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Reading, Fast and Slow: Characterizing Radiologists' Visual Search Through Abdominal CT for Detecting Hepatic

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Drilling, a method of viewing computed tomography (CT) slices, may improve liver metastasis detection sensitivity compared to scanning. Longer interpretation time is also linked to higher sensitivity in detecting these lesions.

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Area of Science:

  • Radiology
  • Medical Imaging
  • Oncology

Background:

  • Limited evidence exists comparing "drilling" and "scanning" viewing techniques for lesion detection.
  • "Drilling" involves fixating on one slice location while rapidly scrolling, whereas "scanning" involves slow scrolling with rapid eye movement within slices.

Purpose of the Study:

  • To investigate the association between "drilling" or "scanning" viewing techniques and sensitivity for detecting liver metastases.
  • To evaluate the impact of interpretation time and eye movement patterns on detection accuracy.

Main Methods:

  • Twenty-five radiologists reviewed 40 contrast-enhanced liver CT exams using eye-tracking technology.
  • Metastasis detection (sensitivity), interpretation time, scrolling rate, and segment change rate were measured.
  • Radiologists were blinded to clinical and prior imaging information.

Main Results:

  • Mean sensitivity for liver metastasis detection was 83%.
  • Higher sensitivity was associated with longer interpretation time (p=0.002) and a smaller segment change rate, indicative of "drilling" (p=0.009).
  • Scrolling rate did not correlate with sensitivity (p=0.37).

Conclusions:

  • "Drilling" may enhance sensitivity for liver metastasis detection, particularly when measured by segment change rate.
  • Increased interpretation time is independently associated with improved sensitivity.
  • "Scanning" did not show a significant association with sensitivity based on scrolling rate.