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Optimizing Large Language Models in Radiology and Mitigating Pitfalls: Prompt Engineering and Fine-tuning.

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April 2025

From the Department of Radiology, George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20052 (T.T.K., R.J.); Yale School of Medicine, New Haven, Conn (M.M.); and University of California San Francisco, San Francisco, Calif (R.S.).

Large language models (LLMs) such as generative pretrained transformers (GPTs) have had a major impact on society, and there is increasing interest in using these models for applications in medicine and radiology. This article presents techniques to optimize these models and describes their known challenges and limitations. Specifically, the authors explore how to best craft natural language prompts, a process known as prompt engineering, for these models to elicit more accurate and desirable responses.

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