From Bench to Bedside With Large Language Models: Expert Panel Narrative Review.

Journal: AJR. American journal of roentgenology
Published Date:

Abstract

Large language models (LLMs) hold immense potential to revolutionize radiology. However, their integration into practice requires careful consideration. Artificial intelligence (AI) chatbots and general-purpose LLMs have potential pitfalls related to privacy, transparency, and accuracy, limiting their current clinical readiness. Thus, LLM-based tools must be optimized for radiology practice to overcome these limitations. Although research and validation for radiology applications remain in their infancy, commercial products incorporating LLMs are becoming available alongside promises of transforming practice. To help radiologists navigate this landscape, this Expert Panel Narrative Review provides a multidimensional perspective on LLMs, encompassing considerations from bench (development and optimization) to bedside (use in practice). At present, LLMs are not autonomous entities that can replace expert decision-making, and radiologists remain responsible for the content of their reports. Patient-facing tools, particularly medical AI chatbots, require additional guardrails to ensure safety and prevent misuse. Still, if responsibly implemented, LLMs are well-positioned to transform efficiency and quality in radiology. Radiologists must be well-informed and proactively involved in guiding the implementation of LLMs in practice to mitigate risks and maximize benefits to patient care.

Authors

  • Rajesh Bhayana
    University Medical Imaging Toronto, Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, Department of Medical Imaging, University of Toronto, Toronto General Hospital, 200 Elizabeth St, Peter Munk Building, 1st Fl, Toronto, ON, Canada M5G 24C.
  • Som Biswas
    Le Bonheur Children's Hospital, The University of Tennessee Health Science Center, Memphis, TN, USA.
  • Tessa S Cook
    Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104 (J.M.S., T.P., J.A., C.E.K., T.S.C.); and Boston University School of Medicine, Boston, Mass (J.M.S.).
  • Woojin Kim
    Nuance Communications, Inc. Los Angeles, California.
  • Felipe C Kitamura
  • Judy Gichoya
    Department of Radiology, Medical College of Georgia at Augusta University, 1120 15th St, Augusta, GA 30912 (Y.T.); and Department of Radiology, Emory University, Atlanta, Ga (B.V., E.K., A.P., J.G., N.S., H.T.).
  • Paul H Yi
    The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: Pyi10@jhmi.edu.