# An Iterative LLM Framework for SIBT utilizing RAG-based Adaptive Weight Optimization

arXiv: https://arxiv.org/abs/2509.08407 · HTML: https://mlsanity.com/paper/2509.08407/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 15 of its 44 references that are in the map.
- First posted on arXiv 10 Sep 2025.

## Builds on (most cited first, 15 of 15)

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- [DeepSeek-R1: Incentivizing Reasoning Capability in LLMs via Reinforcement Learning](https://mlsanity.com/paper/2501.12948/) (2025)
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- [BioGPT: Generative Pre-trained Transformer for Biomedical Text Generation and Mining](https://mlsanity.com/paper/2210.10341/) (2022)
- [A Survey on Active Learning and Human-in-the-Loop Deep Learning for Medical Image Analysis](https://mlsanity.com/paper/1910.02923/) (2019)
- [MedExpQA: Multilingual Benchmarking of Large Language Models for Medical Question Answering](https://mlsanity.com/paper/2404.05590/) (2024)
- [Automated Radiology Report Generation: A Review of Recent Advances](https://mlsanity.com/paper/2405.10842/) (2024)
- [Automated radiotherapy treatment planning guided by GPT-4Vision](https://mlsanity.com/paper/2406.15609/) (2024)

## Abstract (arXiv)

Seed implant brachytherapy (SIBT) is an effective cancer treatment modality; however, clinical planning often relies on manual adjustment of objective function weights, leading to inefficiencies and suboptimal results. This study proposes an adaptive weight optimization framework for SIBT planning, driven by large language models (LLMs). A locally deployed DeepSeek-R1 LLM is integrated with an automatic planning algorithm in an iterative loop. Starting with fixed weights, the LLM evaluates plan quality and recommends new weights in the next iteration. This process continues until convergence criteria are met, after which the LLM conducts a comprehensive evaluation to identify the optimal plan. A clinical knowledge base, constructed and queried via retrieval-augmented generation (RAG), enhances the model's domain-specific reasoning. The proposed method was validated on 23 patient cases, showing that the LLM-assisted approach produces plans that are comparable to or exceeding clinically approved and fixed-weight plans, in terms of dose homogeneity for the clinical target volume (CTV) and sparing of organs at risk (OARs). The study demonstrates the potential use of LLMs in SIBT planning automation.