ISSN 1004-4140
    CN 11-3017/P

    胸部CT规范化描述对通用大语言模型诊断效能的影响

    Effect of Standardized Description of Chest CT on Diagnostic Performance of General Large Language Models

    • 摘要: 目的:探讨胸部影像术语规范化描述对通用大语言模型(DeepSeek-R1)诊断效能的影响。方法:纳入100例多发、多形态肺部病变CT资料(感染性肺炎23例、肺结核22例、纤维化20例、肺水肿18例、过敏性肺炎7例、少见病例10例),输入文本分为:条件A(仅影像描述)、条件B(影像+病史/实验室检查),每组均设原始与规范描述。以临床诊断为金标准,计算Top1符合率、Top3/Top5包含率。采用配对McNemar检验比较组间差异,Wilcoxon检验分析效能提升幅度。结果:规范化描述使条件A的总体Top1符合率从32%提升至70%(Δ38%,P < 0.001);多模态输入(B)在原始描述下提升Top1符合率24%;规范B组所有病种Top5包含率达100%,但Top1符合率仍有提升空间(最高95%)。结论:规范化术语显著提升模型对影像特征的解读能力;多模态输入可弥补非规范描述缺陷,二者联用可实现最优诊断效能。

       

      Abstract: Objective: To investigate the effect of standardized descriptions of chest imaging terminologies on the diagnostic efficacy of general large language models (DeepSeek-R1). Methods: One hundred cases of multiple and varied pulmonary lesions from CT scans were examined (23 pneumonia, 22 tuberculosis, 20 fibrosis, 18 pulmonary edema, 7 allergic pneumonia, and 10 rare cases). The input text was classified into Condition A (imaging description only) and Condition B (imaging + medical history/laboratory examinations), with each group including both original and standardized descriptions. Based on clinical diagnosis as the benchmark, the accuracy rate for the top result as well as the Top-3 and Top-5 inclusion rates were calculated. The paired McNemar test was performed to compare differences between groups, while the Wilcoxon test was conducted to assess the performance improvement. Results: The standardized descriptions improved the overall Top-1 accuracy rate for Condition A from 32% to 70% (Δ38%, P < 0.001), while multimodal input (B) increased the Top-1 accuracy rate by 24% relative to the original descriptions. The Top-5 inclusion rate for all diseases in the standardized B group reached 100%, whereas the Top-1 accuracy rate was 95%. Conclusion: Standardized terminology significantly enhances the model’s ability to interpret imaging features. Multimodal input can compensate for the deficiencies of nonstandard descriptions, while the combined use of both can yield optimal diagnostic efficacy.

       

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