生成式AI正推动医学影像进入基础模型时代,有望重塑临床实践。
The Era of Foundation Models in Medical Imaging is Approaching : A Scoping Review of the Clinical Value of Large-Scale Generative AI Applications in Radiology
- 系统梳理15项研究,聚焦生成式AI在影像报告与诊断中的临床应用
- 多数研究用GPT提升报告效率,少数尝试多模态模型直接解读影像
- 虽表现优异但尚未超越放射科医生,预示基础模型时代将至
放射科医生短缺带来的社会问题日益严峻,人工智能被视为潜在解决方案。近年来,大规模生成式AI从大语言模型(LLMs)扩展至多模态模型,展现出重塑医学影像全流程的潜力。然而,相关发展现状与未来挑战的全面综述仍属空白。本研究遵循PCC指南,系统检索PubMed、EMbase、IEEE-Xplore和Google Scholar四个数据库,共纳入15项符合标准的研究。多数研究集中于提升特定环节的报告生成效率或辅助患者理解,最新研究已拓展至由AI直接进行影像解读。所有研究均经临床医生定量评估,主要采用LLMs,仅三项使用多模态模型。两类模型在特定领域表现优异,但尚无一项在诊断性能上超越放射科医生。多数研究使用GPT,鲜有采用医疗影像专用模型。该综述揭示了当前生成式AI在医学影像领域的状态与局限,提供了基础数据,并指出医学影像基础模型时代即将到来,或将根本性改变临床实践。
原文摘要 · Abstract (English)
Social problems stemming from the shortage of radiologists are intensifying, and artificial intelligence is being highlighted as a potential solution. Recently emerging large-scale generative AI has expanded from large language models (LLMs) to multi-modal models, showing potential to revolutionize the entire process of medical imaging. However, comprehensive reviews on their development status and future challenges are currently lacking. This scoping review systematically organizes existing literature on the clinical value of large-scale generative AI applications by following PCC guidelines. A systematic search was conducted across four databases: PubMed, EMbase, IEEE-Xplore, and Google Scholar, and 15 studies meeting the inclusion/exclusion criteria set by the researchers were reviewed. Most of these studies focused on improving the efficiency of report generation in specific parts of the interpretation process or on translating reports to aid patient understanding, with the latest studies extending to AI applications performing direct interpretations. All studies were quantitatively evaluated by clinicians, with most utilizing LLMs and only three employing multi-modal models. Both LLMs and multi-modal models showed excellent results in specific areas, but none yet outperformed radiologists in diagnostic performance. Most studies utilized GPT, with few using models specialized for the medical imaging domain. This study provides insights into the current state and limitations of large-scale generative AI-based applications in the medical imaging field, offering foundational data and suggesting that the era of medical imaging foundation models is on the horizon, which may fundamentally transform clinical practice in the near future.
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