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Characterizing search, recognition, and decision in the detection of lung nodules on CT scans: elucidation with eye tracking.

Publication ,  Journal Article
Rubin, GD; Roos, JE; Tall, M; Harrawood, B; Bag, S; Ly, DL; Seaman, DM; Hurwitz, LM; Napel, S; Roy Choudhury, K
Published in: Radiology
January 2015

PURPOSE: To determine the effectiveness of radiologists' search, recognition, and acceptance of lung nodules on computed tomographic (CT) images by using eye tracking. MATERIALS AND METHODS: This study was performed with a protocol approved by the institutional review board. All study subjects provided informed consent, and all private health information was protected in accordance with HIPAA. A remote eye tracker was used to record time-varying gaze paths while 13 radiologists interpreted 40 lung CT images with an average of 3.9 synthetic nodules (5-mm diameter) embedded randomly in the lung parenchyma. The radiologists' gaze volumes ( GV gaze volume s) were defined as the portion of the lung parenchyma within 50 pixels (approximately 3 cm) of all gaze points. The fraction of the total lung volume encompassed within the GV gaze volume s, the fraction of lung nodules encompassed within each GV gaze volume (search effectiveness), the fraction of lung nodules within the GV gaze volume detected by the reader (recognition-acceptance effectiveness), and overall sensitivity of lung nodule detection were measured. RESULTS: Detected nodules were within 50 pixels of the nearest gaze point for 990 of 992 correct detections. On average, radiologists searched 26.7% of the lung parenchyma in 3 minutes and 16 seconds and encompassed between 86 and 143 of 157 nodules within their GV gaze volume s. Once encompassed within their GV gaze volume , the average sensitivity of nodule recognition and acceptance ranged from 47 of 100 nodules to 103 of 124 nodules (sensitivity, 0.47-0.82). Overall sensitivity ranged from 47 to 114 of 157 nodules (sensitivity, 0.30-0.73) and showed moderate correlation (r = 0.62, P = .02) with the fraction of lung volume searched. CONCLUSION: Relationships between reader search, recognition and acceptance, and overall lung nodule detection rate can be studied with eye tracking. Radiologists appear to actively search less than half of the lung parenchyma, with substantial interreader variation in volume searched, fraction of nodules included within the search volume, sensitivity for nodules within the search volume, and overall detection rate.

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Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

January 2015

Volume

274

Issue

1

Start / End Page

276 / 286

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Solitary Pulmonary Nodule
  • Nuclear Medicine & Medical Imaging
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Eye Movements
  • Decision Making
  • Clinical Competence
 

Citation

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Rubin, G. D., Roos, J. E., Tall, M., Harrawood, B., Bag, S., Ly, D. L., … Roy Choudhury, K. (2015). Characterizing search, recognition, and decision in the detection of lung nodules on CT scans: elucidation with eye tracking. Radiology, 274(1), 276–286. https://doi.org/10.1148/radiol.14132918
Rubin, Geoffrey D., Justus E. Roos, Martin Tall, Brian Harrawood, Sukantadev Bag, Donald L. Ly, Danielle M. Seaman, Lynne M. Hurwitz, Sandy Napel, and Kingshuk Roy Choudhury. “Characterizing search, recognition, and decision in the detection of lung nodules on CT scans: elucidation with eye tracking.Radiology 274, no. 1 (January 2015): 276–86. https://doi.org/10.1148/radiol.14132918.
Rubin GD, Roos JE, Tall M, Harrawood B, Bag S, Ly DL, et al. Characterizing search, recognition, and decision in the detection of lung nodules on CT scans: elucidation with eye tracking. Radiology. 2015 Jan;274(1):276–86.
Rubin, Geoffrey D., et al. “Characterizing search, recognition, and decision in the detection of lung nodules on CT scans: elucidation with eye tracking.Radiology, vol. 274, no. 1, Jan. 2015, pp. 276–86. Pubmed, doi:10.1148/radiol.14132918.
Rubin GD, Roos JE, Tall M, Harrawood B, Bag S, Ly DL, Seaman DM, Hurwitz LM, Napel S, Roy Choudhury K. Characterizing search, recognition, and decision in the detection of lung nodules on CT scans: elucidation with eye tracking. Radiology. 2015 Jan;274(1):276–286.

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

January 2015

Volume

274

Issue

1

Start / End Page

276 / 286

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Solitary Pulmonary Nodule
  • Nuclear Medicine & Medical Imaging
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Eye Movements
  • Decision Making
  • Clinical Competence