The Effect of Window Size on Pathologists' Search for Rare Elements in a Digital Pathology Setting

Area of Science:

• Digital pathology and medical imaging analysis.
• Human-computer interaction in diagnostic settings.
• Pathology workflow optimization.

Background:

• Digital pathology is replacing traditional microscopy for tissue assessment.
• The influence of digital display configurations, specifically window size, on pathologist performance remains unclear.
• Understanding these factors is crucial for optimizing digital pathology workflows.

Purpose of the Study:

• To investigate the effect of digital image viewer window size on pathologists' diagnostic accuracy and efficiency.
• To assess how window size influences tumor detection in lymph node whole slide images under time constraints.
• To evaluate pathologists' subjective preferences for different window sizes.

Main Methods:

• Six pathologists evaluated breast lymph node whole slide images for tumors.
• Assessments were conducted using four digital image viewer window sizes (8, 14, 24, 32 inches) under a time limit.
• Eye-gaze data and subjective window size preferences were collected.

Main Results:

• No significant relationship was found between window size and diagnostic performance (false negatives) or assessment time.
• A significant association was observed between window size and the fraction of the window not covered by foveated vision.
• Pathologists significantly preferred larger window sizes, citing improved contextual information.

Conclusions:

• Digital image viewer window size does not significantly impact diagnostic performance in lymph node tumor detection.
• Pathologists adjust their slide navigation strategies based on the context provided by different window sizes.
• Larger display windows are preferred by pathologists for enhanced diagnostic assessment in digital pathology.