Exploring the accuracy of embedded ChatGPT-4 and ChatGPT-4o in generating BI-RADS scores: a pilot study in radiologic clinical support

Clin Imaging. 2025 Jan:117:110335. doi: 10.1016/j.clinimag.2024.110335. Epub 2024 Oct 30.

Abstract

This study evaluates the accuracy of ChatGPT-4 and ChatGPT-4o in generating Breast Imaging Reporting and Data System (BI-RADS) scores from radiographic images. We tested both models using 77 breast cancer images from radiopaedia.org, including mammograms and ultrasounds. Images were analyzed in separate sessions to avoid bias. ChatGPT-4 and ChatGPT-4o achieved a 66.2 % accuracy across all BI-RADS cases. Performance was highest in BI-RADS 5 cases, with ChatGPT-4 and ChatGPT4o scoring 84.4 % and 88.9 %, respectively. However, both models struggled with BIRADS 1-3 cases, often assigning higher severity ratings. This study highlights the limitations of current LLMs in accurately grading these images and emphasizes the need for further research in these technologies before clinical integration.

Keywords: AI; BIRADS; Breast imaging; Machine learning; Mammography; Radiology.

MeSH terms

  • Breast / diagnostic imaging
  • Breast Neoplasms* / diagnostic imaging
  • Female
  • Humans
  • Mammography* / methods
  • Pilot Projects
  • Radiology Information Systems
  • Reproducibility of Results
  • Ultrasonography, Mammary / methods