Large Language Models to Label CT Radiology Reports for Incidental Findings Found in Lung Cancer Screening: A Comparative Analysis

In this study, LLM and prompting strategies for labeling Specific Incidental Findings (SIFs) occurring during lung cancer screening, in radiology reports were compared. In this retrospective study, 300 CT reports from a Dutch academic hospital were included between 19th March 2003 and 28th December 2020. GPT-5, GPT-4-Turbo, Llama-3.1-8B-INST, MedGemma-4B-IT, a keyword-based search method, and a radiologist labelled the reports for the presence or absence of nine SIFs. The radiologist's scores were the reference standard. Each LLM was evaluated with four different prompting strategies: two with

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