Can Agentic Systems Close the Gap in Radiology with Production AI Tools?

Abstract

Radiology AI has developed along two paths: specialized models that perform well on narrow tasks but cover few clinical findings, and generalist models that address a broader range of tasks but remain prone to hallucination and inaccurate measurements. Combining the two through agentic systems offers a route towards comprehensive radiology reporting, but published systems are tied to one modality or body part. We describe a radiology agentic framework that standardizes how an orchestrator calls modular tools to produce a structured report, and use it to measure what such a system can do with the tools from FDA-cleared radiology AI devices. Report generation is simulated on a large multi-modality report corpus, with the orchestrator given either a catalog of finding classes consolidated from the cleared devices, each available on the modalities it is cleared for, or an unlimited catalog in which any class can be requested, and planning either from the clinical indication or from the target report. Tool outputs are simulated from the reference report, so the comparison isolates tool availability and orchestration from tool error. With the cleared catalog and the indication alone, the