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Updated: Aug 7, 2026
A 3D Digital Model for the Diagnosis and Treatment of Pulmonary Nodules
Published on: May 19, 2023
Thin-section CT of the lungs: eye-tracking analysis of the visual approach to reading tiled and stacked display
S M Ellis1, X Hu, L Dempere-Marco
1Department of Radiology, London Chest Hospital, Bonner Road, London E2 9JX, UK. Stephen.ellis@bartsandthelondon.nhs.uk
Objective:
To use eye-tracking analysis to identify the differences in approach to and efficiency of reading thin-section CT of the lungs presented tiled and stacked soft-copy displays.
Materials And Methods:
Four chest radiologists read 16 thin-section CT examinations displayed in either a tiled (four images at once) or stacked (full screen cine) format. Eye-movements were recorded and analysed in terms of movement type; saccade distance (classified by the calculated range of useful peripheral vision), number of fixations, duration and direction of gaze-comparison of the areas of the images viewed.
Results:
Cases presented in stacked format were read quicker than when presented in tiled format with a greater fixation frequency (5 fixations versus 4.5 fixations points per 100 data points; p<0.001) and a greater proportion of short saccades (97% versus 94%; p<0.005). The consistency with which the observers viewed equivalent areas of the scan images in different cases was greater when viewing in stacked format (mean kappa 0.45 versus 0.36; p<0.05) suggesting a more systematic approach to reading.
Conclusion:
Eye-tracking data demonstrates why thin-section CT examinations of the lungs are read more efficiently when displayed in a stack as opposed to a tiled format.
