Perceptual learning of lesions in mammograms induced by response feedback during training

Abstract

14Detecting subtle lesions in mammograms indicative of early breast cancer usually requires years of 15 experience. Well-designed training paradigms could be a strong tool for promoting perceptual 16 learning (PL) with rapid and long-lasting improvement in detectability of these subtle 17 mammographic lesions. Given that PL occurs without feedback about the accuracy of subjects' 18 responses, the role of feedback has been completely ignored in clinical applications of PL. However, 19in this study, we found that the contents of the feedback profoundly and differentially influence the 20 formation and retention of PL to detect calcification and architectural distortion lesions, two types of 21 mammographic lesions that are frequently missed in mammographic screenings. We trained subjects 22to detect one type of lesion in a mammogram and manipulated the content of the response feedback 23 during training for 3 groups (no feedback, correctness only, and both correctness and location of the 24 lesion). We found that PL occurred for both lesions when both correctness and location feedback 25 were provided. PL also occurred for calcifications but not for distortions when only correctness was 26 provided. No learning occurred without feedback for either lesion. A retest conducted six months 34 Running Title: Perceptual learning of lesions induced by feedback 35 107Depending on the assigned feedback condition, subjects were then presented with different response 108 feedback conditions. In the detailed feedback condition (bottom left), subjects were informed about the 109 correctness of their response and the true location of the lesion. The mammogram was then shown again,