Plumb Andrew A, Phillips Peter, Spence Graeme, Mallett Susan, Taylor Stuart A, Halligan Steve, Fanshawe Thomas
From the Centre for Medical Imaging, University College London, 3rd Floor East, 250 Euston Rd, London NW1 2PG, England (A.A.P., S.A.T., S.H.); Health and Medical Sciences Group, University of Cumbria, Lancaster, England (P.P.); Department of Primary Care Health Sciences, University of Oxford, Oxford, England (G.S., T.F.); Institute of Applied Health Sciences, University of Birmingham, Birmingham, England (S.M.).
Radiology. 2017 Aug;284(2):413-422. doi: 10.1148/radiol.2017162037. Epub 2017 Mar 10.
Purpose To investigate the effect of increasing navigation speed on the visual search and decision making during polyp identification for computed tomography (CT) colonography Materials and Methods Institutional review board permission was obtained to use deidentified CT colonography data for this prospective reader study. After obtaining informed consent from the readers, 12 CT colonography fly-through examinations that depicted eight polyps were presented at four different fixed navigation speeds to 23 radiologists. Speeds ranged from 1 cm/sec to 4.5 cm/sec. Gaze position was tracked by using an infrared eye tracker, and readers indicated that they saw a polyp by clicking a mouse. Patterns of searching and decision making by speed were investigated graphically and by multilevel modeling. Results Readers identified polyps correctly in 56 of 77 (72.7%) of viewings at the slowest speed but in only 137 of 225 (60.9%) of viewings at the fastest speed (P = .004). They also identified fewer false-positive features at faster speeds (42 of 115; 36.5%) of videos at slowest speed, 89 of 345 (25.8%) at fastest, P = .02). Gaze location was highly concentrated toward the central quarter of the screen area at faster speeds (mean gaze points at slowest speed vs fastest speed, 86% vs 97%, respectively). Conclusion Faster navigation speed at endoluminal CT colonography led to progressive restriction of visual search patterns. Greater speed also reduced both true-positive and false-positive colorectal polyp identification. RSNA, 2017 Online supplemental material is available for this article.
目的 研究在计算机断层扫描（CT）结肠成像中提高导航速度对息肉识别过程中视觉搜索和决策的影响。材料与方法 获得机构审查委员会许可，将去识别化的CT结肠成像数据用于这项前瞻性阅片者研究。在获得阅片者的知情同意后，向23名放射科医生以四种不同的固定导航速度展示了12次描绘8个息肉的CT结肠成像快速浏览检查。速度范围为1厘米/秒至4.5厘米/秒。使用红外眼动仪跟踪注视位置，阅片者通过点击鼠标表示他们看到了息肉。通过图形和多水平建模研究不同速度下的搜索和决策模式。结果 阅片者在最慢速度下77次观察中有56次（72.7%）正确识别息肉，但在最快速度下225次观察中仅137次（60.9%）正确识别（P = 0.004）。他们在较快速度下识别的假阳性特征也更少（最慢速度下115个视频中有42个；36.5%，最快速度下345个中有89个；25.8%，P = 0.02）。在较快速度下，注视位置高度集中在屏幕区域的中心四分之一处（最慢速度与最快速度下的平均注视点分别为86%和97%）。结论 腔内CT结肠成像中更快的导航速度导致视觉搜索模式逐渐受限。更高的速度也降低了结直肠息肉真阳性和假阳性的识别率。RSNA，2017 本文有在线补充材料。
