Refining deep learning segmentation in gallium-68-prostate-specific membrane antigen-11 positron emission tomography: evaluation of small lesion filtering and intersection-over-union thresholds

Implementing small lesion filtering criteria improves the reliability of automated segmentation outputs, particularly for quantitative evaluation. For lesion-level metrics, defining true positives within the range of 20-40% IoU thresholds is optimal. Further validation through multicenter studies and larger datasets is essential to ensure the generalizability of these findings.