Searching for nodules: what features attract attention and influence detection?

RATIONALE AND OBJECTIVES The goal of the study was to determine whether there are certain physical features of pulmonary nodules that attract visual attention and contribute to increased recognition and detection by observers. MATERIALS AND METHODS A series of posteroanterior chest images with solitary pulmonary nodules were searched by six radiologists as their eye-position was recorded. The signal-to-noise ratio, size, conspicuity, location, and calcification status were measured for each nodule. Dwell parameters were correlated with nodule features and related to detection rates. RESULTS Only nodule size (F = 5.08, P = .0254) and conspicuity (F = 4.625, P = .0329) influenced total dwell time on nodules, with larger, more conspicuous nodules receiving less visual attention than smaller, less conspicuous nodules. All nodule features examined influenced overall detection performance (P < .05) even though most did not influence visual search and attention. CONCLUSION Individual nodule features do not attract attention as measured by "first hit" fixation data, but certain features do tend to hold attention once the nodule has been fixated. The combination of all features influences whether or not it is detected.

[1]  Jill L. King,et al.  Radiologists' confidence in detecting abnormalities on chest images and their subjective judgments of image quality , 1991, Medical Imaging.

[2]  H L Kundel,et al.  The influence of film density on the radiologic detection of lung lesions. , 1977, Investigative radiology.

[3]  Alastair G. Gale,et al.  Circadian Variation in Radiology , 1984 .

[4]  B. Hemminger,et al.  Image presentation in digital radiology: perspectives on the emerging DICOM display function standard and its application. , 1997, Radiographics : a review publication of the Radiological Society of North America, Inc.

[5]  H L Kundel,et al.  Searching for bone fractures: a comparison with pulmonary nodule search. , 1994, Academic radiology.

[6]  J W Oestmann,et al.  Lung lesions: correlation between viewing time and detection. , 1988, Radiology.

[7]  C A Kelsey,et al.  Effect of size and position on chest lesion detection. , 1977, AJR. American journal of roentgenology.

[8]  J G Goldin,et al.  Detection of simulated lung nodules with computed radiography: effects of nodule size, local optical density, global object thickness, and exposure. , 1996, Academic radiology.

[9]  K. Preston White,et al.  Modeling human eye behavior during mammographic scanning: preliminary results , 1997, IEEE Trans. Syst. Man Cybern. Part A.

[10]  Harold L. Kundel.  Peripheral vision, structured noise and film reader error. , 1975 .

[11]  J. J. Geraghty,et al.  The Influence of Clinical History on Visual Search with Single and Multiple Abnormalities , 1993, Investigative radiology.

[12]  J. Stern.  Theoretical and applied aspects of eye movement research A. G. Gale and F. Johnson, (Elsevier Science Publishers B.V., Amsterdam, 1984) pp. xiii + 565, Dfl. 185 , 1985, Biological Psychology.

[13]  H L Kundel,et al.  Visual scanning, pattern recognition and decision-making in pulmonary nodule detection. , 1978, Investigative radiology.

[14]  E. Krupinski,et al.  Searching for lung nodules. Visual dwell indicates locations of false-positive and false-negative decisions. , 1989, Investigative radiology.

[15]  G W Humphreys,et al.  Driving attention with the top down: The relative contribution of target templates to the linear separability effect in the size dimension , 2001, Perception & psychophysics.

[16]  E. Lansdown,et al.  VISUAL SEARCH PATTERNS OF RADIOLOGISTS IN TRAINING. , 1963, Radiology.

[17]  William J. Dallas,et al.  Software for CRT image quality evaluation , 2000, Medical Imaging.

[18]  H L Kundel,et al.  Contrast gradient and the detection of lung nodules. , 1979, Investigative radiology.

[19]  J. Duncan,et al.  Visual search and stimulus similarity. , 1989, Psychological review.

[20]  Paul T. Sowden,et al.  Perceptual learning of the detection of features in X-ray images: a functional role for improvements in adults' visual sensitivity? , 2000, Journal of experimental psychology. Human perception and performance.

[21]  Jill L. King,et al.  Correlations between time required for radiological diagnoses, readers' performance, display environments, and difficulty of cases , 1991, Medical Imaging.

[22]  H L Kundel,et al.  Finding lung nodules with and without comparative visual scanning , 1981, Perception & psychophysics.

[23]  W. Cowan,et al.  Visual search for colour targets that are or are not linearly separable from distractors , 1996, Vision Research.

[24]  Garland Lh.  Studies on the accuracy of diagnostic procedures. , 1959 .

[25]  Harold L. Kundel,et al.  THE COGNITIVE SIDE OF VISUAL SEARCH IN RADIOLOGY , 1987 .

[26]  A. Hillstrom.  Repetition effects in visual search , 2000, Perception & psychophysics.

[27]  R G Swensson,et al.  The value of searching films without specific preconceptions. , 1985, Investigative radiology.

[28]  Michael D'Zmura,et al.  Color in visual search , 1991, Vision Research.

[29]  H L Kundel,et al.  Searching for lung nodules. The guidance of visual scanning. , 1991, Investigative radiology.

[30]  E A Krupinski,et al.  The solitary pulmonary nodule on chest radiography: can we really tell if the nodule is calcified? , 2001, AJR. American journal of roentgenology.

[31]  H L Kundel,et al.  Searching for lung nodules. A comparison of human performance with random and systematic scanning models. , 1987, Investigative radiology.

[32]  H L Kundel,et al.  Visual sampling and estimates of the location of information on chest films. , 1974, Investigative radiology.

[33]  H. Kundel,et al.  Lesion conspicuity, structured noise, and film reader error. , 1976, AJR. American journal of roentgenology.

[34]  H L Kundel,et al.  Psychophysical studies of detection errors in chest radiology. , 1977, Radiology.

[35]  C. Chiles,et al.  Visual skill. Correlation with detection of solitary pulmonary nodules. , 1990, Investigative radiology.

[36]  D. Shaham,et al.  The solitary pulmonary nodule: radiologic considerations. , 2000, Seminars in ultrasound, CT, and MR.

[37]  H L Kundel,et al.  Visual search patterns and experience with radiological images. , 1972, Radiology.

[38]  D Ozonoff,et al.  A model for the radiologic process. , 1972, Radiology.

[39]  D. Ost,et al.  Solitary Pulmonary Nodule , 2005 .

[40]  Elizabeth A. Krupinski,et al.  Recording and analyzing eye-position data using a microcomputer workstation , 1992 .

[41]  H L Kundel,et al.  Interpreting chest radiographs without visual search. , 1975, Radiology.

[42]  P G Herman,et al.  Accuracy and its relationship to experience in the interpretation of chest radiographs. , 1975, Investigative radiology.

[43]  Calvin F. Nodine,et al.  Eye Movements and the Detection of Lung Tumors in Chest Images , 1984 .

[44]  L. Garland.  On the scientific evaluation of diagnostic procedures. , 1949, Radiology.

[45]  E. Krupinski,et al.  Visual scanning patterns of radiologists searching mammograms. , 1996, Academic radiology.

[46]  Elizabeth S. Olds,et al.  Does partial difficult search help difficult search? , 2003, Perception & psychophysics.