Blog Logo

30 Nov 2021 ~ 3 min read

o3-medical-image-analysis-example


Inspired by o3 guess a photo’s location. This demo shows chatgpt-o3’s thinking and analyzing process. I pasted the result here, since gpt share url DOES NOT include images.

TODO: find a better pair of (goodcase, badcase)

NOTE: the first prompt does regular reasoning, this is result of second prompt, which I explicitly asked it to

can you zoom in to check if there’s any subtle abnormalities?

o3 medical image analysis step 1 o3 medical image analysis step 2 o3 medical image analysis step 3 o3 medical image analysis step 4 o3 medical image analysis step 5

Final interpretations

What I did to “zoom in”

I loaded the raw pixel data, enlarged each quadrant to ≈4× native resolution, and then inspected:

  • Both sub-pleural crescents and costophrenic angles

  • Central hila / main bronchi

  • Segmental vessels out to the pleura

  • Bony cortices and surrounding soft tissue

What I looked for (and did not see)

Region examinedSubtle findings that would raise concernObservation on this slice
Peripheral 1 cm strip (common spot for tiny sub-pleural nodules, early fibrosis, pleural plaques)Micronodules, reticulation, pleural tags, calcified plaquesPleural contour is smooth & continuous; no nodular densities or striae.
Secondary pulmonary lobules (centrilobular area-filling nodules < 3 mm, mosaic attenuation)Tree-in-bud pattern, ill-defined centrilobular dots, air-trapping, focal ground glassLobules are uniformly aerated; interlobular septa are not thickened. No GG haziness; vessel caliber tapers normally.
Fissures (subtle pleural nodules or plaques)Irregular thickening, focal bulgesMinor normal curvilinear fissural line; no plaque or nodularity.
Hilar soft tissue (≈1 cm medial to main bronchi)Discrete rounded node, asymmetric density, vessel cut-off (emboli)All rounded opacities correspond to vascular cross-sections; margins blend into contiguous vessels, size symmetric L↔R.
Small airwaysWall thickening, luminal impaction, “signet-ring” bronchiectasisBronchial walls are hair-thin; lumens patent; adjacent artery-to-bronchus ratio appropriate; no cylindrical dilation.
Bone window checksSubtle lytic/blastic foci, occult fracture lineCortical outlines remain unbroken; internal trabeculation homogeneous.

Bottom-line interpretation of the magnified review

Even with close-in digital scrutiny there is no evidence of a subtle nodule, ground-glass opacity, focal fibrosis, bronchiectasis, pleural disease, or occult bone lesion on this particular axial section.

Important limitations & next steps

  • Single-slice view – pathology can lie one slice above or below, or become evident only on coronal/sagittal reformats.

  • Window setting – this is a lung window; a mediastinal window series is needed for the tiniest lymph nodes or vascular detail.

  • Clinical correlation – symptoms (e.g., cough, dyspnoea) or risk factors (smoking, occupational exposures) might prompt a full low-dose chest CT interpretation, thin-section HRCT, or follow-up imaging even when one slice looks normal.


Hi, I'm Qianyi. I'm a ML engineer based in Beijing. read more about me on my website.