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Large language model ensemble for automated TNM staging from radiology reports
Wen-Chao Yeh1,2, Yi-Shin Chen1, Wen-Lian Hsu1,3
1Institute of Information Systems and Applications, National Tsing Hua University, Hsinchu City, 300, Taiwan.
Motivation:
Accurate TNM staging from lung cancer radiology reports is crucial for treatment planning and prognosis assessment. Manual staging processes are time-consuming and subject to inter-observer variability. Large language models (LLMs) offer opportunities to automate TNM staging with enhanced interpretability and clinical reasoning.
Results:
We developed two complementary systems for automated TNM staging from English radiology reports. System I employs GPT-4o with reasoning-based few-shot learning and multi-step voting. System II integrates multiple LLMs (GPT-4o and Gemini-2) using DSPy framework with MIPROv2 optimization. In NTCIR-18 RadNLP 2024 English main task, our approaches achieved first (joint accuracy: 0.6543) and second place (joint accuracy: 0.6296), demonstrating superior performance in T, N, and M classification with accuracies of 0.7037/0.9136/0.8889 and 0.7284/0.9383/0.8395, respectively.
Availability And Implementation:
Source code freely available at https://github.com/nlptmu/multi-expert-tnm-staging under MIT license. An archival snapshot of the version used in this study is deposited on Zenodo at https://doi.org/10.5281/zenodo.20338561. Implemented in Python 3.12+ with PyTorch 2.6 and DSPY 3.0, supporting Linux.
