In recent years, Artificial Intelligence (AI) and in particular Deep Neural Networks (DNN) became a relevant research topic in biomedical image segmentation due to the availability of more and more data sets along with the establishment of well known competitions. Despite the popularity of DNN based segmentation on the research side, these techniques are almost unused in the daily clinical practice even if they could support effectively the physician during the diagnostic process. Apart from the issues related to the explainability of the predictions of a neural model, such systems are not integrated in the diagnostic workflow, and a standardization of their use is needed to achieve this goal. This paper presents IODeep a new DICOM Information Object Definition (IOD) aimed at storing both the weights and the architecture of a DNN already trained on a particular image dataset that is labeled as regards the acquisition modality, the anatomical region, and the disease under investigation. The IOD architecture is presented along with a DNN selection algorithm from the PACS server based on the labels outlined above, and a simple PACS viewer purposely designed for demonstrating the effectiveness of the DICOM integration, while no modifications are required on the PACS server side. Also a service based architecture in support of the entire workflow has been implemented. IODeep ensures full integration of a trained AI model in a DICOM infrastructure, and it is also enables a scenario where a trained model can be either fine-tuned with hospital data or trained in a federated learning scheme shared by different hospitals. In this way AI models can be tailored to the real data produced by a Radiology ward thus improving the physician decision making process. Source code is freely available at https://github.com/CHILab1/IODeep.git.

Head–Neck Cancer (HNC) has a relevant impact on the oncology patient population and for this reason, the present review is dedicated to this type of neoplastic disease. In particular, a collection of methods aimed at tumor delineation is presented, because this is a fundamental task to perform efficient radiotherapy. Such a segmentation task is often performed on uni-modal data (usually Positron Emission Tomography (PET)) even though multi-modal images are preferred (PET-Computerized Tomography (CT)/PET-Magnetic Resonance (MR)). Datasets can be private or freely provided by online repositories on the web. The adopted techniques can belong to the well-known image processing/computer-vision algorithms or the newest deep learning/artificial intelligence approaches. All these aspects are analyzed in the present review and comparison among various approaches is performed. From the present review, the authors draw the conclusion that despite the encouraging results of computerized approaches, their performance is far from handmade tumor delineation result.

In this paper, we propose a Linux-based operating system, namely, DicomOS, tailored for medical imaging and enhanced interoperability, addressing user-friendly functionality and the main critical needs in radiology workflows. Traditional operating systems in clinical settings face limitations, such as fragmented software ecosystems and platform-specific restrictions, which disrupt collaborative workflows and hinder diagnostic efficiency. Built on Ubuntu 22.04 LTS, DicomOS integrates essential DICOM functionalities directly into the OS, providing a unified, cohesive platform for image visualization, annotation, and sharing. Methods include custom configurations and the development of graphical user interfaces (GUIs) and command-line tools, making them accessible to medical professionals and developers. Key applications such as ITK-SNAP and 3D Slicer are seamlessly integrated alongside specialized GUIs that enhance usability without requiring extensive technical expertise. As preliminary work, DicomOS demonstrates the potential to simplify medical imaging workflows, reduce cognitive load, and promote efficient data sharing across diverse clinical settings. However, further evaluations, including structured clinical tests and broader deployment with a distributable ISO image, must validate its effectiveness and scalability in real-world scenarios. The results indicate that DicomOS provides a versatile and adaptable solution, supporting radiologists in routine tasks while facilitating customization for advanced users. As an open-source platform, DicomOS has the potential to evolve alongside medical imaging needs, positioning it as a valuable resource for enhancing workflow integration and clinical collaboration.