MammoWise: Multi-Model Local RAG Pipeline for Mammography Report Generation

Screening mammography is high volume, time sensitive, and documentation heavy. Radiologists must translate subtle visual findings into consistent BI-RADS assessments, breast density categories, and structured narrative reports. While recent Vision Language Models (VLMs) enable image-to-text reporting, many rely on closed cloud systems or tightly coupled architectures that limit privacy, reproducibility, and adaptability. We present MammoWise, a local multi-model pipeline that transforms open source VLMs into mammogram report generators and multi-task classifiers. MammoWise supports any Ollama-hosted VLM and mammography dataset, and enables zero-shot, few-shot, and Chain-of-Thought prompting, with optional multimodal Retrieval Augmented Generation (RAG) using a vector database for case-specific context. We evaluate MedGemma, LLaVA-Med, and Qwen2.5-VL on VinDr-Mammo and DMID datasets, assessing report quality (BERTScore, ROUGE-L), BI-RADS classification, breast density, and key findings. Report generation is consistently strong and improves with few-shot prompting and RAG. Classification is feasible but sensitive to model and dataset choice. Parameter-efficient fine-tuning (QLoRA) of MedGemma improves reliability, achieving BI-RADS accuracy of 0.7545, density accuracy of 0.8840, and calcification accuracy of 0.9341 while preserving report quality. MammoWise provides a practical and extensible framework for deploying local VLMs for mammography reporting within a unified and reproducible workflow.

Intelligent Documentation in Medical Education: Can AI Replace Manual Case Logging?

Procedural case logs are a core requirement in radiology training, yet they are time-consuming to complete and prone to inconsistency when authored manually. This study investigates whether large language models (LLMs) can automate procedural case log documentation directly from free-text radiology reports. We evaluate multiple local and commercial LLMs under instruction-based and chain-of-thought prompting to extract structured procedural information from 414 curated interventional radiology reports authored by nine residents between 2018 and 2024. Model performance is assessed using sensitivity, specificity, and F1-score, alongside inference latency and token efficiency to estimate operational cost. Results show that both local and commercial models achieve strong extraction performance, with best F1-scores approaching 0.87, while exhibiting different trade-offs between speed and cost. Automation using LLMs has the potential to substantially reduce clerical burden for trainees and improve consistency in case logging. These findings demonstrate the feasibility of AI-assisted documentation in medical education and highlight the need for further validation across institutions and clinical workflows.