Cited by 46Artificial Intelligence in Healthcare and EducationRadiology practices and educationArtificial Intelligence Applications

The impact of ChatGPT and LLMs on medical imaging stakeholders: Perspectives and use cases

Open access
Yang, Jiancheng, Li, Hongwei Bran, Wei, Donglai·2023·Meta-Radiology

Abstract

This study investigates the transformative potential of Large Language Models (LLMs), such as OpenAI ChatGPT, in medical imaging. With the aid of public data, these models, which possess remarkable language understanding and generation capabilities, are augmenting the interpretive skills of radiologists, enhancing patient-physician communication, and streamlining clinical workflows. The paper introduces an analytic framework for presenting the complex interactions between LLMs and the broader ecosystem of medical imaging stakeholders, including businesses, insurance entities, governments, research institutions, and hospitals (nicknamed BIGR-H). Through detailed analyses, illustrative use cases, and discussions on the broader implications and future directions, this perspective seeks to raise discussion in strategic planning and decision-making in the era of AI-enabled healthcare.

AI snapshot

Written from the paper’s full text.

TL;DR

This perspective paper proposes the BIGR-H framework to analyze how ChatGPT and other LLMs may affect medical imaging stakeholders: businesses, insurance entities, governments, research institutions, and hospitals. It discusses illustrative use cases in clinical workflow, patient communication, and medical education/research, while highlighting ethical, privacy, bias, and regulatory challenges.

Key findings

  • LLMs are presented as augmenting radiologists’ interpretive skills, improving patient-physician communication, and streamlining clinical workflows, with impacts extending across the broader medical imaging ecosystem.
  • The paper introduces the BIGR-H framework—businesses, insurance entities, governments, research institutions, and hospitals—to structure discussion of LLM interactions with each stakeholder group.
  • Illustrative use cases include clinical report structuring and automated report generation, simplified patient communication from radiology reports, medical knowledge Q&A, and research plan design.
  • Future directions include multi-modality LLMs trained on text, medical imaging, and other omics data, plus improving liability and reducing malpractice. No quantitative results or performance metrics are reported.

Methods

  • This is a perspective/analytic paper, not an empirical study; it proposes the BIGR-H framework and discusses implications and use cases.
  • The illustrative examples are described as generated via prompt engineering with OpenAI ChatGPT.
  • No dataset, sample, statistical analysis, or formal evaluation is reported.

Limitations

  • The paper states challenges including ethical issues around trust and responsibility, patient data safety and privacy, bias and fairness, and regulatory/legal concerns.
  • Evident from the text: the use cases are illustrative and generated via prompt engineering, with no empirical validation or quantitative assessment.
  • Evident from the text: the paper is a perspective and does not test the proposed framework or use cases in real clinical or stakeholder settings.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.metrad.2023.100007

Cites

30 of 30 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 12 cited sources checked · 0 supported · 0 flagged

  • Premisecitation
    § 1. Introduction · p. 1

    LLMs, particularly ChatGPT and GPT-4, have shown promise in medical imaging, aiding in text-related tasks like interpreting radiology reports and structured reporting.

    “LLMs, particularly ChatGPT and GPT-4, recently have shown promise in medical imaging, aiding in text-related tasks like interpreting radiology reports [5] and structured reporting [1].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [5] Bommasani, 2021, On the opportunities and risks of foundation models, arXiv Preprint

      Not checked in the free run.

    • cites [1] Gulshan, 2016, Development and validation of a deep learning algorithm for detection of diabetic retinopathy in retinal fundus photographs, JAMA source

      Not checked in the free run.

  • Interpretationcitation
    § (b) Automated Report Generation · p. 4

    LLMs can serve as virtual tutors, answering complex questions about different imaging techniques or specificities of certain pathological findings.

    “In the educational setting, LLMs can serve as virtual tutors [17], answering complex questions about different imaging techniques or specificities of certain pathological findings.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Adams, 2023, Leveraging gpt-4 for post hoc transformation of free-text radiology reports into structured reporting: a multilingual feasibility study, Radiology source

      Not checked in the free run.

  • Interpretationcitation
    § 3. Use Cases · p. 3

    LLMs have the potential to significantly optimize clinical workflows, particularly in medical imaging contexts, by streamlining time-consuming tasks.

    “LLMshave the potential to significantly optimize clinical workflows, particularly in medical imaging contexts. Through their ability to interpret and analyze vast quantities of data quickly and accurately, they can streamline several time-consuming tasks in clinical workflows [1].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1] Gulshan, 2016, Development and validation of a deep learning algorithm for detection of diabetic retinopathy in retinal fundus photographs, JAMA source

      Not checked in the free run.

  • Classified as probably not a substantial claim. 23
  • May combine two claims. 11
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation
    § (b) Automated Report Generation · p. 4

    The answer generated by an LLM for a research problem aligns well with previous studies for the same research questions.

    “Notably, the answer aligns well with previous studies for the same research questions [29, 26].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [29] Yang, 2021, A multi-omics-based serial deep learning approach to predict clinical outcomes of single-agent anti-pd-1/pd-l1 immunotherapy in advanced stage non-small-cell lung cancer, Am J Tourism Res

      Not checked in the free run.

