A governance horizon for ethical-use constraints in open-weight AI models

Ethical constraints on open-weight AI models are both a reflection of societal concerns and a foundation for AI governance policy. They are expected to propagate to downstream derivatives while implemented as voluntary metadata disclosures that must be restated at each generation of reuse. We audit 2,142,823 model repositories on Hugging Face Hub to test whether this disclosure-based governance infrastructure can sustain traceability across deep model lineages. Restriction evidence decays with a half-life of 1.31 derivation steps ($R^2$=0.98), and beyond seven downstream generations at least 80% of descendant models lack sufficient public evidence for a governance determination, a depth boundary we formalize as the governance horizon. Platform-level interventions to restore missing licence metadata reveal that policy design (not enforcement alone) is the binding factor: inheritance-only designs require near-complete enforcement to move the horizon, whereas a mandatory-declaration design that explicitly resolves orphan lineage components shifts the horizon already at moderate enforcement. The structural bottleneck is lineages with no inheritable upstream intent: such orphan components remain undecidable under any inheritance-only policy regardless of enforcement rate, and unresolved upstream nodes additionally create direct downstream undecidability bottlenecks that inheritance rules alone cannot recover. Comparison with PyPI, where governance signals are carried by explicit machine-readable declarations, corroborates that the collapse is topology-specific to open-weight derivation rather than inherent to open ecosystems. These results establish that disclosure-based governance has a shallow, structurally determined reach in open-weight AI, and that achieving deep supply-chain accountability requires provenance mechanisms propagating governance signals through derivation itself.

RadAnnotate: Large Language Models for Efficient and Reliable Radiology Report Annotation

Radiology report annotation is essential for clinical NLP, yet manual labeling is slow and costly. We present RadAnnotate, an LLM-based framework that studies retrieval-augmented synthetic reports and confidence-based selective automation to reduce expert effort for labeling in RadGraph. We study RadGraph-style entity labeling (graph nodes) and leave relation extraction (edges) to future work. First, we train entity-specific classifiers on gold-standard reports and characterize their strengths and failure modes across anatomy and observation categories, with uncertain observations hardest to learn. Second, we generate RAG-guided synthetic reports and show that synthetic-only models remain within 1-2 F1 points of gold-trained models, and that synthetic augmentation is especially helpful for uncertain observations in a low-resource setting, improving F1 from 0.61 to 0.70. Finally, by learning entity-specific confidence thresholds, RadAnnotate can automatically annotate 55-90% of reports at 0.86-0.92 entity match score while routing low-confidence cases for expert review.

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.