Automatic Extraction of Structured Information from Brain MRI Reports Using an Open-Weight Large Language Model

Objectives: Automatic data extraction from free-text radiology reports enables large-scale research, but few studies assessed the performance of large language models (LLMs) on Dutch neuroradiology reports. Methods: We analyzed 947 brain MRI reports from a tertiary memory clinic (2016-2021), authored by consultant neuroradiologists. Trained medical students annotated thirty variables; 100 reports were double-annotated to assess inter-rater reliability. We evaluated the performance of the open-weight LLM LLaMA 3.1 using different languages (Dutch vs. English translation) and few-shot prompting with different example selection strategies. Performance was evaluated using balanced accuracy for categorical variables, accuracy and mean absolute error for counts, and text similarity for free-text. Metrics were computed across 10 random splits of the 947 reports. Results: LLaMA 3.1 demonstrated high zero-shot performance for visual rating scores (mean [95%-CI]): Medial Temporal Atrophy: 90% [77-100%] on the left and 96% [94-99%] on the right, Global Cortical Atrophy: 87% [83-91%], and Fazekas: 94% [93-96%]. Microbleed mentions were detected with 93% accuracy [92-95%] and infarct mentions with 82% [80-84%]. Text similarity for lesion location reached 0.95 [0.95-0.96]. Performance was lower for numerical variables: 80% [78-82%] for the number of microbleeds and 66% [63-68%] for infarcts. English translation yielded comparable results. Few-shot prompting improved performance for numerical variables, achieving 92% [90-93%] for microbleeds and 81% [77-85%] for infarcts using structural similarity-based selection. Conclusion: LLaMA 3.1 shows strong potential for extracting data from Dutch neuroradiology reports. Few-shot prompting enhances performance for numerical variables, whereas challenges remain for location-specific variables.

Identifying latent disease factors differently expressed in patient subgroups using group factor analysis

In this study, we propose a novel approach to uncover subgroup-specific and subgroup-common latent factors addressing the challenges posed by the heterogeneity of neurological and mental disorders, which hinder disease understanding, treatment development, and outcome prediction. The proposed approach, sparse Group Factor Analysis (GFA) with regularised horseshoe priors, was implemented with probabilistic programming and can uncover associations (or latent factors) among multiple data modalities differentially expressed in sample subgroups. Synthetic data experiments showed the robustness of our sparse GFA by correctly inferring latent factors and model parameters. When applied to the Genetic Frontotemporal Dementia Initiative (GENFI) dataset, which comprises patients with frontotemporal dementia (FTD) with genetically defined subgroups, the sparse GFA identified latent disease factors differentially expressed across the subgroups, distinguishing between "subgroup-specific" latent factors within homogeneous groups and "subgroup common" latent factors shared across subgroups. The latent disease factors captured associations between brain structure and non-imaging variables (i.e., questionnaires assessing behaviour and disease severity) across the different genetic subgroups, offering insights into disease profiles. Importantly, two latent factors were more pronounced in the two more homogeneous FTD patient subgroups (progranulin (GRN) and microtubule-associated protein tau (MAPT) mutation), showcasing the method's ability to reveal subgroup-specific characteristics. These findings underscore the potential of sparse GFA for integrating multiple data modalities and identifying interpretable latent disease factors that can improve the characterization and stratification of patients with neurological and mental health disorders.