Investigating reading strategies and eye behaviours associated with high diagnostic performance when reading digital breast tomosynthesis (DBT) images

Partridge, George, Phillips, Peter ORCID logo ORCID: , Darker, Iain and Chen, Yan (2022) Investigating reading strategies and eye behaviours associated with high diagnostic performance when reading digital breast tomosynthesis (DBT) images. In: Mello-Thoms, Claudia R. and Taylor-Phillips, Sian, (eds.) Medical Imaging 2022: Image perception, observer performance, and technology assessment. Proceedings of SPIE, 12035 . SPIE, Bellingham, WA, US. Full text not available from this repository.

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Purpose: Digital breast tomosynthesis (DBT) exhibits increased sensitivity and specificity compared to 2D mammography (DM), but DBT images are complex and interpretation takes longer. Clinicians may fatigue or hit a cognitive limit sooner when reading DBT, potentially reducing diagnostic accuracy. Eye blink behaviour was investigated to explore fatigue and cognitive load.

Methods: Screeners (N=47) from five UK breast screening centres were eye tracked as they read 40 DBT cases (15 normal, 6 benign and 19 malignant), from November 2019-July 2021. Differences in diagnostic accuracy and blink behaviour were analysed over the course of the reading session. Blink rates and case durations were investigated by case malignancy and outcome using T-tests and ANOVAs (alpha=0.05).

Results: Blink rates were higher on malignant cases than on normal cases (p=0.004), and blink rates were higher for cases with true positive outcomes than for cases with true negative outcomes (p=0.013). Participants spent less time on malignant cases than normal or benign cases (ps=< 0.0001), whilst spending more time on cases with a false positive outcome than on cases with a true negative or true positive outcome (ps < 0.0001). No significant difference in blink rate or diagnostic performance by time through reporting session.

Conclusion: Differences in blink rate and time on case are associated with case malignancy and outcome, potentially reflecting varying cognitive demand and interpretation strategies. Further investigation into blinking during medical image interpretation may identify robust signals of cognition and fatigue that could be used for education and training purposes, whilst indicating optimal screening session duration.

Item Type: Book Section
Journal / Publication Title: Medical Imaging 2022: Image Perception, Observer Performance, and Technology Assessment
Publisher: SPIE
ISBN: 9781510649460
Departments: Institute of Health > Medical Sciences
Additional Information: Paper in conference proceedings from event: SPIE Conference on Medical Imaging: Image Perception, Observer Performance, and Technology Assessment, 2022, San Diego, CA, US.
Depositing User: Anna Lupton
Date Deposited: 01 Sep 2022 07:30
Last Modified: 13 Jan 2024 13:46
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