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Main Authors: Johno, Hisashi, Johno, Yuki, Amakawa, Akitomo, Sato, Junichi, Tozuka, Ryota, Komaba, Atsushi, Watanabe, Hiroaki, Watanabe, Hiroki, Goto, Chihiro, Morisaka, Hiroyuki, Onishi, Hiroshi, Nakamoto, Kazunori
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2503.15664
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author Johno, Hisashi
Johno, Yuki
Amakawa, Akitomo
Sato, Junichi
Tozuka, Ryota
Komaba, Atsushi
Watanabe, Hiroaki
Watanabe, Hiroki
Goto, Chihiro
Morisaka, Hiroyuki
Onishi, Hiroshi
Nakamoto, Kazunori
author_facet Johno, Hisashi
Johno, Yuki
Amakawa, Akitomo
Sato, Junichi
Tozuka, Ryota
Komaba, Atsushi
Watanabe, Hiroaki
Watanabe, Hiroki
Goto, Chihiro
Morisaka, Hiroyuki
Onishi, Hiroshi
Nakamoto, Kazunori
contents Purpose: Retrieval-augmented generation (RAG) is a technology to enhance the functionality and reliability of large language models (LLMs) by retrieving relevant information from reliable external knowledge (REK). RAG has gained interest in radiology, and we previously reported the utility of NotebookLM, an LLM with RAG (RAG-LLM), for lung cancer staging. However, since the comparator LLM differed from NotebookLM's internal model, it remained unclear whether its advantage stemmed from RAG or inherent model differences. To better isolate RAG's impact and assess its utility across different cancers, we compared NotebookLM with its internal LLM, Gemini 2.0 Flash, in a pancreatic cancer staging experiment. Materials and Methods: A summary of Japan's pancreatic cancer staging guidelines was used as REK. We compared three groups - REK+/RAG+ (NotebookLM with REK), REK+/RAG- (Gemini 2.0 Flash with REK), and REK-/RAG- (Gemini 2.0 Flash without REK) - in staging 100 fictional pancreatic cancer cases based on CT findings. Staging criteria included TNM classification, local invasion factors, and resectability classification. In REK+/RAG+, retrieval accuracy was quantified based on the sufficiency of retrieved REK excerpts. Results: REK+/RAG+ achieved a staging accuracy of 70%, outperforming REK+/RAG- (38%) and REK-/RAG- (35%). For TNM classification, REK+/RAG+ attained 80% accuracy, exceeding REK+/RAG- (55%) and REK-/RAG- (50%). Additionally, REK+/RAG+ explicitly presented retrieved REK excerpts, achieving a retrieval accuracy of 92%. Conclusion: NotebookLM, a RAG-LLM, outperformed its internal LLM, Gemini 2.0 Flash, in a pancreatic cancer staging experiment, suggesting that RAG may improve LLM's staging accuracy. Furthermore, its ability to retrieve and present REK excerpts provides transparency for physicians, highlighting its applicability for clinical diagnosis and classification.
format Preprint
id arxiv_https___arxiv_org_abs_2503_15664
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Enhancing Pancreatic Cancer Staging with Large Language Models: The Role of Retrieval-Augmented Generation
Johno, Hisashi
Johno, Yuki
Amakawa, Akitomo
Sato, Junichi
Tozuka, Ryota
Komaba, Atsushi
Watanabe, Hiroaki
Watanabe, Hiroki
Goto, Chihiro
Morisaka, Hiroyuki
Onishi, Hiroshi
Nakamoto, Kazunori
Computation and Language
Purpose: Retrieval-augmented generation (RAG) is a technology to enhance the functionality and reliability of large language models (LLMs) by retrieving relevant information from reliable external knowledge (REK). RAG has gained interest in radiology, and we previously reported the utility of NotebookLM, an LLM with RAG (RAG-LLM), for lung cancer staging. However, since the comparator LLM differed from NotebookLM's internal model, it remained unclear whether its advantage stemmed from RAG or inherent model differences. To better isolate RAG's impact and assess its utility across different cancers, we compared NotebookLM with its internal LLM, Gemini 2.0 Flash, in a pancreatic cancer staging experiment. Materials and Methods: A summary of Japan's pancreatic cancer staging guidelines was used as REK. We compared three groups - REK+/RAG+ (NotebookLM with REK), REK+/RAG- (Gemini 2.0 Flash with REK), and REK-/RAG- (Gemini 2.0 Flash without REK) - in staging 100 fictional pancreatic cancer cases based on CT findings. Staging criteria included TNM classification, local invasion factors, and resectability classification. In REK+/RAG+, retrieval accuracy was quantified based on the sufficiency of retrieved REK excerpts. Results: REK+/RAG+ achieved a staging accuracy of 70%, outperforming REK+/RAG- (38%) and REK-/RAG- (35%). For TNM classification, REK+/RAG+ attained 80% accuracy, exceeding REK+/RAG- (55%) and REK-/RAG- (50%). Additionally, REK+/RAG+ explicitly presented retrieved REK excerpts, achieving a retrieval accuracy of 92%. Conclusion: NotebookLM, a RAG-LLM, outperformed its internal LLM, Gemini 2.0 Flash, in a pancreatic cancer staging experiment, suggesting that RAG may improve LLM's staging accuracy. Furthermore, its ability to retrieve and present REK excerpts provides transparency for physicians, highlighting its applicability for clinical diagnosis and classification.
title Enhancing Pancreatic Cancer Staging with Large Language Models: The Role of Retrieval-Augmented Generation
topic Computation and Language
url https://arxiv.org/abs/2503.15664