Role of AI in Theranostics: Towards Routine Personalized Radiopharmaceutical Therapies

We highlight emerging uses of artificial intelligence (AI) in the field of theranostics, focusing on its significant potential to enable routine and reliable personalization of radiopharmaceutical therapies (RPTs). Personalized RPTs require patient-individual dosimetry calculations accompanying therapy. Image-based dosimetry needs: 1) quantitative imaging; 2) co-registration and organ/tumor identification on serial and multimodality images; 3) determination of the time-integrated activity; and 4) absorbed dose determination. AI models that facilitate these steps are reviewed. Additionally we discuss the potential to exploit biological information from diagnostic and therapeutic molecular images to derive biomarkers for absorbed dose and outcome prediction, towards personalization of therapies. We try to motivate the nuclear medicine community to expand and align efforts into making routine and reliable personalization of RPTs a reality.