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Enhancing Radiologist Reading Performance by Ordering Screening Mammograms Based on Characteristics That Promote

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Summary

Ordering mammograms by increasing volumetric breast density (VBD) improves radiologist screening performance and reduces reading time. This method enhances detection of abnormalities, unlike grouping by self-supervised learning (SSL).

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Area of Science:

  • Radiology and Medical Imaging
  • Artificial Intelligence in Healthcare
  • Human Visual Perception

Background:

  • Mammographic background characteristics may influence visual adaptation in radiologists, potentially improving abnormality detection.
  • The specific characteristic driving this visual adaptation, such as breast density, remains unclear.

Purpose of the Study:

  • To determine if screening mammography performance is enhanced when examinations are batched based on characteristics that may promote visual adaptation.
  • Investigate the impact of ordering mammograms by volumetric breast density (VBD) and self-supervised learning (SSL) groupings on radiologist performance.

Main Methods:

  • Retrospective multireader multicase study using mammograms from 2016-2019.
  • 13 radiologists interpreted examinations in random, increasing VBD, and SSL-ordered batches.
  • Eye-tracking recorded radiologist eye movements; performance metrics (AUC, sensitivity, specificity) and reading times were analyzed.

Main Results:

  • Increasing VBD order significantly improved the area under the receiver operating characteristic curve (AUC) compared to random order (0.93 vs 0.92).
  • VBD ordering reduced reading time (24.3 vs 27.9 seconds) and fixation time in malignant regions (3.7 vs 4.6 seconds).
  • Self-supervised learning (SSL) ordering showed no significant improvement in AUC, sensitivity, or specificity compared to random order.

Conclusions:

  • Ordering screening mammography examinations by increasing volumetric breast density (VBD) enhances radiologist screening performance.
  • This VBD-based ordering strategy also reduces reading time and visual fixation duration, suggesting improved efficiency and effectiveness.