Visual scanning patterns of radiologists searching mammograms

Rationale and Objectives. I examined whether the principles of search, detection, and decision making described for pulmonary nodule detection can be applied to lesion detection in mammographic images. Methods. The eye position of six radiologists (three staff mammographers and three radiology residents) was recorded as they searched mammograms for masses and microcalcifications. Results. True- and false-positive decisions were associated with prolonged gaze durations; false-negative decisions were associated with longer gaze durations than true-negatives. Readers with more experience tended to detect lesions earlier in the search than did readers with less experience, but those with less experience tended to spend more time overall searching the images and cover more image area than; did those with more experience. Conclusion. Gaze duration is a useful predictor of missed lesions in mammography, making gaze duration a potential tool for perceptual feedback, Mammographic search for readers with different degrees of experience can be characterized by gaze durations, scan paths, and detection times.