The past few decades have been marked by the ever-increasing presence of digital technology. This growth, often called digital transformation, places a heavy burden on our environment. We are now facing a potential new phase of digital transformation,6 represented by the emergence of generative AI (GenAI), a subfield of artificial intelligence focused on generating content, such as human-like text, code, and images.14 In particular, the deployment of GenAI as a service, such as ChatGPT or Stable Diffusion, is raising questions around sustainability. The sustainability of any computing technology, however, cannot be addressed without a way to evaluate its environmental impact.

India faces a significant cancer burden, with an incidence - to - mortality ratio indicating that nearly three out of five individuals diagnosed with cancer succumb to the disease. While the limitations of physical healthcare infrastructure are widely acknowledged as a primary challenge, concerted efforts by government and healthcare agencies are underway to mitigate these constraints. However, given the country's vast geography and high population density, it is imperative to explore alternative soft infrastructure solutions to complement existing frameworks . Artificial Intelligence agents are increasingly transforming problem - solving approaches across various domains, with their application in medicine proving particularly transformative. In this perspective, we examine the potential role of AI agents in advancing nuclear medicine fo r cancer research, diagnosis, and management in India. We begin with a brief overview of AI agents and their capabilities, followed by a proposed agent - based ecosystem that can address prevailing sustainability challenges in India's nuclear medicine. Keywords: AI Agents; cancer; nuclear medicine ecosystem; sustainability challenges 1. Introduction India's with population of 1.4 billion faces a significant cancer burden, with ~1.5 million new cases and ~850,000 deaths annually [1] [2] . With an i ncidence - to - m ortality p ercentage of approximately 64.8%, nearly three out of five individuals diagnosed with cancer are expected to succumb to the disease [2] . Projections indicate that mortality rates will rise significantly, increasing from 64.7% to 109.6% between 2022 and 2050, largely due to demographic shifts as the reproductive - age population transitions into middle and old age. This growing cancer burden will place even more pressure on the already overburdened healthcare system, making it essential to address the gaps in both infrastructure and indigenous research and innovations to ensure timely and effective patient treatment [3] . This trend underscores the urgent need for a resilient, patient - centred framework that integrates medical advancements, early detection through diagnostics, timely therapeutic interventions, and equitable access to care. Nuclear medicine uses a small amount of targeted radioactive material to diagnose and treat cancer [4] .

Artificial intelligence has been front and center in recent months. The global pandemic has pushed governments and private companies worldwide to propose AI solutions for everything from analyzing cough sounds to deploying disinfecting robots in hospitals. These efforts are part of a wider trend that has been picking up momentum: the deployment of projects by companies, governments, universities, and research institutes aiming to use AI for societal good. The goal of most of these programs is to deploy cutting-edge AI technologies to solve critical issues such as poverty, hunger, crime, and climate change, under the "AI for good" umbrella. But what makes an AI project good?

Artificial intelligence has been front and center in recent months. The global pandemic has pushed governments and private companies worldwide to propose AI solutions for everything from analyzing cough sounds to deploying disinfecting robots in hospitals. These efforts are part of a wider trend that has been picking up momentum: the deployment of projects by companies, governments, universities, and research institutes aiming to use AI for societal good. The goal of most of these programs is to deploy cutting-edge AI technologies to solve critical issues such as poverty, hunger, crime, and climate change, under the "AI for good" umbrella. But what makes an AI project good?

Now is a particularly opportune time to drive towards this goal. As the world moves towards a COVID-19 post-pandemic recovery, the UN has called on governments to heed the "unprecedented wake-up call" and "build back better" by creating more sustainable, resilient and inclusive societies. There are two approaches to Green AI – using AI to solve sustainability challenges and using AI in a more sustainable way. How can AI solve sustainability challenges? Delivering societal and environmental well-being through AI are key strategic considerations of the European Commission, who acknowledge that "AI systems promise to help [tackle] the most pressing concerns, including climate change and environmental degradation".