The Evolution of Radiology Image Annotation in the Era of Large Language Models.

Journal: Radiology. Artificial intelligence
Published Date:

Abstract

Although there are relatively few diverse, high-quality medical imaging datasets on which to train computer vision artificial intelligence models, even fewer datasets contain expertly classified observations that can be repurposed to train or test such models. The traditional annotation process is laborious and time-consuming. Repurposing annotations and consolidating similar types of annotations from disparate sources has never been practical. Until recently, the use of natural language processing to convert a clinical radiology report into labels required custom training of a language model for each use case. Newer technologies such as large language models have made it possible to generate accurate and normalized labels at scale, using only clinical reports and specific prompt engineering. The combination of automatically generated labels extracted and normalized from reports in conjunction with foundational image models provides a means to create labels for model training. This article provides a short history and review of the annotation and labeling process of medical images, from the traditional manual methods to the newest semiautomated methods that provide a more scalable solution for creating useful models more efficiently. Feature Detection, Diagnosis, Semi-supervised Learning © RSNA, 2025.

Authors

  • Adam E Flanders
  • Xindi Wang
    Montreal Neurological Institute, McGill University, Montreal, Québec, Canada. Electronic address: sandywang.rest@gmail.com.
  • Carol C Wu
    University of Texas MD Anderson Cancer Center, Houston, Texas.
  • Felipe C Kitamura
  • George Shih
  • John Mongan
    From the Departments of Urology (T.C., M.U., H.C.C., M.S.) and Radiology and Biomedical Imaging (J.M., M.P.K., A.T., P.J., R.G., S.W.), University of California, San Francisco. 505 Parnassus Ave, M-391, San Francisco, CA 94143; and Division of Urology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, The Thai Red Cross Society, Bangkok, Thailand (M.U.).
  • Yifan Peng
    Department of Population Health Sciences, Weill Cornell Medicine, New York, USA.