Large Language Models for Chest X-Ray Image Diagnosis and Report Generation: A Stepwise, Multicenter, Early-Stage Clinical Validation Study

The global shortage of radiologists is a pressing issue, particularly in regions with limited medical resources. Against this backdrop, making report generation the core objective of radiology AI systems not only aligns with the practical needs of radiologists but also better serves patient requirements. With the development of multimodal large models, it has become possible to develop automatic report generation systems for medical images. Although ChatGPT 4o has demonstrated certain capabilities in multiple medical sub - fields, as a closed - source system, it has limitations. Its model generation mechanism is opaque, and issues such as hallucination exist. Recently, Deepseek's open - source multimodal large model, Janus - Pro, an "any to any" model, has the advantages of high performance, low cost, and open - source. Nature published three consecutive articles introducing its stunning features. After training and fine - tuning, Janus - Pro shows great potential in medical image diagnosis and report generation. However, currently, the application of Janus - Pro in image diagnosis has not been evaluated. Most existing models are highly versatile but lack optimization for specific domains, and there is a lack of systematic and multi - dimensional evaluation methods to determine the pros and cons of multimodal large models in medical radiology. Based on these current situations, the purpose of our research is to develop and verify the application value of large models dedicated to medical images in image diagnosis and radiology report generation.