# Development and Validation of a Large Language Model for Generating Fully-Structured Radiology Reports

arXiv: https://arxiv.org/abs/2409.18319 · HTML: https://mlsanity.com/paper/2409.18319/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 6 of its 25 references that are in the map.
- First posted on arXiv 26 Sep 2024.

## Builds on (most cited first, 6 of 6)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [Qwen2 Technical Report](https://mlsanity.com/paper/2407.10671/) (2024)
- [Translating Radiology Reports into Plain Language using ChatGPT and GPT-4 with Prompt Learning: Promising Results, Limitations, and Potential](https://mlsanity.com/paper/2303.09038/) (2023)
- [Unsupervised Contrastive Learning based Transformer for Lung Nodule Detection](https://mlsanity.com/paper/2205.00122/) (2022)
- [Specialty-Oriented Generalist Medical AI for Chest CT Screening](https://mlsanity.com/paper/2304.02649/) (2023)

## Abstract (arXiv)

Current LLMs for creating fully-structured reports face the challenges of formatting errors, content hallucinations, and privacy leakage issues when uploading data to external servers.We aim to develop an open-source, accurate LLM for creating fully-structured and standardized LCS reports from varying free-text reports across institutions and demonstrate its utility in automatic statistical analysis and individual lung nodule retrieval. With IRB approvals, our retrospective study included 5,442 de-identified LDCT LCS radiology reports from two institutions. We constructed two evaluation datasets by labeling 500 pairs of free-text and fully-structured radiology reports and one large-scale consecutive dataset from January 2021 to December 2023. Two radiologists created a standardized template for recording 27 lung nodule features on LCS. We designed a dynamic-template-constrained decoding method to enhance existing LLMs for creating fully-structured reports from free-text radiology reports. Using consecutive structured reports, we automated descriptive statistical analyses and a nodule retrieval prototype. Our best LLM for creating fully-structured reports achieved high performance on cross-institutional datasets with an F1 score of about 97%, with neither formatting errors nor content hallucinations. Our method consistently improved the best open-source LLMs by up to 10.42%, and outperformed GPT-4o by 17.19%. The automatically derived statistical distributions were consistent with prior findings regarding attenuation, location, size, stability, and Lung-RADS. The retrieval system with structured reports allowed flexible nodule-level search and complex statistical analysis. Our developed software is publicly available for local deployment and further research.