Hi aabajian, thanks for replying!

I might quibble with your math a little. Most CTs have more than 100 images, in fact as you know stroke protocols have thousands. And many scans are reconstructed with different kernels, i.e. soft tissue, bone, lung. So maybe your number is a little low.

Still your point is a good one, that there is probably a finite number of imaging presentations possible. Let's pre-dictate them all! That's a lot of RVUs, where do I sign up ;-)

Now, consider this point. Two identical scans can have different "correct" interpretations.

How is that possible? To simplify things, consider an x-ray of a pediatric wrist. Is it fractured? Well, that depends. Where does it hurt? How old are they? What happened? What does the other wrist look like? Where did they grow up?

This may seems like an artificial example but I promise you it is not. There can be identical x-rays, and one is fractured and one is not.

So add this example to the training data set. Now do this for hundreds or thousands of other "corner cases". Does that head CT show acute blood, or is that just a small focus of gyriform dystrophic calcification? Etc.

I guess my point it, you may end up being right. But I don't think we are particularly close, and LLMs might not get us there.