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Performance of State-of-the-Art Multimodal Large Language Models on an Image-Rich Radiology Board Examination: Comparison to Human Examinees

delete2025-11-29
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OA
AI
T
Takeshi Nakaura *
N
Naoki Kobayashi
T
Takanori Masuda
Y
Yasunori Nagayama
H
Hiroyuki Uetani
M
Masafumi Kidoh
S
Seitaro Oda
Y
Yoshinori Funama
T
Toshinori Hirai
DOI:10.1016/j.acra.2025.10.051delete
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Abstract

Abstract

En 中文
• Top-performing MLLMs (Gemini 2.5 Pro Preview: 76.0%; o3: 75.0%) exceeded the average human examinee score (72.9%) on the 2024 Japanese Radiology Board Examination (2nd stage). • Gemini 2.5 Pro Preview and Gemini 2.5 Flash Preview-thinking demonstrated statistically significant improvements in accuracy when provided with images (p = 0.035 and p = 0.019, respectively), effectively utilizing multimodal information. • Gemini models, despite their recent release, deliver top-class performance at a substantially lower cost (e.g., Gemini 2.5 Pro Preview at $1.25/$10.00 per 1 M input/output tokens vs. o3 at $10.00/$40.00), suggesting excellent cost-effectiveness for applications in radiology.
Keywords:
AI
Artificial Intelligence
API
Application Programming Interface
CT
Computed Tomography
JRS
Japan Radiological Society
LLM
Large Language Model
MLLM
Multimodal Large Language Model
MRI
Magnetic Resonance Imaging
MSK
Musculoskeletal
PACS
Picture Archiving and Communication Systems
PDF
Portable Document Format
RI
Radioisotope
RLHF
Reinforcement Learning from Human Feedback
SD
Standard Deviation
Large language models (LLMs)
Multimodal AI
Radiology Board Examination
Medical image analysis
Cost-effectiveness
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Journal

Academic Radiology cover
Academic Radiology
IF:
3.9
Papers:
8.6K
Citations:
1.0W

Organization

K
Kumamoto University
Scholars:
1.1W
Papers: 8.5K
Citations: 7.9K
K
Kumamoto University Hospital
Scholars:
49
Papers: 22
Citations: 381
K
Kawasaki University of Medical Welfare
Scholars:
28
Papers: 18
Citations: 128
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