Performance of Natural Language Processing Model in Extracting Information from Free-Text Radiology Reports: A Systematic Review and Meta-Analysis.

The free-text format is widely used in radiology reports for its flexibility of expression; however, its unstructured nature leads to substantial amounts of report data remaining underutilized. A natural language processing (NLP) model for automatic extraction of information from free-text radiology...

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Published in:Journal of Imaging Informatics in Medicine Vol. 39; no. 4; pp. 3639 - 3654
Main Authors: Yang, Qingwen, Jiang, Jiahui, Dong, Xue, Yang, Huai, Wang, Qiuren, Yang, Zhenghan, Yang, Dawei, Liu, Peng
Format: meta analysis research systematic review tables/charts Journal Article
Published: Springer Nature Aug2026
Online Access:View this record in EBSCOhost
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      jtl: Journal of Imaging Informatics in Medicine
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      dt: Aug2026
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10278-025-01728-8
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        atl: Performance of Natural Language Processing Model in Extracting Information from Free-Text Radiology Reports: A Systematic Review and Meta-Analysis.
      aug:
        au:
          Yang, Qingwen
          Jiang, Jiahui
          Dong, Xue
          Yang, Huai
          Wang, Qiuren
          Yang, Zhenghan
          Yang, Dawei
          Liu, Peng
        affil: https://ror.org/013xs5b60 Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong'an Road, Xicheng District, 100050, Beijing, China
      sug:
        subj:
          Information Retrieval
          Natural Language Processing Utilization
          Electronic Health Records
          Reports
          Radiology Information Systems
          Human
          Systematic Review
          Meta Analysis
          PubMed
          Medline
          Embase
          Cochrane Library
          Scales
          Sensitivity and Specificity
          Confidence Intervals
          Maximum Likelihood
          Regression
          ROC Curve
          Data Analysis Software
          Descriptive Statistics
          Funding Source
      ab: The free-text format is widely used in radiology reports for its flexibility of expression; however, its unstructured nature leads to substantial amounts of report data remaining underutilized. A natural language processing (NLP) model for automatic extraction of information from free-text radiology reports can significantly contribute to the development of structured databases, thereby optimizing data utilization. This study aimed to perform a systematic review and meta-analysis that evaluates the performance of NLP systems in extracting information from free-text radiology reports. A systematic literature search was conducted from November 21 to 23, 2024, in PubMed/MEDLINE, Embase, EBSCO, Ovid, Web of Science, and the Cochrane Library. Study quality was assessed using the QUADAS-2 tool. A bivariate random-effects model was applied to obtain the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and area under the summary receiver operating characteristic curve (AUC). Subgroup analyses (e.g., NLP model types, dataset source, and language types) and a random-effects multivariable meta-regression based on the restricted maximum likelihood (REML) method were conducted to explore potential sources of heterogeneity. Sensitivity analyses (excluding high-risk studies, leave-one-out method, and data integration strategy comparison) were performed to assess the robustness of the findings. A total of 28 studies were included in the final analysis, with 421,692 extracted entities in 51,187 free-text radiology reports. NLP systems achieved high pooled sensitivity (91% [95% CI: 87, 93]) and specificity (96% [95% CI: 93, 97]), with a diagnostic odds ratio of 220 (95% CI: 112, 435) and an area under the curve of 0.98 (95% CI: 0.96, 0.99). Subgroup analysis revealed significantly better performance for extracting single anatomical sites (AUC 0.99; 95% CI: 0.97, 0.99) compared with multiple sites (AUC 0.95; 95% CI: 0.93, 0.97; p = 0.001). No significant differences were observed across NLP model types, dataset sources, external validations, languages, or imaging modalities. Multivariable meta-regression further identified anatomical site as the only significant contributor to heterogeneity (coefficient = 2.26; 95% CI: 0.25, 4.27; p = 0.027). Sensitivity analyses confirmed the robustness of the findings, and no evidence of publication bias was detected. NLP models demonstrated excellent performance in extracting information from free-text radiology reports. However, the observed heterogeneity highlights the need for enhanced report standardization and improved model generalizability.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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