Digital twins in computational medicine with a specific focus on nuclear oncology. Where do we stand?

In medicine, digital twins (DTs) serve as computational models that replicate biological and physiological characteristics of a specific individual — whether a patient, an organ, or even a single cell — and simulate virtual biomedical experiments. DT-based simulations hold the potential to identify the most beneficial intervention at any given moment. A range of technological approaches has been explored across various medical fields, with oncology being one of the most suitable areas of application in view of the necessity of timely and personalized treatment decisions. Medical imaging, and especially nuclear medicine, might have a central role in the development of DTs. In this review we define digital twins, examine current evidence, and discuss opportunities that digital twins can offer in computational nuclear oncology. We also briefly summarize the state-of-the-art of DTs in other fields.