Although the interest in the use of Digital Twins (DTs) in nuclear energy is increasing rapidly, at present their implementation is limited. This rapid increase in interest is not surprising considering that implementing DT technology would allow for continuous monitoring, facilitate the implementation of predictive maintenance with optimized staffing plans, enable the automation and autonomy opportunities that can drastically reduce the fixed operation and maintenance costs, and provide training for operations and maintenance. Other industries are using DTs for construction and in the nuclear arena DTs can provide great benefit in decommission activities. Their ability to operate in real time vastly increases their potential impact.It has been recognized that before a DT can be used in design, operations, or as a regulatory tool, the specifics on the regulations applicable to the use of DTs need to be established. The difficulty is that the specific use cases will dictate the applicability of regulations. For example, even within the application domain associated with operations, the regulations may vary if the DT is used to create a virtual reference for plant operations, be used for training, optimization of maintenance intervals, prioritize of maintenance activities, etc. Different still is if the DT is to be used for design. A DT that is integrated into the design or design process can facilitate improved decision making and greater operational flexibilities and its use to support the selection of technical specifications will introduce other requirements. This report describes the research results to date to identify regulatory implications of DT technologies and their uses. Specifically, this report reviews current regulatory guidance relevant to the application of predictive maintenance DTs, artificial intelligence (AI), and automation. The focus of this review included determination of constraints on the application of DT technology, identification of any regulatory gaps or uncertainties, and clarification of anticipated technical basis information likely to be important for regulatory acceptance of these technologies. The research included review of topical reports and other submissions to the US Nuclear Regulatory Commission (NRC) on technologies relevant to using DTs for predictive maintenance, NRC safety evaluation (SE) reports, and other relevant literature to identify specific regulatory concerns. v CONTENTS ABSTRACT.