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Dec 26

Refining Focus in AI for Lung Cancer: Comparing Lesion-Centric and Chest-Region Models with Performance Insights from Internal and External Validation

Background: AI-based classification models are essential for improving lung cancer diagnosis. However, the relative performance of lesion-level versus chest-region models in internal and external datasets remains unclear. Purpose: This study evaluates the performance of lesion-level and chest-region models for lung cancer classification, comparing their effectiveness across internal Duke Lung Nodule Dataset 2024 (DLND24) and external (LUNA16, NLST) datasets, with a focus on subgroup analyses by demographics, histology, and imaging characteristics. Materials and Methods: Two AI models were trained: one using lesion-centric patches (64,64,64) and the other using chest-region patches (512,512,8). Internal validation was conducted on DLND24, while external validation utilized LUNA16 and NLST datasets. The models performances were assessed using AUC-ROC, with subgroup analyses for demographic, clinical, and imaging factors. Statistical comparisons were performed using DeLongs test. Gradient-based visualizations and probability distribution were further used for analysis. Results: The lesion-level model consistently outperformed the chest-region model across datasets. In internal validation, the lesion-level model achieved an AUC of 0.71(CI: 0.61-0.81), compared to 0.68(0.57-0.77) for the chest-region model. External validation showed similar trends, with AUCs of 0.90(0.87-0.92) and 0.81(0.79-0.82) on LUNA16 and NLST, respectively. Subgroup analyses revealed significant advantages for lesion-level models in certain histological subtypes (adenocarcinoma) and imaging conditions (CT manufacturers). Conclusion: Lesion-level models demonstrate superior classification performance, especially for external datasets and challenging subgroups, suggesting their clinical utility for precision lung cancer diagnostics.

  • 1 authors
·
Nov 25, 2024

LLM Output Drift: Cross-Provider Validation & Mitigation for Financial Workflows

Financial institutions deploy Large Language Models (LLMs) for reconciliations, regulatory reporting, and client communications, but nondeterministic outputs (output drift) undermine auditability and trust. We quantify drift across five model architectures (7B-120B parameters) on regulated financial tasks, revealing a stark inverse relationship: smaller models (Granite-3-8B, Qwen2.5-7B) achieve 100% output consistency at T=0.0, while GPT-OSS-120B exhibits only 12.5% consistency (95% CI: 3.5-36.0%) regardless of configuration (p<0.0001, Fisher's exact test). This finding challenges conventional assumptions that larger models are universally superior for production deployment. Our contributions include: (i) a finance-calibrated deterministic test harness combining greedy decoding (T=0.0), fixed seeds, and SEC 10-K structure-aware retrieval ordering; (ii) task-specific invariant checking for RAG, JSON, and SQL outputs using finance-calibrated materiality thresholds (plus or minus 5%) and SEC citation validation; (iii) a three-tier model classification system enabling risk-appropriate deployment decisions; and (iv) an audit-ready attestation system with dual-provider validation. We evaluated five models (Qwen2.5-7B via Ollama, Granite-3-8B via IBM watsonx.ai, Llama-3.3-70B, Mistral-Medium-2505, and GPT-OSS-120B) across three regulated financial tasks. Across 480 runs (n=16 per condition), structured tasks (SQL) remain stable even at T=0.2, while RAG tasks show drift (25-75%), revealing task-dependent sensitivity. Cross-provider validation confirms deterministic behavior transfers between local and cloud deployments. We map our framework to Financial Stability Board (FSB), Bank for International Settlements (BIS), and Commodity Futures Trading Commission (CFTC) requirements, demonstrating practical pathways for compliance-ready AI deployments.

  • 2 authors
·
Nov 10

SpiroLLM: Finetuning Pretrained LLMs to Understand Spirogram Time Series with Clinical Validation in COPD Reporting

Chronic Obstructive Pulmonary Disease (COPD), a major chronic respiratory disease with persistent airflow limitation, is a leading global cause of disability and mortality. Respiratory spirogram time series, routinely collected during pulmonary function tests (PFTs), play a critical role in the early detection of repsiratory diseases and in monitoring lung function over time. However, most current AI models for COPD diagnosis are limited to outputting classification results without providing a rationale for their diagnostic process, while current Large Language Models (LLMs) cannot understand spirograms yet, which severely limits their clinical trust and adoption. To tackle this challenge, we leverage a cohort of 234,028 individuals from the UK Biobank (UKB) to propose SpiroLLM, the first multimodal large language model that can understand spirogram. The model extracts morphological features from respiratory curves via a SpiroEncoder and aligns them with PFT numerical values in a unified latent space using a SpiroProjector, ultimately empowering a large language model to generate a comprehensive diagnostic report. Experimental results confirm that SpiroLLM achieved a diagnostic AUROC of 0.8980 (95% CI: 0.8820-0.9132). In a robustness test with missing core data, it maintained a 100% valid response rate, far surpassing the 13.4% of a text-only model and showcasing the superiority of its multimodal design. This work demonstrates the substantial potential of deeply fusing physiological signals with large language models, establishing a new paradigm for the next generation of interpretable and reliable clinical decision support tools.

  • 8 authors
·
Jul 21