Moritz C Halfmann, Peter Mildenberger, Tobias Jorg
{"title":"[Artificial intelligence in radiology : Literature overview and reading recommendations].","authors":"Moritz C Halfmann, Peter Mildenberger, Tobias Jorg","doi":"10.1007/s00117-025-01419-z","DOIUrl":"10.1007/s00117-025-01419-z","url":null,"abstract":"<p><strong>Background: </strong>Due to the ongoing rapid advancement of artificial intelligence (AI), including large language models (LLMs), radiologists will soon face the challenge of the responsible clinical integration of these models.</p><p><strong>Objectives: </strong>The aim of this work is to provide an overview of current developments regarding LLMs, potential applications in radiology, and their (future) relevance and limitations.</p><p><strong>Materials and methods: </strong>This review analyzes publications on LLMs for specific applications in medicine and radiology. Additionally, literature related to the challenges of clinical LLM use was reviewed and summarized.</p><p><strong>Results: </strong>In addition to a general overview of current literature on radiological applications of LLMs, several particularly noteworthy studies on the subject are recommended.</p><p><strong>Conclusions: </strong>In order to facilitate the forthcoming clinical integration of LLMs, radiologists need to engage with the topic, understand various application areas, and be aware of potential limitations in order to address challenges related to patient safety, ethics, and data protection.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"266-270"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Misdiagnoses in the diagnostics of the abdomen and pelvis].","authors":"Andreas G Schreyer, Markus Juchems","doi":"10.1007/s00117-025-01425-1","DOIUrl":"10.1007/s00117-025-01425-1","url":null,"abstract":"<p><p>Misdiagnoses in abdominal radiology are a frequent source of clinical errors, often stemming from cognitive biases and perception errors. Typical sources of error include perceptual and interpretative issues, frequently influenced by cognitive mechanisms, such as anchoring and confirmation biases or the satisfaction of search bias. Technical errors, such as suboptimal windowing in computed tomography, also contribute to diagnostic inaccuracies. Enhancing diagnostic accuracy requires awareness of these biases and a systematic reflection on the diagnostic process. This approach enables early error prevention and improves the diagnostic quality in abdominal imaging.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"275-284"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Technical foundations of large language models].","authors":"Christian Blüthgen","doi":"10.1007/s00117-025-01427-z","DOIUrl":"10.1007/s00117-025-01427-z","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) such as ChatGPT have rapidly revolutionized the way computers can analyze human language and the way we can interact with computers.</p><p><strong>Objective: </strong>To give an overview of the emergence and basic principles of computational language models.</p><p><strong>Methods: </strong>Narrative literature-based analysis of the history of the emergence of language models, the technical foundations, the training process and the limitations of LLMs.</p><p><strong>Results: </strong>Nowadays, LLMs are mostly based on transformer models that can capture context through their attention mechanism. Through a multistage training process with comprehensive pretraining, supervised fine-tuning and alignment with human preferences, LLMs have developed a general understanding of language. This enables them to flexibly analyze texts and produce outputs of high linguistic quality.</p><p><strong>Conclusion: </strong>Their technical foundations and training process make large language models versatile general-purpose tools for text processing, with numerous applications in radiology. The main limitation is the tendency to postulate incorrect but plausible-sounding information with high confidence.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"227-234"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Philipp Arnold, Maurice Henkel, Fabian Bamberg, Elmar Kotter
{"title":"[Integration of large language models into the clinic : Revolution in analysing and processing patient data to increase efficiency and quality in radiology].","authors":"Philipp Arnold, Maurice Henkel, Fabian Bamberg, Elmar Kotter","doi":"10.1007/s00117-025-01431-3","DOIUrl":"10.1007/s00117-025-01431-3","url":null,"abstract":"<p><strong>Background: </strong>Large Language Models (LLMs) like ChatGPT, Llama and Claude are transforming healthcare by interpreting complex text, extracting information, and providing guideline-based support. Radiology, with its high patient volume and digital workflows, is a ideal field for LLM integration.</p><p><strong>Objective: </strong>Assessment of the potential of LLMs to enhance efficiency, standardization, and decision support in radiology, while addressing ethical and regulatory challenges.</p><p><strong>Material and methods: </strong>Pilot studies at Freiburg and Basel university hospitals evaluated local LLM systems for tasks like prior report summarization and guideline-driven reporting. Integration with Picture Archiving and Communication System (PACS) and Electronic Health Record (EHR) systems was achieved via Digital Imaging and Communications in Medicine (DICOM) and Fast Healthcare Interoperability Resources (FHIR) standards. Metrics included time savings, compliance with the European Union (EU) Artificial Intelligence (AI) Act, and user acceptance.</p><p><strong>Results: </strong>LLMs demonstrate significant potential as a support tool for radiologists in clinical practice by reducing reporting times, automating routine tasks, and ensuring consistent, high-quality results. They also support interdisciplinary workflows (e.g., tumor boards) and meet data protection requirements when locally implemented.