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Characterization of Radiologists’ Search Strategies for Lung Nodule Detection: Slice-Based Versus Volumetric Displays

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Abstract

The goal of this study was to assess whether radiologists’ search paths for lung nodule detection in chest computed tomography (CT) between different rendering and display schemes have reliable properties that can be exploited as an indicator of ergonomic efficiency for the purpose of comparing different display paradigms. Eight radiologists retrospectively viewed 30 lung cancer screening CT exams, containing a total of 91 nodules, in each of three display modes [i.e., slice-by-slice, orthogonal maximum intensity projection (MIP) and stereoscopic] for the purpose of detecting and classifying lung nodules. Radiologists’ search patterns in the axial direction were recorded and analyzed along with the location, size, and shape for each detected feature, and the likelihood that the feature is an actual nodule. Nodule detection performance was analyzed by employing free-response receiver operating characteristic methods. Search paths were clearly different between slice-by-slice displays and volumetric displays but, aside from training and novelty effects, not between MIP and stereographic displays. Novelty and training effects were associated with the stereographic display mode, as evidenced by differences between the beginning and end of the study. The stereo display provided higher detection and classification performance with less interpretation time compared to other display modes tested in the study; however, the differences were not statistically significant. Our preliminary results indicate a potential role for the use of radiologists’ search paths in evaluating the relative ergonomic efficiencies of different display paradigms, but systematic training and practice is necessary to eliminate training curve and novelty effects before search strategies can be meaningfully compared.

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Acknowledgment

This work is sponsored in part by the Department of Defense, US Army Medical Research Acquisition Center, 820 Chandler Street, Fort Detrick, MD 21702-5014 under Contract PR043488, and also by grant CA80836 from the National Cancer Institute, National Institutes of Health. The content of the contained information does not necessarily reflect the position or the policy of the government, and no official endorsement should be inferred.

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Authors and Affiliations

  1. Department of Radiology, School of Medicine, University of Pittsburgh, 3362 Fifth Ave., Pittsburgh, PA, 15231, USA

    Xiao Hui Wang, Janet E. Durick, Amy Lu, David L. Herbert, Saraswathi K. Golla, Kristin Foley, C. Samia Piracha, Dilip D. Shinde, Betty E. Shindel, Carl R. Fuhrman, Cynthia A. Britton, Diane C. Strollo, Sherry S. Shang, Joan M. Lacomis & Walter F. Good

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  1. Xiao Hui Wang
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  2. Janet E. Durick
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  3. Amy Lu
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  5. Saraswathi K. Golla
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  13. Sherry S. Shang
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Correspondence to Xiao Hui Wang.

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Wang, X.H., Durick, J.E., Lu, A. et al. Characterization of Radiologists’ Search Strategies for Lung Nodule Detection: Slice-Based Versus Volumetric Displays. J Digit Imaging 21 (Suppl 1), 39–49 (2008). https://doi.org/10.1007/s10278-007-9076-x

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  • DOI: https://doi.org/10.1007/s10278-007-9076-x

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