The 'Impression' section of a radiology report is a critical basis for communication between radiologists and other physicians, and it is typically written by radiologists based on the 'Findings' section. However, writing numerous impressions can be laborious and error-prone for radiologists. Although recent studies have achieved promising results in automatic impression generation using large-scale medical text data for pre-training and fine-tuning pre-trained language models, such models often require substantial amounts of medical text data and have poor generalization performance. While large language models (LLMs) like ChatGPT have shown strong generalization capabilities and performance, their performance in specific domains, such as radiology, remains under-investigated and potentially limited. To address this limitation, we propose ImpressionGPT, which leverages the in-context learning capability of LLMs by constructing dynamic contexts using domain-specific, individualized data. This dynamic prompt approach enables the model to learn contextual knowledge from semantically similar examples from existing data. Additionally, we design an iterative optimization algorithm that performs automatic evaluation on the generated impression results and composes the corresponding instruction prompts to further optimize the model. The proposed ImpressionGPT model achieves state-of-the-art performance on both MIMIC-CXR and OpenI datasets without requiring additional training data or fine-tuning the LLMs. This work presents a paradigm for localizing LLMs that can be applied in a wide range of similar application scenarios, bridging the gap between general-purpose LLMs and the specific language processing needs of various domains.

提出了ImpressionGPT，利用建立动态上下文的方法，使模型通过语言模型的上下文学习能力获得从现有数据中语义相似的示例的上下文知识，并设计一种迭代优化算法，用于对生成的印象结果进行自动评估和对应的指令提示，从而在不需要额外训练数据或微调语言模型的情况下在MIMIC-CXR和OpenI数据集上实现了最佳性能。

ImpressionGPT: 面向放射学报告摘要的迭代优化框架和ChatGPT