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

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.