • Manual PERCIST analysis is complex and time-consuming, limiting its clinical application.

Purpose of the Study:

  • To present coPERCIST, an AI-assisted module for the RECOMIA platform.
  • To semi-automate and streamline PERCIST analysis for [18F]FDG PET-CT.

Main Methods:

  • coPERCIST automates organ segmentation, background quantification, lesion detection, SULpeak calculation, and longitudinal comparison.
  • A novel image alignment method with uncertainty estimation ensures accurate lesion tracking.
  • The system was evaluated on 58 cancer patients with two PET-CT scans each.

Main Results:

  • AI-suggested volumes of interest for threshold calculation were accurate in all cases.
  • Accurate anatomical alignment was achieved for all 130 evaluated lesions.
  • Pairwise SULpeak quantification accuracy was 95%, with most cases reviewed in under a minute.

Conclusions:

  • AI-assisted PERCIST evaluation using coPERCIST is feasible and shows promising accuracy.
  • coPERCIST facilitates reproducible cancer treatment response assessment.
  • The tool is freely available for researchers on the RECOMIA platform.