    • cites [26] Zou, 2018

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationreasoning
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 3

    Public health authorities could leverage LLMs to scrutinize large volumes of health data, enhancing disease surveillance capabilities.

    “On the other hand, public health authorities could also leverage the analytical prowess of these models to scrutinize large volumes of health data. By identifying trends and patterns, LLMs could significantly enhance disease surveillance capabilities, providing valuable insights for proactive disease control and prevention measures.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationcitation
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 2

    The integration of LLMs into the healthcare ecosystem is not just enhancing existing capabilities but also redefining the interactions and balance among the stakeholders, heralding a new era of high-performance medicine.

    “Thus, the integration of LLMs into the healthcare ecosystem is not just enhancing existing capabilities but also redefining the interactions and balance among the stakeholders, heralding a new era of high-performance medicine [23]-a paradigm defined by technology-enabled, data-driven healthcare services.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Zhao, 2018, 3d deep learning from ct scans predicts tumor invasiveness of subcentimeter pulmonary adenocarcinomas, Cancer Res source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 2

    LLMs such as ChatGPT are emerging as influential players in the healthcare ecosystem, transforming the roles and operations of each stakeholder.

    “In this complex web of interactions, LLMs such as ChatGPT are emerging as influential players. With their unparalleled ability to interpret health data, improve communication, and facilitate decision-making processes, these models are transforming the roles and operations of each stakeholder in the healthcare ecosystem [17, 18].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [17] Adams, 2023, Leveraging gpt-4 for post hoc transformation of free-text radiology reports into structured reporting: a multilingual feasibility study, Radiology source

      Not checked in the free run.

    • cites [18] Varoquaux, 2022, Machine learning for medical imaging: methodological failures and recommendations for the future, NPJ digital medicine source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 2

    LLMs can aid in answering policyholder queries and providing personalized advice, improving the overall customer experience.

    “In addition, LLMs can aid in answering policyholder queries and providing personalized advice, improving the overall customer experience and ensuring policyholders receive the most accurate and helpful information.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationreasoning
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 2

    CROs could harness LLMs to re-engineer their data processing and analysis workflows in clinical trials, bolstering the speed and accuracy of their research processes.

    “By employing LLMs in data handling and analysis, these organizations can bolster the speed and accuracy of their research processes.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 2

    LLMs can optimize user manuals and device operation guidelines into talking agents, enhancing their clarity and comprehensibility for healthcare professionals.

    “The applicability of LLMs can also optimize user manuals and device operation guidelines into talking agents, enhancing their clarity and comprehensibility for healthcare professionals.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 2

    LLMs can identify patterns and anomalies that could signify potential fraudulent activities in insurance claims.

    “With the ability to process large volumes of data, LLMs can identify patterns and anomalies that could signify potential fraudulent activities, providing an essential tool for insurance companies to prevent such occurrences.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationreasoning
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 2

    Insurance entities can use LLMs to enhance customer service, facilitate more accurate risk assessment, and improve fraud detection.

    “These models can enhance customer service, facilitate more accurate risk assessment, and improve fraud detection.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 2

    Existing AI diagnostic tools augmented by LLMs can facilitate interactive patient consultation, thereby improving patient understanding and engagement.

    “Besides, existing AI diagnostic tools augmented by LLMs can facilitate interactive patient consultation, thereby improving patient understanding and engagement.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 3

    LLMs can augment the regulatory review process for medical product submissions.

    “For regulatory agencies, LLMscan augment the regulatory review process, assisting in the meticulous scrutiny of medical product submissions.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 2

    LLMs can serve as valuable tools for analyzing copious amounts of user feedback and technical documentation, which could provide significant insights, leading to the evolution of existing medical devices.

    “LLMs can serve as valuable tools for analyzing copious amounts of user feedback and technical documentation, which could provide significant insights, leading to the evolution of existing devices.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationcitation
    § (b) Automated Report Generation · p. 4

    LLMs can bridge the gap by translating complex medical language into comprehensible layman's terms, thereby improving patient understanding and engagement.

    “LLMs can bridge this gap by translating complex medical language into comprehensible layman's terms, thereby improving patient understanding and engagement [3].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] Moor, 2023, Foundation models for generalist medical artificial intelligence, Nature source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning
    § (b) Automated Report Generation · p. 4

    LLMs can assist in the design of research plans by providing insights on experimental design, data analysis methods, or suggesting relevant literature.

    “In terms of research, LLMs can assist in the design of research plans by providing insights on experimental design, data analysis methods, or even suggesting relevant literature.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 3

    LLMs are adept at interpreting and analyzing extensive biomedical datasets, facilitating more precise conclusions and novel discoveries in research.

    “These models are adept at interpreting and analyzing extensive biomedical datasets, facilitating more precise conclusions and novel discoveries.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationreasoning
    § (b) Designing Research Plan · p. 6

    Regulatory and legal challenges emerge for LLM integration in medical imaging, requiring clear guidelines from regulatory bodies to protect patient safety and ensure data integrity.

