Directed Versus Free Search for Nodules in Chest Radiographs

Parker, Timothy W.; Kelsey, Charles A.; Moseley, Robert D.; Mettler, Fred A.; Garcia, José Fernando; Briscoe, David E.

doi:10.1097/00004424-198203000-00007

Cited by 16 publications

(10 citation statements)

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“…Numerous attempts have been made to improve the tumor detection performance of the radiologist by cuing or directing visual search to potential target-eontaining image areas (Berbaum, Franken, Dorfman, & Barloon, 1988;Berbaum et al, 1986;Carmody, Nodine, & Kundel, 1980;Parker et al, 1982;Swensson, Hessel, & Herman, 1977. Surprisingly, cuing in which clinical history information (e.g., a fall on the wrist, the location of a pain, the possibility of a fracture) is used to direct attention has This work was supported by Grant CA-32870 from the National Cancer Institute, USPHS.…”

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confidence: 99%

“…This type of experimental condition was more like those in which potential target locations have been cued either by providing a clinical history or by giving a complete spatial and physical description of the target, without any reference to what the radiologist mayor may not have fixated during an initial search (see Berbaum et al, 1988;Berbaum et al, 1986;Cannody et al, 1980;Parker et al, 1982;Swensson et al, 1977Swensson et al, , 1982. Circling alone without reference to eye-position data also resulted in a significant increase in perfonnance (21 %), suggesting that cuing ROIs can be decoupled from the eye-position and dwell infonnation and still facilitate detection.…”

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confidence: 99%

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Perceptual enhancement of tumor targets in chest X-ray images

Krupiński

Nodine

Kundel

1993

Perception & Psychophysics

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Under tachistoscopic viewing conditions, precuing the location of potential lung tumor targets in chest X-ray images was less effective than precuing followed by bounding the region of interest (ROI) with a circle directly on the image. Detection performance increased as the image was systematically masked so that its size approximated that of the circled ROt When viewing time was extended to allow shifts in eye position, circling the ROI was found to restrict the dispersion of fixations and increase the accuracy of fixating the target tumor. When targets were placed outside the ROI, the circle inhibited their detection relative to detection of targets inside the circled region. These findings suggest that cuing by circling restricts target detection to the ROI, and by doing so reduces the interfering effects of outside distractors that compete with the target for attention.In medical X-ray imaging, tumors of the lungs, breasts, and other major organs make up a major class of search and detection targets. The detection and recognition of these targets is especially difficult because of (1) the presence of numerous anatomical objects that also possess similar features (e.g., blood vessels on end in the lungs); and (2) camouflaging effects created by projection X-ray imaging techniques. Essentially, the observer is searching a two-dimensional, translucent picture of internal human anatomy created from the shadows of the absorption pattern of X-rays passing through the body to the film plate, and interpreting these patterns as three-dimensional objects. The magnitude of the difficulty of this particular search and detection task is evident when error rates in radiology are considered. Misses (false-negatives) of tumors, fractures, and other diagnostic findings can be as high as 30%, and false-positive rates typically run at 10%-15%

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confidence: 99%

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confidence: 99%

Perceptual enhancement of tumor targets in chest X-ray images

Krupiński

Nodine

Kundel

1993

Perception & Psychophysics

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“…These results are interesting in that they may help to explain why eye-position based feedback by circling significantly increased observer performance while other studies designed to increase detection performance showed mixed results (Berbaum et al, 1988;Parker et al, 1982;Swensson et al, 1982). Some of these studies have given clinical histories describing what the target is and where is should be, or have gone as far as providing a complete physical and spatial description of the target.…”

Section: Discussionmentioning

confidence: 76%

“…There have been numerous attempts to improve tumor detection performance of the radiologist by cueing or directing visual search to potential target-containing image areas (Berbaum et al, 1988;Parker et al, 1982;Swensson et al, 1982). Surprisingly, cueing with clinical history information has not led consistently to enhancement of detection performance.…”

Section: Introductionmentioning

confidence: 99%

<title>Perceptual enhancement of pulmonary nodule recognition in chest radiographs</title>

Krupiński

1994

Medical Imaging 1994: Image Perception

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Perceptual feedback (by circling) of chest image areas receiving prolonged gaze duration significantly increases pulmonary nodule detection performance. Other methods of perceptual cueing do not lead to such dramatic increases in performance. The mechanisms by which circling influences detection performance were examined. The results of a number of experiments indicate that circling improves nodule detection because 1) the circle isolates the nodule-containing region from the rest of the image, making the disembedding and perceptual integration of nodule features more likely, 2) the circle insulates the regionof interest from distracters in the chest anatomy outside of the circle boundary which tend to interfere with attention and detection processes, and 3) the circle increases the precision with which the eye fixates relevant nodule features within the region-of-interest, and decreases the dispersion of fixations within this area. The facilitative effects of circling thus seem to influence some basic visual processes. The results should be generalizable to other types of radiological search and detection tasks.

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“…To ensure that the right lesion would be analyzed, its location was indicated. This so-called direct search has been said to result in higher diagnostic performances [44], but a substantial increase of false-positive decisions has also been observed [45]. The participants knew that half of the patients were positive for IPA, in contrast to clinical practice where the prevalence of IPA in patients with HIV is less than its differential diagnoses.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of IPA in HIV: the role of the chest X-ray and radiologist

et al. 2004

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The role of clinical information and chest film for the discrimination between invasive pulmonary aspergillosis (IPA) and its differential diagnoses in human immunodeficiency virus (HIV) infection was studied. The diagnostic performance of clinical information and chest film alone and in combination was studied for eight internists and eight radiologists with regular exposure to IPA patients. The multicenter case sample consisted of 25 patients with proven IPA and 25 with other pulmonary diseases typical for HIV. The cases were presented on a CD-ROM. Receiver operating characteristics (ROC) methodology was employed. With clinical information alone, internists achieved the highest diagnostic performance (area under curve/AUC=0.84). Viewing the chest films did not contribute to their performance (AUC=0.80, P=0.26). The radiologist's performance on the basis of viewing the chest film (AUC=0.75) increased significantly ( P=0.012) when clinical information (AUC=0.83) was supplied. IPA cases with characteristic radiological appearance were correctly identified in 90% with chest film. For radiologists with regular exposure to HIV patients, chest films hold relevant information and contribute to the determination in cases with characteristic radiological appearance. Overall and especially in cases with less characteristic radiological appearance, they have significant profit from full access to the clinical data. For internists with regular exposure to HIV patients, chest films do not provide information essential for the verification or differentiation of potential IPA.

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Directed Versus Free Search for Nodules in Chest Radiographs

Cited by 16 publications

References 0 publications

Perceptual enhancement of tumor targets in chest X-ray images

Perceptual enhancement of tumor targets in chest X-ray images

<title>Perceptual enhancement of pulmonary nodule recognition in chest radiographs</title>

Diagnosis of IPA in HIV: the role of the chest X-ray and radiologist

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