MedPAO-Assist: Edge-Deployable, Modality-Aware Agentic AI for Radiology Report Structuring

Shrish Shrinath Vaidya, Minmini Selvam, Ganapathy Krishnamurthi

The adoption of Large Language Models for radiology report structuring has been largely dominated by either proprietary cloud-based models or large open models requiring high-end GPUs for deployment, which is a critical bottleneck for clinical adoption in radiology workflows that demand data privacy and offline operation. To address this, we present MedPAO-Assist, an edge-deployable agentic framework that generates structured radiology reports directly from radiologist dictation and voice commands, requiring only $\approx3.3$ GB peak RAM and achieving an average end-to-end latency of $\approx31$ seconds on a standard laptop CPU through an asynchronous, multi-threaded execution pipeline. The system currently supports four major imaging modalities -- Chest X-ray, Chest CT, Abdomen CT, and Brain MRI. To our knowledge, it is among the earliest agentic systems to run its entire pipeline with a Small Language Model (SLM) in the 0.6B-parameter range. This multi-agent architecture, built around an Extract-Ground-Generate paradigm, performs concept extraction, SNOMED-CT grounding, and structured report generation, followed by a speech-driven human-in-the-loop correction phase, together…