Comparison of techniques for fine-tuning open-weight models for entity extraction from radiology reports· 开放权重模型微调技术对比

Converting free-text radiology reports into structured labels supports cohort building, quality assurance, and monitoring of clinical imaging models, but the strongest label extractors are hosted proprietary models whose use raises privacy, cost, and reproducibility concerns. We asked whether a fine-tuned open-weight model (Gemma-3-12B) can match GPT-4o at multi-label intracranial hemorrhage (ICH) acuity extraction from non-contrast head-CT reports, and which ingredients matter. Using a 2x2 design, we crossed two adaptation strategies (a discriminative classification head, CH; generative instruction fine-tuning, IFT) with two training-data sources (distillation of real GPT-4o-labeled reports; synthetic reports generated by GPT-4o from real exemplars), across five training sizes, benchmarke