{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T19:19:04Z","timestamp":1789759144988,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018542","name":"Natural Science Foundation of Sichuan Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Whether large language models (LLMs) could be integrated into the diagnostic workflow of focal liver lesions (FLLs) remains unclear. We aimed to investigate two generic LLMs (ChatGPT\u20104o and Gemini) regarding their diagnostic accuracies referring to the CT\/MRI reports, compared to and combined with radiologists of different experience levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From April 2022 to April 2024, this single\u2010center retrospective study included consecutive adult patients who underwent contrast\u2010enhanced CT\/MRI for single FLL and subsequent histopathologic examination. The LLMs were prompted by clinical information and the \u201cfindings\u201d section of radiology reports three times to provide differential diagnoses in the descending order of likelihood, with the first considered the final diagnosis. In the research setting, six radiologists (three junior and three middle\u2010level) independently reviewed the CT\/MRI images and clinical information in two rounds (first alone, then with LLM assistance). In the clinical setting, diagnoses were retrieved from the \u201cimpressions\u201d section of radiology reports. Diagnostic accuracy was investigated against histopathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>228 patients (median age, 59\u2009years; 155 males) with 228 FLLs (median size, 3.6\u2009cm) were included. Regarding the final diagnosis, the accuracy of <jats:italic>two\u2010step<\/jats:italic> ChatGPT\u20104o (78.9%) was higher than <jats:italic>single\u2010step<\/jats:italic> ChatGPT\u20104o (68.0%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and <jats:italic>single\u2010step<\/jats:italic> Gemini (73.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.004), similar to real\u2010world radiology reports (80.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.34) and junior radiologists (78.9%\u201382.0%; <jats:italic>p<\/jats:italic>\u2010values, 0.21 to &gt;\u20090.99), but lower than middle\u2010level radiologists (84.6%\u201385.5%; <jats:italic>p<\/jats:italic>\u2010values, 0.001 to 0.02). No incremental diagnostic value of ChatGPT\u20104o was observed for any radiologist (<jats:italic>p<\/jats:italic>\u2010values, 0.63 to &gt;\u20090.99).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:italic>Two\u2010step<\/jats:italic> ChatGPT\u20104o showed matching accuracies to real\u2010world radiology reports and junior radiologists for diagnosing FLLs but was less accurate than middle\u2010level radiologists and demonstrated little incremental diagnostic value.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.70115","type":"journal-article","created":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T09:37:01Z","timestamp":1746869821000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Large Language Models for Diagnosing Focal Liver Lesions From <scp>CT<\/scp>\/<scp>MRI<\/scp> Reports: A Comparative Study With Radiologists"],"prefix":"10.1111","volume":"45","author":[{"given":"Liuji","family":"Sheng","sequence":"first","affiliation":[{"name":"Department of Radiology and Functional and Molecular Imaging Key Laboratory of Sichuan Province West China Hospital, Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6293-4624","authenticated-orcid":false,"given":"Yidi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology and Functional and Molecular Imaging Key Laboratory of Sichuan Province West China Hospital, Sichuan University  Chengdu Sichuan China"},{"name":"Department of Radiology The First Affiliated Hospital of Guangxi Medical University  Nanning Guangxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Radiology and Functional and Molecular Imaging Key Laboratory of Sichuan Province West China Hospital, Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Che","sequence":"additional","affiliation":[{"name":"Department of Radiology and Functional and Molecular Imaging Key Laboratory of Sichuan Province West China Hospital, Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6499-3211","authenticated-orcid":false,"given":"Yingyi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiology and Functional and Molecular Imaging Key Laboratory of Sichuan Province West China Hospital, Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Radiology and Functional and Molecular Imaging Key Laboratory of Sichuan Province West China Hospital, Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chongtu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiology and Functional and Molecular Imaging Key Laboratory of Sichuan Province West China Hospital, Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanshu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology and Functional and Molecular Imaging Key Laboratory of Sichuan Province West China Hospital, Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingwen","family":"Peng","sequence":"additional","affiliation":[{"name":"College of Nursing, North Sichuan Medical College  Nanchong Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa R.","family":"Bashir","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Radiology, Center for Advanced Magnetic Resonance in Medicine, Department of Medicine Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7464-3939","authenticated-orcid":false,"given":"Maxime","family":"Ronot","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, UMR 1149, CRI, Paris &amp; Service de Radiologie, H\u00f4pital Beaujon, APHP. 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