The medical imaging industry is rapidly advancing due to emerging global health challenges. The imaging technology market is expected to be worth $54.47 billion by 2028 with a compound annual growth rate of 6.1%. ITK-Snap, an open-source framework, has gained popularity for its ease of use and flat learning curve but lacks scalability, collaborative features, and automation. Several alternatives have emerged to address these limitations, including Encord, OsiriX, 3D Slicer, HOROS, OHIF, CVAT, and MONAI. These tools offer advanced features such as fully automated segmentation, collaboration tools, data security, scalability, and integration with existing technology stacks, making them suitable for large-scale medical image processing and complex healthcare data management.