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Tracking Cancer Through Text: Longitudinal Extraction From Radiology Reports Using Open-Source Large Language Models

arXiv cs.CL / 3/11/2026

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Key Points

  • The paper introduces an open-source, locally deployable pipeline using large language models to extract longitudinal cancer-related data from unstructured radiology reports.
  • The system leverages the qwen2.5-72b model within the llm_extractinator framework to extract and link lesion data across multiple time points following RECIST guidelines.
  • Evaluation on 50 Dutch CT thorax/abdomen report pairs demonstrated high accuracy (above 93%) for extracting target, non-target, and new lesion attributes.
  • This approach addresses privacy concerns by avoiding proprietary models and supports reproducible and scalable extraction of structured clinical longitudinal data.
  • The results suggest that open-source LLMs are viable tools for meaningful clinical text processing in oncology monitoring tasks.

Computer Science > Computation and Language

arXiv:2603.09638 (cs)
[Submitted on 10 Mar 2026]

Title:Tracking Cancer Through Text: Longitudinal Extraction From Radiology Reports Using Open-Source Large Language Models

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Abstract:Radiology reports capture crucial longitudinal information on tumor burden, treatment response, and disease progression, yet their unstructured narrative format complicates automated analysis. While large language models (LLMs) have advanced clinical text processing, most state-of-the-art systems remain proprietary, limiting their applicability in privacy-sensitive healthcare environments. We present a fully open-source, locally deployable pipeline for longitudinal information extraction from radiology reports, implemented using the \texttt{llm\_extractinator} framework. The system applies the \texttt{qwen2.5-72b} model to extract and link target, non-target, and new lesion data across time points in accordance with RECIST criteria. Evaluation on 50 Dutch CT Thorax/Abdomen report pairs yielded high extraction performance, with attribute-level accuracies of 93.7\% for target lesions, 94.9\% for non-target lesions, and 94.0\% for new lesions. The approach demonstrates that open-source LLMs can achieve clinically meaningful performance in multi-timepoint oncology tasks while ensuring data privacy and reproducibility. These results highlight the potential of locally deployable LLMs for scalable extraction of structured longitudinal data from routine clinical text.
Comments:
Subjects: Computation and Language (cs.CL)
Cite as: arXiv:2603.09638 [cs.CL]
  (or arXiv:2603.09638v1 [cs.CL] for this version)
  https://doi.org/10.48550/arXiv.2603.09638
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Submission history

From: Luc Builtjes [view email]
[v1] Tue, 10 Mar 2026 13:13:43 UTC (1,529 KB)
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