# Application of NotebookLM, a Large Language Model with Retrieval-Augmented Generation, for Lung Cancer Staging

arXiv: https://arxiv.org/abs/2410.10869 · HTML: https://mlsanity.com/paper/2410.10869/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Placed in Medical and biomedical RAG, one of 15 directions in Retrieval-augmented generation.
- Builds on 8 of its 22 references that are in the map.
- First posted on arXiv 8 Oct 2024.

## Placed in

- Retrieval-augmented generation / [Medical and biomedical RAG](https://mlsanity.com/rag/medical-and-biomedical-rag/)

## Builds on (most cited first, 8 of 8)

- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Gemini 1.5: Unlocking multimodal understanding across millions of tokens of context](https://mlsanity.com/paper/2403.05530/) (2024)
- [Survey of Hallucination in Natural Language Generation](https://mlsanity.com/paper/2202.03629/) (2022)
- [A Survey on Hallucination in Large Language Models: Principles, Taxonomy, Challenges, and Open Questions](https://mlsanity.com/paper/2311.05232/) (2023)
- [Retrieval Augmentation Reduces Hallucination in Conversation](https://mlsanity.com/paper/2104.07567/) (2021)
- [GSM-Plus: A Comprehensive Benchmark for Evaluating the Robustness of LLMs as Mathematical Problem Solvers](https://mlsanity.com/paper/2402.19255/) (2024)
- [Seven Failure Points When Engineering a Retrieval Augmented Generation System](https://mlsanity.com/paper/2401.05856/) (2024)
- [Exploring Multilingual Large Language Models for Enhanced TNM classification of Radiology Report in lung cancer staging](https://mlsanity.com/paper/2406.06591/) (2024)

## Built on by (most cited first, 3 of 3)

- [Agentic AI with Orchestrator-Agent Trust: A Modular Visual Classification Framework with Trust-Aware Orchestration and RAG-Based Reasoning](https://mlsanity.com/paper/2507.10571/) (2025)
- [Enhancing Pancreatic Cancer Staging with Large Language Models: The Role of Retrieval-Augmented Generation](https://mlsanity.com/paper/2503.15664/) (2025)
- [Concept-Enhanced Multimodal RAG: Towards Interpretable and Accurate Radiology Report Generation](https://mlsanity.com/paper/2602.15650/) (2026)

## Abstract (arXiv)

Purpose: In radiology, large language models (LLMs), including ChatGPT, have recently gained attention, and their utility is being rapidly evaluated. However, concerns have emerged regarding their reliability in clinical applications due to limitations such as hallucinations and insufficient referencing. To address these issues, we focus on the latest technology, retrieval-augmented generation (RAG), which enables LLMs to reference reliable external knowledge (REK). Specifically, this study examines the utility and reliability of a recently released RAG-equipped LLM (RAG-LLM), NotebookLM, for staging lung cancer. Materials and methods: We summarized the current lung cancer staging guideline in Japan and provided this as REK to NotebookLM. We then tasked NotebookLM with staging 100 fictional lung cancer cases based on CT findings and evaluated its accuracy. For comparison, we performed the same task using a gold-standard LLM, GPT-4 Omni (GPT-4o), both with and without the REK. Results: NotebookLM achieved 86% diagnostic accuracy in the lung cancer staging experiment, outperforming GPT-4o, which recorded 39% accuracy with the REK and 25% without it. Moreover, NotebookLM demonstrated 95% accuracy in searching reference locations within the REK. Conclusion: NotebookLM successfully performed lung cancer staging by utilizing the REK, demonstrating superior performance compared to GPT-4o. Additionally, it provided highly accurate reference locations within the REK, allowing radiologists to efficiently evaluate the reliability of NotebookLM's responses and detect possible hallucinations. Overall, this study highlights the potential of NotebookLM, a RAG-LLM, in image diagnosis.