The Radiologist’s Gaze: Mapping Three-Dimensional Visual Search in Computed Tomography of the Abdomen and Pelvis
A radiologist’s search pattern can directly influence patient management. A missed finding is a missed opportunity for intervention. Multiple studies have attempted to describe and quantify search patterns but have mainly focused on chest radiographs and chest CTs. Here, we describe and quantify the visual search patterns of 17 radiologists as they scroll through 6 CTs of the abdomen and pelvis. Search pattern tracings varied among individuals and remained relatively consistent per individual between cases. Attendings and trainees had similar eye metric statistics with respect to time to first fixation (TTFF), number of fixations in the region of interest (ROI), fixation duration in ROI, mean saccadic amplitude, or total number of fixations. Attendings had fewer numbers of fixations per second versus trainees (p < 0.001), suggesting efficiency due to expertise. In those cases that were accurately interpreted, TTFF was shorter (p = 0.04), the number of fixations per second and number of fixations in ROI were higher (p = 0.04, p = 0.02, respectively), and fixation duration in ROI was increased (p = 0.02). We subsequently categorized radiologists as “scanners” or “drillers” by both qualitative and quantitative methods and found no differences in accuracy with most radiologists being categorized as “drillers.” This study describes visual search patterns of radiologists in interpretation of CTs of the abdomen and pelvis to better approach future endeavors in determining the effects of manipulations such as fatigue, interruptions, and computer-aided detection.
KeywordsVisual search Eye tracking CT Body imaging Drillers Scanners
- 6.Kelly BS, Rainford LA, Darcy SP, Kavanagh EC, Toomey RJ: The development of expertise in radiology: In chest radiograph interpretation, “expert” search pattern may predate “expert” levels of diagnostic accuracy for pneumothorax identification. Radiology. 280(1):252–260, 2016. https://doi.org/10.1148/radiol.2016150409 CrossRefPubMedGoogle Scholar
- 8.Cooper, L., Gale, A., Darker, I., Toms, A., & Saada, J. (2009). Radiology image perception and observer performance: How does expertise and clinical information alter interpretation? Stroke detection explored through eye-tracking (p. 72630K), 2009. http://doi.org/10.1117/12.811098.Google Scholar
- 11.Rubin GD, Roos JE, Tall M, Harrawood B, Bag S, Ly DL, Seaman DM, Hurwitz LM, Napel S, Roy Choudhury K: Characterizing search, recognition, and decision in the detection of lung nodules on CT scans: Elucidation with eye tracking. Radiology. 274(1):276–286, 2015. https://doi.org/10.1148/radiol.14132918 CrossRefPubMedGoogle Scholar
- 12.Helbren E, Halligan S, Phillips P, Boone D, Fanshawe TR, Taylor SA, Manning D, Gale A, Altman DG, Mallett S: Towards a framework for analysis of eye-tracking studies in the three dimensional environment: A study of visual search by experienced readers of endoluminal CT colonography. Br J Radiol. 87(1037):20130614, 2014. https://doi.org/10.1259/bjr.20130614 CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Salvucci DD, Goldberg JH. Proceedings : Eye Tracking Research & Applications Symposium 2000 : Palm Beach Gardens, FL, November 6–8, 2000. In: Association for Computing Machinery; 2000:71–78. https://dl-acm-org.ezproxy.galter.northwestern.edu/citation.cfm?id=355017. Accessed August 15, 2018.
- 17.Giovinco NA, Sutton SM, Miller JD, Rankin TM, Gonzalez GW, Najafi B, Armstrong DG: A passing glance? Differences in eye tracking and gaze patterns between trainees and experts reading plain film bunion radiographs. J Foot Ankle Surg. 54(3):382–391, 2015. https://doi.org/10.1053/j.jfas.2014.08.013 CrossRefPubMedGoogle Scholar
- 19.Mayo E. Hawthorne and the Western Electric Company First Phase-The Test Room. In: The Social Problems of an Industrial. ; 161–182, 1949. doi:https://doi.org/10.1017/CBO9781107415324.004.