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This study examined the application of GPT-4 with vision (GPT-4V), a multimodal large language model with visual recognition, in detecting radiologic findings from a set of 100 chest radiographs and suggests that GPT-4V is currently not ready for real-world diagnostic usage in interpreting chest radiographs. 

Abstract Deep neural networks (DNNs) have achieved state-of-the-art performance in many important domains, including medical diagnosis, security, and autonomous driving. In domains where safety is highly critical, an erroneous decision can result in serious consequences. While a perfect prediction accuracy is not always achievable, recent work on Bayesian deep networks shows that it is possible to know when DNNs are more likely to make mistakes. Knowing what DNNs do not know is desirable to increase the safety of deep learning technology in sensitive applications; Bayesian neural networks attempt to address this challenge. Traditional approaches are computationally intractable and do not scale well to large, complex neural network architectures. In this paper, we develop a theoretical framework to approximate Bayesian inference for DNNs by imposing a Bernoulli distribution on the model weights. This method called Monte Carlo DropConnect (MC-DropConnect) gives us a tool to represent the model uncertainty with little change in the overall model structure or computational cost. We extensively validate the proposed algorithm on multiple network architectures and datasets for classification and semantic segmentation tasks. We also propose new metrics to quantify uncertainty estimates. This enables an objective comparison between MC-DropConnect and prior approaches. Our empirical results demonstrate that the proposed framework yields significant improvement in both prediction accuracy and uncertainty estimation quality compared to the state of the art. 

Computer-aided diagnosis (CAD) systems must constantly cope with the perpetual changes in data distribution caused by different sensing technologies, imaging protocols, and patient populations. Adapting these systems to new domains often requires significant amounts of labeled data for re-training. This process is labor-intensive and time-consuming. We propose a memory-augmented capsule network for the rapid adaptation of CAD models to new domains. It consists of a capsule network that is meant to extract feature embeddings from some high-dimensional input, and a memory-augmented task network meant to exploit its stored knowledge from the target domains. Our network is able to efficiently adapt to unseen domains using only a few annotated samples. We evaluate our method using a large-scale public lung nodule dataset (LUNA), coupled with our own collected lung nodules and incidental lung nodules datasets. When trained on the LUNA dataset, our network requires only 30 additional samples from our collected lung nodule and incidental lung nodule datasets to achieve clinically relevant performance (0.925 and 0.891 area under receiving operating characteristic curves (AUROC), respectively). This result is equivalent to using two orders of magnitude less labeled training data while achieving the same performance. We further evaluate our method by introducing heavy noise, artifacts, and adversarial attacks. Under these severe conditions, our network’s AUROC remains above 0.7 while the performance of state-of-the-art approaches reduce to chance level