MRI features and preliminary diagnostic assessment using large language models of cystic tumor progression mimicking radiation necrosis in brain metastasis patients treated with immunotherapy: case report

The application of immunotherapy in patients with brain metastasis (BM) has increased rapidly in recent years, which led to a diagnostic dilemma between pseudoprogression and true progression in the post-treatment evaluation. Here, we reported MRI characteristics of pathology-confirmed large cystic rim-enhancing lesions of tumor progression in two BM cases with immunotherapy treatment, which mimicked radiation necrosis on conventional MRI. In addition, our preliminary findings showed that the custom large language models (LLMs) using ChatGPT and DeepSeek yielded correct diagnoses in these cases, which may suggest the potential utility of LLMs for the decision-making in this field.

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Publication Details

Journal
Frontiers in Immunology
Published
2025-12-10
DOI
https://doi.org/10.3389/fimmu.2025.1661918
Primary Topic
Brain Metastases and Treatment
Type
article
Field-Weighted Citation Impact
0.00
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MRI features and preliminary diagnostic assessment using large language models of cystic tumor progression mimicking radiation necrosis in brain metastasis patients treated with immunotherapy: case report

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MRI features and preliminary diagnostic assessment using large language models of cystic tumor progression mimicking radiation necrosis in brain metastasis patients treated with immunotherapy: case report

Li-Jia Li, Xuwen Liu, Gang Xiao, Henry Z. Wang, Guirong Tan, Haihui Jiang, Yichuan Hu, Shimin Li, Yu Lu, Ming Cai, Amy Liu, Lijuan Zhong, Qiong Liang
article en

Abstract

The application of immunotherapy in patients with brain metastasis (BM) has increased rapidly in recent years, which led to a diagnostic dilemma between pseudoprogression and true progression in the post-treatment evaluation. Here, we reported MRI characteristics of pathology-confirmed large cystic rim-enhancing lesions of tumor progression in two BM cases with immunotherapy treatment, which mimicked radiation necrosis on conventional MRI. In addition, our preliminary findings showed that the custom large language models (LLMs) using ChatGPT and DeepSeek yielded correct diagnoses in these cases, which may suggest the potential utility of LLMs for the decision-making in this field.

Frontiers in ImmunologyVol. 16
Sun Yat-sen University (CN), Peking University (CN), Nazareth College (US), University of Rochester Medical Center (US), Peking University Third Hospital (CN), Third Affiliated Hospital of Zhengzhou University (CN), Third Affiliated Hospital of Sun Yat-sen University (CN)
Openalex Percentile: Top 42%
Brain Metastases and Treatment
DOIOpen Access PDFOpenAlex
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