Large language models for structured reporting in radiology: past, present, and future

European Radiology, vol. 35, pp. 2589–2602

Abstract

Structured reporting (SR) has long been a goal in radiology to standardize and improve the quality of radiology reports. Despite evidence that SR reduces errors, enhances comprehensiveness, and increases adherence to guidelines, its widespread adoption has been limited. Recently, large language models (LLMs) have emerged as a promising solution to automate and facilitate SR. Therefore, this narrative review aims to provide an overview of LLMs for SR in radiology and beyond. We found that the current literature on LLMs for SR is limited, comprising ten studies on the generative pre-trained transformer (GPT)-3.5 (n = 5) and/or GPT-4 (n = 8), while two studies additionally examined the performance of Perplexity and Bing Chat or IT5. All studies reported promising results and acknowledged the potential of LLMs for SR, with six out of ten studies demonstrating the feasibility of multilingual applications. Building upon these findings, we discuss limitations, regulatory challenges, and further applications of LLMs in radiology report processing, encompassing four main areas: documentation, translation and summarization, clinical evaluation, and data mining. In conclusion, this review underscores the transformative potential of LLMs to improve efficiency and accuracy in SR and radiology report processing. KEY POINTS: Question How can LLMs help make SR in radiology more ubiquitous? Findings Current literature leveraging LLMs for SR is sparse but shows promising results, including the feasibility of multilingual applications. Clinical relevance LLMs have the potential to transform radiology report processing and enable the widespread adoption of SR. However, their future role in clinical practice depends on overcoming current limitations and regulatory challenges, including opaque algorithms and training data.

Authors 13

1. Felix Busch corresponding

   TUM Klinikum · Technical University of Munich

   Affiliation as printed

   School of Medicine and Health, Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, TUM University Hospital, Technical University of Munich, Munich, Germany. felix.busch@tum.de

2. Lena Hoffmann

   TUM Klinikum · Technical University of Munich

   Affiliation as printed

   School of Medicine and Health, Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, TUM University Hospital, Technical University of Munich, Munich, Germany

3. Daniel Pinto dos Santos

   University of Cologne · University Hospital Frankfurt · University Hospital Cologne

   Affiliation as printed

   Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany

   Institute of Diagnostic and Interventional Radiology, University Hospital of Frankfurt, Frankfurt, Germany

4. Marcus R. Makowski

   TUM Klinikum · Technical University of Munich

   Affiliation as printed

   School of Medicine and Health, Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, TUM University Hospital, Technical University of Munich, Munich, Germany

5. Luca Saba

   Azienda Ospedaliero-Universitaria Cagliari

   Affiliation as printed

   Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy

6. Philipp Prucker

   TUM Klinikum · Technical University of Munich

   Affiliation as printed

   School of Medicine and Health, Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, TUM University Hospital, Technical University of Munich, Munich, Germany

7. Martin Hadamitzky

   Deutsches Herzzentrum München · Technical University of Munich

   Affiliation as printed

   School of Medicine and Health, Institute for Cardiovascular Radiology and Nuclear Medicine, German Heart Center Munich, TUM University Hospital, Technical University of Munich, Munich, Germany

8. Nassir Navab

   Technical University of Munich

   Affiliation as printed

   Chair for Computer Aided Medical Procedures & Augmented Reality, TUM School of Computation, Information and Technology, Technical University of Munich, Munich, Germany

9. Jakob Nikolas Kather

   Heidelberg University · University Hospital Heidelberg · National Center for Tumor Diseases · Else Kröner Fresenius Center for Digital Health · Technische Universität Dresden

   Affiliation as printed

   Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany

   Else Kroener Fresenius Center for Digital Health, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany

10. Daniel Truhn Aachen Department of Diagnostic and Interventional Radiology

    Universitätsklinikum Aachen

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany

11. Renato Cuocolo

    University of Salerno

    Affiliation as printed

    Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy

12. Lisa C. Adams

    TUM Klinikum · Technical University of Munich

    Affiliation as printed

    School of Medicine and Health, Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, TUM University Hospital, Technical University of Munich, Munich, Germany

13. Keno K. Bressem

    Deutsches Herzzentrum München · Technical University of Munich

    Affiliation as printed

    School of Medicine and Health, Institute for Cardiovascular Radiology and Nuclear Medicine, German Heart Center Munich, TUM University Hospital, Technical University of Munich, Munich, Germany