Fang Mengjie, Wang Zipei, Pan Sitian, Feng Xin, Zhao Yunpeng, Hou Dongzhi, Wu Ling, Xie Xuebin, Zhang Xu-Yao, Tian Jie, Dong Di
Chinese Academy of Sciences Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.
Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Engineering Medicine, Beihang University, Beijing 100191, China.
Chin Med J (Engl). 2025 Jul 20;138(14):1647-1664. doi: 10.1097/CM9.0000000000003699. Epub 2025 Jun 20.
Recent advances in large models demonstrate significant prospects for transforming the field of medical imaging. These models, including large language models, large visual models, and multimodal large models, offer unprecedented capabilities in processing and interpreting complex medical data across various imaging modalities. By leveraging self-supervised pretraining on vast unlabeled datasets, cross-modal representation learning, and domain-specific medical knowledge adaptation through fine-tuning, large models can achieve higher diagnostic accuracy and more efficient workflows for key clinical tasks. This review summarizes the concepts, methods, and progress of large models in medical imaging, highlighting their potential in precision medicine. The article first outlines the integration of multimodal data under large model technologies, approaches for training large models with medical datasets, and the need for robust evaluation metrics. It then explores how large models can revolutionize applications in critical tasks such as image segmentation, disease diagnosis, personalized treatment strategies, and real-time interactive systems, thus pushing the boundaries of traditional imaging analysis. Despite their potential, the practical implementation of large models in medical imaging faces notable challenges, including the scarcity of high-quality medical data, the need for optimized perception of imaging phenotypes, safety considerations, and seamless integration with existing clinical workflows and equipment. As research progresses, the development of more efficient, interpretable, and generalizable models will be critical to ensuring their reliable deployment across diverse clinical environments. This review aims to provide insights into the current state of the field and provide directions for future research to facilitate the broader adoption of large models in clinical practice.
大型模型的最新进展显示出变革医学成像领域的巨大前景。这些模型,包括大语言模型、大型视觉模型和多模态大型模型,在处理和解释各种成像模态的复杂医学数据方面具有前所未有的能力。通过在大量未标记数据集上利用自监督预训练、跨模态表示学习以及通过微调进行特定领域医学知识适配,大型模型可以在关键临床任务中实现更高的诊断准确性和更高效的工作流程。本综述总结了大型模型在医学成像中的概念、方法和进展,突出了它们在精准医学中的潜力。文章首先概述了大型模型技术下多模态数据的整合、使用医学数据集训练大型模型的方法以及对稳健评估指标的需求。然后探讨了大型模型如何能够彻底改变图像分割、疾病诊断、个性化治疗策略和实时交互系统等关键任务中的应用,从而突破传统成像分析的界限。尽管具有潜力,但大型模型在医学成像中的实际应用面临着显著挑战,包括高质量医学数据的稀缺、对成像表型的优化感知需求、安全考量以及与现有临床工作流程和设备的无缝集成。随着研究的进展,开发更高效、可解释和可推广的模型对于确保它们在不同临床环境中的可靠部署至关重要。本综述旨在深入了解该领域的当前状态,并为未来研究提供方向,以促进大型模型在临床实践中的更广泛应用。