    “Regulatory and legal challenges also emerge, as the integration of LLMs requires clear, comprehensive guidelines from regulatory bodies to protect patient safety and ensure data integrity.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given
    § 4. Implications and Future Directions · p. 5

    Efficiency in clinical workflows is enhanced as LLMs automate the reading and interpretation of diagnostic imaging reports, reducing manual workload.

    “Efficiency in clinical workflows is enhanced as LLMs automate the reading and interpretation of diagnostic imaging reports, reducing manual workload and allowing healthcare professionals to devote more time to patient care.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given
    § 4. Implications and Future Directions · p. 5

    By generating patient-friendly explanations of imaging results, LLMs can enhance patient engagement.

    “Furthermore, by generating patient-friendly explanations of imaging results, LLMs can enhance patient engagement, making healthcare a more collaborative and holistic experience.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 3

    LLMs could function as personalized instructors, elucidating complex imaging concepts and results, fostering a more intuitive understanding for students.

    “They could function as personalized instructors, elucidating complex imaging concepts and results, thereby fostering a more intuitive understanding for students.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning
    § 3. Use Cases · p. 3

    In clinical report structuring, LLMs can convert a narrative radiology report into a structured format such as JSON, which is easier to process and analyze.

    “In clinical report structuring, LLMs can convert a narrative radiology report into a structured format such as JSON, which is easier to process and analyze.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationreasoning
    § 4. Implications and Future Directions · p. 5

    LLMs have the potential to revolutionize medical education by providing personalized, intuitive, and interactive learning experiences.

    “Another major advantage of LLMs is their potential to revolutionize medical education. They can provide personalized, intuitive, and interactive learning experiences, adapting to individual learning styles and pacing.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationcitation
    § (b) Designing Research Plan · p. 6

    Bias and fairness are critical issues for LLMs in medical imaging because if training data is inherently biased, these biases could be replicated in AI predictions, leading to unfair outcomes and exacerbating existing healthcare disparities.

    “Bias and fairness are also critical issues [30, 20]. LLMs learn from the data they are trained on; if this data is inherently biased, these biases could be replicated in AI predictions, leading to unfair outcomes and exacerbating existing healthcare disparities.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [30] Gabriel, 2020, Artificial intelligence, values, and alignment, Minds Mach source

      Not checked in the free run.

    • cites [20] Benjamens, 2020, The state of artificial intelligence-based fda-approved medical devices and algorithms: an online database, NPJ digital medicine source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationreasoning
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 3

    Radiologists and referring physicians can utilize LLMs as advanced decision-support tools to augment diagnostic precision and streamline imaging processes.

    “Radiologists and referring physicians can utilize LLMs as advanced decision-support tools. These models' prowess in interpreting vast quantities of radiology reports can potentially augment diagnostic precision and streamline imaging processes.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given
    § 4. Implications and Future Directions · p. 5

    LLMs can improve diagnostic precision by providing more nuanced and comprehensive interpretations of medical imaging data.

    “LLMs can improve diagnostic precision by providing more nuanced and comprehensive interpretations of medical imaging data.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 3

    LLMs' capacity to discern research gaps and generate new hypotheses can catalyze medical research and innovation.

    “In addition, their capacity to discern research gaps and generate new hypotheses can catalyze medical research and innovation.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationreasoning
    § 2. Impacts on Medical Imaging Stakeholders (BIGR-H) · p. 3

    Patients stand to benefit from LLMs serving as advanced communication platforms that distill complex medical information into more understandable terms, encouraging active participation in healthcare.

    “On the other hand, patients, as the central figures in the healthcare landscape, stand to benefit from LLMs serving as advanced communication platforms. These models can distill complex medical information into more understandable terms, encouraging patients to participate actively in their healthcare journey.”
    Quote in the paperNot a substantial claim
26 of 26

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Cites

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Research works printed but not linked: 1

  1. Brown, 2020, Language models are few-shot learners, Adv Neural Inf Process Syst, 33, 1877

Cited by

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Authors
Yang, J., Li, H. B., & Wei, D.
Affiliations
  • École Polytechnique Fédérale de Lausanne (CH)
  • University of Zurich (CH)
  • Boston College (US)
Corresponding author
Yang, Jiancheng
Venue
Meta-Radiology
Publisher
Elsevier BV
Published
2023-06
Volume
1
Issue
1
Pages
100007
ISSN
2950-1628 (ISSN-L)
OpenAlex
W4383377279
Cited by
46
References
30
Citations by year
2026: 6 · 2025: 9 · 2024: 24 · 2023: 7
FWCI
1.84
Type
journal article
Language
en
Open access
Locations
  • Meta-Radiology (publishedVersion, cc-by)
  • arXiv (Cornell University) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion, cc-by-nc-nd)
  • arXiv (Cornell University) (cc-by)
Funders
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
Topics
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
  • Physical Sciences › Computer Science › Artificial Intelligence › Artificial Intelligence Applications
Keywords
large language models, ChatGPT, diagnostic imaging, radiology, artificial intelligence in healthcare, patient-physician communication, clinical workflow, stakeholders, AI adoption strategy

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