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Posted by engmarketer 4 hours ago

I used Claude Code to get a second opinion on my MRI(antoine.fi)
163 points | 255 commentspage 3
lucfranken 3 hours ago|
Why wouldn’t you as a doctor by standard run the images through a certified compliant LLM? The actual cost won’t be it and then you can see if you get any new ideas from it. See if it’s just wrong or that it spotted a little detail you missed?

The LLM doesn’t need to be leading or whatever but then you can have a conversation with the patient. If their ChatGPT reports has differences it can be analyzed as well.

It feels like the time constraint of the 15m doctor sessions is the thing. But if prepared immediately after the scan then why not?

There is always time needed to factor in new developments and innovations and that’s fine. Just moving blindly work from human to LLM is wrong. But learning on and testing with all the ai tools incoming constantly won’t be a waste. There will be more and more tools in those processes outside of human judgement, better improve the workflows now to be able to test and plugin new models and systems when they are ready.

KaiserPro 3 hours ago||
> standard run the images through a certified compliant LLM?

Because they don't exist, yet.

In the UK MRIs and other imaging systems need two opinions. there has been a move to allow the first opinion to be ML based.

The _problem_ is that you are basically doing grey smudge analysis, and thats fucking hard.

foobarian 3 hours ago|||
I've been starting to think of LLM as a great tool for "lead generation," borrowing a term from sales. Most of the things it comes up with don't pan out, but in many cases it's things we wouldn't have thought of, or at least not as quickly. This is especially in the context of web service or SAAS outages.
yread 3 hours ago||
Because they might bias you. And because you have your own brain, training and experience
anigbrowl 2 hours ago||
I use LLMs every day and value the benefits they offer, but this approach seems misguided. A smarter way to use them would be to consult the LLM before seeing the specialist and ask it to bring you up to speed on capabilities/limitations and develop a list of important questions to ask.
Aeolun 4 hours ago||
I would not use Claude to get a second opinion on anything that’s an image.
rmbyrro 3 hours ago||
I agree with you for some kinds of images, but not all.

LLMs are the best PDF-to-markdown converters, in my experience. I have a CLI that converts PDF to PNG, then run a background agent to "read" each PNG and write it down as markdown; it works flawlessly even for complex math formulas, it can "translate" complex charts, graphs, and tables into words.

It's slow and arguably expensive compared to traditional OCR, but very effective and precise.

maxall4 4 hours ago|||
Especially an MRI which is a 3D medium —something current LLMs are very bad at.
lostlogin 2 hours ago|||
> MRI which is a 3D medium

The finer detail (which you may already know) is more complicated.

MR does ‘2D’ scans which are a slice, then a gap of non-imaged tissue (typically 10% the slice thickness) then a slice. Each slice is an image with a number of pixels, say 320. Each pixel in the slice is small, eg 0.5mm but very thick due to the slice being thick, which is required for MRI signal. The pixels are 3mm in the shoulder scan done here.

‘3D’ scans don’t have a gap between slices, and are often isotopic, meaning the same resolution in all directions. The voxel (a pixel with depth) would be something like 1mm x 1mm x 1mm.

3D scans are slow, prone to movement artifact and never as pretty in plane as a good 2D. You can reformat them to look ok in any plane.

amluto 4 hours ago|||
I know little about radiology, but MRI is a 3D medium. I would not be at all surprised if one could slice an MRI the wrong way to produce a 2D image that fails to show a feature that exists in the source data.
yolo3000 4 hours ago|||
I used it on an ankle fracture xray, it was quite useful to make sense of things. But not like a 2nd opinion.
behnamoh 4 hours ago||
What's wrong with Claude? I've asked it to analyze images and even Opus 4 would perfect nail it.
throwrioawfo 4 hours ago|||
Sure, it can see obvious stuff in images, but as far as I'm aware it is not designed for (or tested on) performing the kind microscopic analysis that radiology involves
nostrebored 3 hours ago|||
Claude is the worst FM at image understanding. Prior to gpt-5.4 the only usable models were Gemini and Qwen.
intoXbox 4 hours ago||
Radiologists very often have to weigh up different theories, guidelines based on the symptoms. The certainty of their diagnosis is their added value, or if they don’t know they will tell you why.

An AI telling you it could be X or Y because theory ABC… is the academic answer and a luxury clinicians don’t have. AI doesn’t give you what you want. I don’t see any added value in using generic AI models for this

skybrian 4 hours ago||
Getting an actual second opinion seems like the next step?
LogicFailsMe 3 hours ago||
I did the same exercise here with medical reports and CT scans for a friend's cancer diagnosis and I got ahead of the oncologists predicting they were about to be cured. Spoilers: yep, cancer free now.

And well, yes, I have the appropriate life science degrees to navigate clinical trial reports and research publications, and that was likely indispensable for steering Claude Code where it went, the radiologist's caution is merited here. But it's just not amateur hour for me to do this, it's 2 decades of academic research in my rearview mirror.

jochem9 4 hours ago||
Right now the article reads as "AI can play doctor if you give MRI scans".

If the author would actually go for a second opinion (maybe bring along the AI to let it explain it's findings), then the article could read as "AI did MRI analysis and proved my doctor wrong" (or: "AI did MRI analysis and failed").

lycos 2 hours ago||
I'm surprised about the 266 MB of DICOM images, I've never had an MRI but my CT results are generally between 1-2GB (zipped) and I always assumed an MRI would have more data, guess I was wrong about that!
darepublic 3 hours ago|
I would like if we could have a site where you submit your MRI then doctor commenters anonymously post their opinion. In general I want a forum where.. when people come with questions for which there are varying opinions we don't just have people leave their 2c and then jet. The thread persists, duplicated ideas get merged, erroneous statements get purged and gradually we refine shining truth
lostlogin 2 hours ago|
I’m wondering how many radiologist want to work all day, then come home and work.

Many can get paid fee-for-service for after hours work, so would probably prefer that.

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