Objective. This paper describes the development and validation of a GPU-accelerated Monte Carlo (MC) dose computing module dedicated to organ dose calculations of individual patients undergoing nuclear medicine (NM) internal radiation exposures involving PET/CT examination. Approach. This new module extends the more-than-10-years-long ARCHER project that developed a GPU-accelerated MC dose engine by adding dedicated NM source-definition features. To validate the code, we compared dose distributions from the point ion source, including 18F, 11C, 15O, and 68Ga, calculated for a water phantom against a well-tested MC code, GATE. To demonstrate the clinical utility and advantage of ARCHER-NM, one set of 18F-FDG PET/CT data for an adult male NM patient is calculated using the new code. Radiosensitive organs in the CT dataset are segmented using a CNN-based tool called DeepViewer. The PET image intensity maps are converted to radioactivity distributions to allow for MC radiation transport dose calculations at the voxel level. The dose rate maps and corresponding statistical uncertainties were calculated at the acquisition time of PET image. Main results. The water-phantom results show excellent agreement, suggesting that the radiation physics module in the new NM code is adequate. The dose rate results of the 18F-FDG PET imaging patient show that ARCHER-NM’s results agree very well with those of the GATE within −2.45% to 2.58% (for a total of 28 organs considered in this study). Most impressively, ARCHER-NM obtains such results in 22 s while it takes GATE about 180 min for the same number of 5 × 108 simulated decay events. Significance. This is the first study presenting GPU-accelerated patient-specific MC internal radiation dose rate calculations for clinically realistic 18F-FDG PET/CT imaging case involving autosegmentation of whole-body PET/CT images. This study suggests that the proposed computing tools—ARCHER-NM— are accurate and fast enough for routine internal dosimetry in NM clinics.