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6 April 2005How does lesion conspicuity affect visual search strategy in mammogram reading?
In Mammography, gaze duration at given locations has been shown to positively correlate with decision outcome in those locations. Furthermore, most locations that contain an unreported malignant lesion attract the eye of experienced radiologists for almost as long as locations that contain correctly reported cancers. This suggests that faulty detection is not the main reason why cancers are missed; rather, failures in the perceptual and decision making processes in the location of these finding may be of significance as well. Models of medical image perception advocate that the decision to report or to dismiss a perceived finding depends not only on the finding itself but also on the background areas selected by the observer to compare the finding with, in order to determine its uniqueness. In this paper we studied the visual search strategy of experienced mammographers as they examined a case set containing cancer cases and lesion-free cases. For the cancer cases, two sets of mammograms were used: the ones in which the lesion was reported in the clinical practice, and the most recent prior mammogram. We determined how changes in lesion conspicuity between the prior mammogram to the most recent mammogram affected the visual search strategy of the observers. We represented the changes in visual search using spatial frequency analysis, and determined whether there were any significant differences between the prior and the most recent mammograms.