Evidence map›Paper›PMID 42201579›Full record

ArticleInsights into imaging2026

How green are large language models for radiology report labelling? Comparing human, rule-based and hybrid workflows.

Matthias A Fink, Arved Bischoff, Edem Atsiatorme, Alexander Kremer, Jonas Kroschke, Martin Moll, Patrick Stein, Veronika Riebl, Timo Leichenich, Hans-Ulrich Kauczor and 1 more

Abstract read
In one paragraph

Article in Insights into imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Matthias A FinkClinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany. matthias.fink@uni-heidelberg.de.ORCID http://orcid.org/0000-0002-0189-7070
Arved BischoffClinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
Edem AtsiatormeClinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
Alexander KremerClinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
Jonas KroschkeClinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
Martin MollClinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
Patrick SteinClinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
Veronika RieblClinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
Timo LeichenichClinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
Hans-Ulrich KauczorClinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
Kai SchlampClinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo address limited quantitative data on sustainable use of large language models (LLMs) in radiology, we quantified the resource footprint of LLMs for labelling CT pulmonary embolism reports and assessed how a hybrid rule-based-LLM workflow changes time, cost and carbon emissions compared with manual labelling. MATERIALS AND

methodsIn this single-centre retrospective study, 2923 structured CT reports were labelled using four workflows: a rule-based extractor (RBE), an LLM-only pipeline using 18 open-weight and four proprietary models, a hybrid RBE-LLM pipeline that routed RBE failures to an LLM, and full manual labelling by radiologists. Ground truth was based on radiologist adjudication. For each LLM, we measured per-report latency, estimated CO

resultsManual labelling required 32.8 h for 2923 reports (40.4 s/report; €0.42/report) with 95.0% accuracy (95% CI: 93.7-96.2). LLM-only pipelines were less accurate (85.1%; 95% CI: 84.9-85.5) but reduced labelling time to 12.4 h and cost to €2.60 (both p < 0.001). Hybrid RBE-LLM workflows yielded the highest accuracy (98.5%) and lowest resource use: across 22 models, switching from LLM-only to hybrid reduced time (6.7 to 0.97 h), cost (€1.19 to €0.17), and CO

conclusionLLM-only labelling reduced labour time and direct costs compared with manual annotation. A hybrid RBE-LLM pipeline that forwards rule-based failures to an LLM concentrated compute where needed and markedly decreased time, cost and emissions, supporting targeted deployment of LLMs for sustainable data-annotation workflows in radiology. CRITICAL RELEVANCE: By quantifying time, cost and carbon emissions of manual, rule-based, LLM and hybrid report labelling, this study identifies sustainable workflows for deploying LLMs in routine radiology reporting. KEY POINTS: Manual expert labelling of CT pulmonary embolism reports is time-intensive and costly. Mid-sized LLM configurations provide favourable trade-offs between performance and resource use. Hybrid rule-based-LLM workflows sustain accuracy while reducing resource demands.

Indexed as

Data miningLarge language modelsResource footprintStructured reportingSustainability

Identifiers

PMID42201579
PMCPMC13216412

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.