Improving the use of LLMs in radiology through prompt engineering: from precision prompts to zero-shot learning
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PURPOSE: Large language models (LLMs) such as ChatGPT have shown significant potential in radiology. Their effectiveness often depends on prompt engineering, which optimizes the interaction with the chatbot for accurate results. Here, we highlight the critical role of prompt engineering in tailoring the LLMs' responses to specific medical tasks. MATERIALS AND METHODS: Using a clinical case, we elucidate different prompting strategies to adapt the LLM ChatGPT using GPT4 to new tasks without additional training of the base model. These approaches range from precision prompts to advanced in-context methods such as few-shot and zero-shot learning. Additionally, the significance of embeddings, which serve as a data representation technique, is discussed. RESULTS: Prompt engineering substantially improved and focused the chatbot's output. Moreover, embedding of specialized knowledge allows for more transparent insight into the model's decision-making and thus enhances trust. CONCLUSION: Despite certain challenges, prompt engineering plays a pivotal role in harnessing the potential of LLMs for specialized tasks in the medical domain, particularly radiology. As LLMs continue to evolve, techniques like few-shot learning, zero-shot learning, and embedding-based retrieval mechanisms will become indispensable in delivering tailored outputs. KEY POINTS: · Large language models might impact radiological practice and decision-masking.. · However, implementation and performance are dependent on the assigned task.. · Optimization of prompting strategies can substantially improve model performance.. · Strategies for prompt engineering range from precision prompts to zero-shot learning.. CITATION FORMAT: · Russe MF, Reisert M, Bamberg F et al. Improving the use of LLMs in radiology through prompt engineering: from precision prompts to zero-shot learning . Fortschr Röntgenstr 2024; 196: 1166 - 1170.
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Prompt engineering improves chatbot performance by tailoring LLM output to be focused and helpful for a specific task.
“Prompt engineering improves chatbot performance by tailoring LLM output to be focused and helpful for a specific task.162,163”
From Large Language Models for Chatbot Health Advice Studies: A Systematic Review (2025) · cites this paper as [163]
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ChatGPT makes medicine easy to swallow: an exploratory case study on simplified radiology reports
Jeblick, K., Schachtner, B., Dexl, J., Mittermeier, A., Stüber, A. T., Topalis, J., Weber, T., Wesp, P., Sabel, B. O., Ricke, J., et al. (2023) · European Radiology · doi:10.1007/s00330-023-10213-1 · Cited by 549 · see citing works
Lyu, Q., Tan, J., Zapadka, M. E., Ponnatapura, J., Niu, C., Myers, K. J., Wang, G., & Whitlow, C. T. (2023) · Visual Computing for Industry, Biomedicine, and Art · doi:10.1186/s42492-023-00136-5 · Cited by 367 · see citing works
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Large Language Models for Chatbot Health Advice Studies: A Systematic Review
Huo, B., Boyle, A., Marfo, N., Tangamornsuksan, W., Steen, J. P., McKechnie, T., Lee, Y., Mayol, J., Antoniou, S. A., Thirunavukarasu, A. J., et al. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.57879 · Cited by 283 · see citing works
Meyer, B., Kfuri‐Rubens, R., Schmidt, G., Tariq, M., Riedel, C., Recker, F., Riedel, F., Kiechle, M., & Riedel, M. (2025) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.70251 · Cited by 10 · see citing works
- Authors
- Russe, M. F., Reisert, M., Bamberg, F., & Rau, A.
- Affiliations
- University Medical Center Freiburg (DE)
- Corresponding author
- Rau, Alexander
- Venue
- RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren
- Publisher
- Georg Thieme Verlag KG
- Published
- 2024-02-26
- Volume
- 196
- Issue
- 11
- Pages
- 1166-1170
- ISSN
- 1438-9010 (ISSN-L)
- 1438-9029
- OpenAlex
- W4392151399
- Cited by
- 52
- References
- 2
- Citations by year
- 2026: 16 · 2025: 25 · 2024: 11
- FWCI
- 4.86
- Type
- journal article
- Language
- de
- Open access
- bronze
- doi.org
- Locations
- RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Multimodal Machine Learning Applications
- Physical Sciences › Computer Science › Artificial Intelligence › Topic Modeling
- Keywords
- large language models, prompt engineering, radiology, ChatGPT, zero-shot learning, few-shot learning, embeddings, in-context learning, model interpretability, clinical decision support, artificial intelligence in radiology
- MeSH terms
- Machine Learning, Humans, Radiology
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