Effects of Lesion Conspicuity on Visual Search in Mammogram Reading1

Mello‐Thoms, Claudia; Hardesty, Lara A.; Sumkin, Jules H.; Ganott, Marie A.; Hakim, Christiane M.; Britton, Cynthia A.; Stalder, Jennifer S.; Maitz, Glenn S.

doi:10.1016/j.acra.2005.03.068

Cited by 74 publications

(55 citation statements)

References 37 publications

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“…14,15 Therefore, their anticipation is not satisfied until a suspicious feature(s) is reported as disease condition. 13 Additionally, external variables such as artificiality of test environment and extent of scrutiny of one's assessment influence performance in a laboratory setting. 16 These variables cause discrepancy between laboratory findings and results obtained in real clinical situations and are often cited as limitations to generalizing laboratory findings to prospective clinical situations.…”

Section: Discussionmentioning

confidence: 99%

“…Location sensitivity is particularly important in radiology, as it provides information about the location and characteristics of a disease, and is useful in guiding treatment such as surgical interventions. 13 Overall, it was observed that readers' final diagnoses were based on radiographic features rather than guesswork. Location sensitivity and diagnostic accuracy were lower for readers working in public hospitals, those who have worked for fewer years, and younger readers ( Table 2).…”

Section: Discussionmentioning

confidence: 99%

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Radiographers' performance in chest X-ray interpretation: the Nigerian experience

Ekpo¹,

Egbe²,

Akpan³

2015

BJR

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Radiographers' performance in chest X-ray interpretation: the Nigerian experience

Ekpo¹,

Egbe²,

Akpan³

2015

BJR

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“…The assumption is that if the reader marks a location within this 2.5 u radius from the centre of the lesion, the lesion has been perceived. This method has been used by Mello-Thoms et al [15,16] in studies of detection of mammographic masses. One difficulty with this method is that the physical distance encompassed by any particular visual angle changes depending on how far away the eye is from the target.…”

Section: Discussionmentioning

confidence: 99%

“…It is impractical to measure the actual visual angle or eye-to-monitor distance at each moment when the subject marks a suspected lesion, so geometry is used to calculate an acceptance radius based on a 2.5 u visual angle at an assumed eye distance from the target. In Mello-Thoms et al's 2005 mammographic study [15], the assumed eye distance was 35 cm. Maintenance of this distance was encouraged by the use of a chair that was fixed to the floor (personal communication, C Mello-Thoms, 2011).…”

Section: Discussionmentioning

confidence: 99%

On the choice of acceptance radius in free-response observer performance studies

Haygood

Ryan²,

Brennan³

et al. 2013

BJR

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Objectives: Choosing an acceptance radius or proximity criterion is necessary to analyse free-response receiver operating characteristic (FROC) observer performance data. This is currently subjective, with little guidance in the literature about what is an appropriate acceptance radius. We evaluated varying acceptance radii in a nodule detection task in chest radiography and suggest guidelines for determining an acceptance radius. Methods: 80 chest radiographs were chosen, half of which contained nodules. We determined each nodule's centre. 21 radiologists read the images. We created acceptance radii bins of ,5 pixels, ,10 pixels, ,20 pixels and onwards up to ,200 and 200+ pixels. We counted lesion localisations in each bin and visually compared marks with the borders of nodules. Results: Most reader marks were tightly clustered around nodule centres, with tighter clustering for smaller than for larger nodules. At least 70% of readers' marks were placed within ,10 pixels for small nodules, ,20 pixels for medium nodules and ,30 pixels for large nodules. Of 72 inspected marks that were less than 50 pixels from the centre of a nodule, only 1 fell outside the border of a nodule. Conclusion: The acceptance radius should be based on the larger nodule sizes. For our data, an acceptance radius of 50 pixels would have captured all but 2 reader marks within the borders of a nodule, while excluding only 1 true-positive mark. The choice of an acceptance radius for FROC analysis of observer performance studies should be based on the size of larger abnormalities. Observer performance studies are often used to evaluate imaging systems in medicine. These studies are usually organised so that observers search for a particular abnormality in a set of images, indicate whether the abnormality is present and then do the same thing again on another occasion under different circumstances. There is a variety of ways in which to judge the accuracy of the observers' responses. Perhaps the most widely used method is one in which observers indicate the presence or absence of the searched-for lesion and the level of confidence with which they have identified or excluded the lesion. From this information, a receiver operating characteristic (ROC) curve is generated [1][2][3][4][5]. The free-response ROC (FROC) method is an alternative approach to analysis that uses lesion location information, and thus more closely mimicks those actual clinical practices that involve a challenging search and yields a higher statistical power than the ROC method [6,7]. Free-response methods also allow separate analysis of success in finding more than one abnormality per image [7]. In the free-response method, the observer locates each lesion, marks it and assigns a confidence rating to each marked lesion. This method is intended to avoid counting a response as correct in situations in which the observer, although correctly indicating the presence of an abnormality in an image actually containing the abnormality, was led astray by a false-positive and did not ...

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“…Mello-Thoms, Hardesty, Sumkin et al, classified errors in mammograms as Kundel, Nodine and Carmody had done, finding that 30% of missed lesions corresponded to errors of search, 40% to errors of detection and 30% to errors of decision [40]. They also collected data using images on which a visible cancer had been missed at the original screening exam.…”

Section: Studies Of Radiologists' Perceptual Processesmentioning

confidence: 99%

A Review of Research Into the Development of Radiologic Expertise: Implications for Computer-Based Training

Taylor

2007

Academic Radiology

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Studies of radiological error reveal high levels of variation between radiologists.Although it is known that experts outperform novices, we have only limited knowledge about radiological expertise and how it is acquired. This review identifies three areas of research: studies of the impact of experience and related factors on the accuracy of decision-making; studies of the organisation of expert knowledge; and studies of radiologists' perceptual processes.Interpreting evidence from these three paradigms in the light of recent research into perceptual learning and studies of the visual pathway has a number of conclusions for the training of radiologists, particularly for the design of computer-based learning programs which are able to illustrate the similarities and differences between diagnoses, to give access to large numbers of cases and to help identify weaknesses in the way trainees build up a global representation from fixated regions.

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Effects of Lesion Conspicuity on Visual Search in Mammogram Reading1

Cited by 74 publications

References 37 publications

Radiographers' performance in chest X-ray interpretation: the Nigerian experience

Radiographers' performance in chest X-ray interpretation: the Nigerian experience

On the choice of acceptance radius in free-response observer performance studies

A Review of Research Into the Development of Radiologic Expertise: Implications for Computer-Based Training

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