Quantization of Deep Neural Networks for Medical Image Analysis: A Systematic Review and Meta-Analysis

Neural network quantization has become established as a key strategy for transitioning medical imaging models from research environments to clinical devices and resource-constrained edge platforms; however, the available evidence remains fragmented and focused on highly heterogeneous use cases. This study presents a systematic review of 72 studies on quantization applied to medical images, following PRISMA guidelines, with the aim of characterizing the relationship among quantization technique, network architecture, imaging modality, and execution environment, as well as their impact on latency, memory footprint, and clinical deployment. Based on a structured variable matrix, we analyze—through tailored visualizations—usage patterns of Post-Training Quantization (PTQ), Quantization-Aware Training (QAT), mixed precision, and binary/low-bit schemes across frameworks such as PyTorch V 2.6.0, TensorFlow 2.19.0, and TensorFlow Lite, executed on server-class GPUs, edge/embedded devices, and specialized hardware. The results reveal a strong concentration of evidence in PyTorch/TensorFlow pipelines using INT8 or mixed precision on GPUs and edge platforms, contrasted with limited attention to PACS/RIS interoperability, model lifecycle management, energy consumption, cost, and regulatory traceability. We conclude that, although quantization can approximate real-time performance and reduce memory footprint, its clinical adoption remains constrained by integration challenges, model governance requirements, and the maturity of the hardware–software ecosystem.