</p><p><strong>Discussion: </strong>Local LLM systems are feasible and beneficial in radiology, enhancing efficiency and diagnostic quality. Future work should refine transparency, expand applications, and ensure LLMs complement medical expertise while adhering to ethical and legal standards.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"243-248"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Transformation of free-text radiology reports into structured data].","authors":"Markus M Graf, Keno K Bressem, Lisa C Adams","doi":"10.1007/s00117-025-01422-4","DOIUrl":"10.1007/s00117-025-01422-4","url":null,"abstract":"<p><strong>Background: </strong>The rapid development of large language models (LLMs) opens up new possibilities for the automated processing of medical texts. Transforming unstructured radiology reports into structured data is crucial for efficient use in clinical decision support systems, research, and improving patient care.</p><p><strong>Objectives: </strong>What are the challenges of transforming natural language radiology reports into structured data using LLMs? Which methods and architectures are promising? How can the quality and reliability of the extracted data be ensured?</p><p><strong>Materials and methods: </strong>This article examines current research on the application of LLMs in radiological information processing. Various approaches such as rule-based systems, machine learning, and deep learning models, particularly neural network architectures, are analyzed and compared. The focus is on extracting information such as diagnoses, anatomical locations, findings, and measurements.</p><p><strong>Results and conclusion: </strong>LLMs show great potential in transforming reports into structured data. In particular, deep learning models trained on large datasets achieve high accuracies. However, challenges remain, such as dealing with ambiguities, abbreviations, and the variability of linguistic expressions. Combining LLMs with domain-specific knowledge, for example, in the form of ontologies, can further improve the performance of the systems. Integrating contextual information and developing robust evaluation metrics are also important research directions.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"249-256"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Fink, Alexander Rau, Elmar Kotter, Fabian Bamberg, Maximilian Frederik Russe
{"title":"[Optimized interaction with Large Language Models : A practical guide to Prompt Engineering and Retrieval-Augmented Generation].","authors":"Anna Fink, Alexander Rau, Elmar Kotter, Fabian Bamberg, Maximilian Frederik Russe","doi":"10.1007/s00117-025-01416-2","DOIUrl":"10.1007/s00117-025-01416-2","url":null,"abstract":"<p><strong>Background: </strong>Given the increasing number of radiological examinations, large language models (LLMs) offer promising support in radiology. Optimized interaction is essential to ensure reliable results.</p><p><strong>Objectives: </strong>This article provides an overview of interaction techniques such as prompt engineering, zero-shot learning, and retrieval-augmented generation (RAG) and gives practical tips for their application in radiology.</p><p><strong>Materials and methods: </strong>Demonstration of interaction techniques based on practical examples with concrete recommendations for their application in routine radiological practice.</p><p><strong>Results: </strong>Advanced interaction techniques allow task-specific adaptation of LLMs without the need for retraining. The creation of precise prompts and the use of zero-shot and few-shot learning can significantly improve response quality. RAG enables the integration of current and domain-specific information into LLM tools, increasing the accuracy and relevance of the generated content.</p><p><strong>Conclusions: </strong>The use of prompt engineering, zero-shot and few-shot learning, and RAG can optimize interaction with LLMs in radiology. Through these targeted strategies, radiologists can efficiently integrate general chatbots into routine practice to improve patient care.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"235-242"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Temporal bone surgery and requirements for radiology].","authors":"Alessandro Bozzato","doi":"10.1007/s00117-025-01429-x","DOIUrl":"https://doi.org/10.1007/s00117-025-01429-x","url":null,"abstract":"<p><strong>Background: </strong>Perioperative imaging plays a central role in otorhinolaryngology, particularly in procedures involving the complex temporal bone. Detailed understanding and precise depiction of its specialised anatomy are essential to minimise risks during surgical interventions and to optimise surgical planning.</p><p><strong>Materials and methods: </strong>This article highlights the value of cross-sectional imaging, primarily computed tomography (CT) and magnetic resonance imaging (MRI), in the context of surgical challenges, critical aspects in the assessment of inflammatory conditions, the planning of middle ear procedures, and tumour diagnostics in the temporal bone. Surgical concepts are illustrated using common pathological conditions.</p><p><strong>Conclusion: </strong>Close collaboration between radiologists and surgeons is crucial to minimise patient-specific risks and to optimise surgical outcomes in inflammatory diseases and neoplasms of the temporal bone.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Parametric imaging of the breast-a paradigm shift?]","authors":"Maximilian Reiser, R Schulz-Wendtland","doi":"10.1007/s00117-025-01420-6","DOIUrl":"https://doi.org/10.1007/s00117-025-01420-6","url":null,"abstract":"","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":"65 3","pages":"151-153"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}