Pub Date : 2026-04-01Epub Date: 2026-04-28DOI: 10.1177/2993091x261446348
Nikhil G Thaker, Wei Liu, Mark Waddle, Timothy Showalter, Federico Mastroleo, Join Luh, Chad Levitt, Matthew Ning, Arturo Loaiza-Bonilla, Julian Hong
Retrieval-augmented generation (RAG) is rapidly emerging as a transformative paradigm for large language models (LLMs), especially in high-stakes domains like oncology that demand precision, factual grounding, and up-to-date knowledge. By pairing LLMs with external knowledge repositories, RAG systems explicitly ground model outputs in relevant retrieved documents, helping to reduce hallucinations and ensure responses reflect current evidence. In oncology, where clinical knowledge evolves continually with new research and drug approvals, RAG offers a way to integrate the latest data (e.g., trial results, guidelines, genomic databases) into decision-making. This review synthesizes the technical foundations of RAG, including its architecture and key components, and examines current applications in oncology such as clinical decision support, patient education, radiology reporting, pathology analysis, and genomics-driven precision medicine. We highlight recent studies that demonstrate RAG's potential-for instance, improving treatment recommendations by incorporating genetic profiles and literature, and enhancing diagnostic accuracy by integrating guidelines. We also discuss emerging developments like multimodal RAG (combining text with imaging or other data), ensemble model approaches, and new explainability tools that trace model outputs to sources. Finally, we critically analyze the limitations and challenges of deploying RAG in healthcare, including computational costs, retrieval errors, noise or conflicts in retrieved information, and ethical and regulatory considerations. While RAG-based systems show promise in augmenting oncologists' expertise with timely knowledge, careful implementation, high-quality curation of knowledge bases, and human oversight will be crucial for safe and effective adoption in clinical practice.
{"title":"Retrieval-Augmented Generation in Oncology: Promises, Pitfalls, and Early Applications.","authors":"Nikhil G Thaker, Wei Liu, Mark Waddle, Timothy Showalter, Federico Mastroleo, Join Luh, Chad Levitt, Matthew Ning, Arturo Loaiza-Bonilla, Julian Hong","doi":"10.1177/2993091x261446348","DOIUrl":"10.1177/2993091x261446348","url":null,"abstract":"<p><p>Retrieval-augmented generation (RAG) is rapidly emerging as a transformative paradigm for large language models (LLMs), especially in high-stakes domains like oncology that demand precision, factual grounding, and up-to-date knowledge. By pairing LLMs with external knowledge repositories, RAG systems explicitly ground model outputs in relevant retrieved documents, helping to reduce hallucinations and ensure responses reflect current evidence. In oncology, where clinical knowledge evolves continually with new research and drug approvals, RAG offers a way to integrate the latest data (e.g., trial results, guidelines, genomic databases) into decision-making. This review synthesizes the technical foundations of RAG, including its architecture and key components, and examines current applications in oncology such as clinical decision support, patient education, radiology reporting, pathology analysis, and genomics-driven precision medicine. We highlight recent studies that demonstrate RAG's potential-for instance, improving treatment recommendations by incorporating genetic profiles and literature, and enhancing diagnostic accuracy by integrating guidelines. We also discuss emerging developments like multimodal RAG (combining text with imaging or other data), ensemble model approaches, and new explainability tools that trace model outputs to sources. Finally, we critically analyze the limitations and challenges of deploying RAG in healthcare, including computational costs, retrieval errors, noise or conflicts in retrieved information, and ethical and regulatory considerations. While RAG-based systems show promise in augmenting oncologists' expertise with timely knowledge, careful implementation, high-quality curation of knowledge bases, and human oversight will be crucial for safe and effective adoption in clinical practice.</p>","PeriodicalId":520494,"journal":{"name":"AI in precision oncology","volume":"3 2-3","pages":"34-45"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-19eCollection Date: 2024-08-01DOI: 10.1089/aipo.2024.0022
Leslie R Lamb, Constance D Lehman, Synho Do, Kyungsu Kim, Saul Langarica, Manisha Bahl
In recent years, the emergence of new-generation deep learning-based artificial intelligence (AI) tools has reignited enthusiasm about the potential of computer-assisted detection (CADe) and diagnosis (CADx) for screening mammography. For screening mammography, digital breast tomosynthesis (DBT) combined with acquired digital 2D mammography or synthetic 2D mammography is widely used throughout the United States. As of this writing in July 2024, there are six Food and Drug Administration (FDA)-cleared AI-based CADe/x tools for DBT. These tools detect suspicious lesions on DBT and provide corresponding scores at the lesion and examination levels that reflect likelihood of malignancy. In this article, we review the evidence supporting the use of AI-based CADe/x for DBT. The published literature on this topic consists of multireader, multicase studies, retrospective analyses, and two "real-world" evaluations. These studies suggest that AI-based CADe/x could lead to improvements in sensitivity without compromising specificity and to improvements in efficiency. However, the overall published evidence is limited and includes only two small postimplementation clinical studies. Prospective studies and careful postimplementation clinical evaluation will be necessary to fully understand the impact of AI-based CADe/x on screening DBT outcomes.
{"title":"Artificial Intelligence (AI)-Based Computer-Assisted Detection and Diagnosis for Mammography: An Evidence-Based Review of Food and Drug Administration (FDA)-Cleared Tools for Screening Digital Breast Tomosynthesis (DBT).","authors":"Leslie R Lamb, Constance D Lehman, Synho Do, Kyungsu Kim, Saul Langarica, Manisha Bahl","doi":"10.1089/aipo.2024.0022","DOIUrl":"10.1089/aipo.2024.0022","url":null,"abstract":"<p><p>In recent years, the emergence of new-generation deep learning-based artificial intelligence (AI) tools has reignited enthusiasm about the potential of computer-assisted detection (CADe) and diagnosis (CADx) for screening mammography. For screening mammography, digital breast tomosynthesis (DBT) combined with acquired digital 2D mammography or synthetic 2D mammography is widely used throughout the United States. As of this writing in July 2024, there are six Food and Drug Administration (FDA)-cleared AI-based CADe/x tools for DBT. These tools detect suspicious lesions on DBT and provide corresponding scores at the lesion and examination levels that reflect likelihood of malignancy. In this article, we review the evidence supporting the use of AI-based CADe/x for DBT. The published literature on this topic consists of multireader, multicase studies, retrospective analyses, and two \"real-world\" evaluations. These studies suggest that AI-based CADe/x could lead to improvements in sensitivity without compromising specificity and to improvements in efficiency. However, the overall published evidence is limited and includes only two small postimplementation clinical studies. Prospective studies and careful postimplementation clinical evaluation will be necessary to fully understand the impact of AI-based CADe/x on screening DBT outcomes.</p>","PeriodicalId":520494,"journal":{"name":"AI in precision oncology","volume":"1 4","pages":"195-206"},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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