KEYWORDS: Liver, Computed tomography, Visual process modeling, Signal detection, Cancer detection, Image quality, Medical image visualization, Medical imaging, Visual information processing, Human vision
Objective assessment of medical image quality can be performed with mathematical model observers matched to radiologists. Foveated channelized Hotelling observer models (FCHO) have been shown to be more accurate predictors of the human search performance in simulated 3D images than standard model observers such as the ideal observer or the non-prewhitening observer with eye filter. However, nothing is known about the performance of FCHOs with the computed tomography (CT) modality as well as with images extracted from real patients. Patient-extracted images are smaller than simulated images and their size could be limiting for FCHOs as peripheral vision is modeled by an increasing spatial extent of channels. This study has two aims: to extend a foveated model observer to 2D anatomical liver CT images and to find channel parameters enabling the FCHO to match human performance. Regions of interest (ROIs) were automatically extracted from CT images of five patients’ livers and their size was of 100x100 pixels, a balance between the anatomical constraints and the modeling of peripheral vision. Two radiologist-validated small low-contrast hypodense hepatic metastases were simulated to generate signal-present ROIs. The signal diameters were of 1 cm relatively to the patient and their contrast of -50 HU. The foveated model observer used was a FCHO with dense difference-of-Gaussians channels that were optimized to the size of the extracted ROIs. The performance of the optimized FCHO could reproduce human performance for a detection task in anatomical liver CT images within standard error up to 9 degrees of visual angle. This study shows that optimized FCHOs could be used in more anthropomorphic assessments of image quality of CT units.
Purpose: Visual search using volumetric images is becoming the standard in medical imaging. However, we do not fully understand how eye movement strategies mediate diagnostic performance. A recent study on computed tomography (CT) images showed that the search strategies of radiologists could be classified based on saccade amplitudes and cross-quadrant eye movements [eye movement index (EMI)] into two categories: drillers and scanners.
Approach: We investigate how the number of times a radiologist scrolls in a given direction during analysis of the images (number of courses) could add a supplementary variable to use to characterize search strategies. We used a set of 15 normal liver CT images in which we inserted 1 to 5 hypodense metastases of two different signal contrast amplitudes. Twenty radiologists were asked to search for the metastases while their eye-gaze was recorded by an eye-tracker device (EyeLink1000, SR Research Ltd., Mississauga, Ontario, Canada).
Results: We found that categorizing radiologists based on the number of courses (rather than EMI) could better predict differences in decision times, percentage of image covered, and search error rates. Radiologists with a larger number of courses covered more volume in more time, found more metastases, and made fewer search errors than those with a lower number of courses. Our results suggest that the traditional definition of drillers and scanners could be expanded to include scrolling behavior. Drillers could be defined as scrolling back and forth through the image stack, each time exploring a different area on each image (low EMI and high number of courses). Scanners could be defined as scrolling progressively through the stack of images and focusing on different areas within each image slice (high EMI and low number of courses).
Conclusions: Together, our results further enhance the understanding of how radiologists investigate three-dimensional volumes and may improve how to teach effective reading strategies to radiology residents.
Task-based image quality procedures in CT that substitute a human observer with a model observer usually use single-slice images with uniform backgrounds from homogeneous phantoms. However, anatomical structures and inhomogeneities in organs generate noise that can affect the detection performance of human observers. The purpose of this work was to assess the impact of background type, uniform or liver, and the viewing modality, single- or multislice, on the detection performance of human and model observers. We collected abdominal CT scans from patients and homogeneous phantom scans in which we digitally inserted low-contrast signals that mimicked a liver lesion. We ran a rating experiment with the two background conditions with three signal sizes and three human observers presenting images in two reading modalities: single- and multislice. In addition, channelized Hotelling observers (CHO) for single- and multislice detection were implemented and evaluated according to their degree of correlation with the human observer performance. For human observers, there was a small but significant improvement in performance with multislice compared to the single-slice viewing mode. Our data did not reveal a significant difference between uniform and anatomical backgrounds. Model observers demonstrated a good correlation with human observers for both viewing modalities. Human observers have very similar performances in both multi- and single-slice viewing mode. It is therefore preferable to use single-slice CHO as this model is computationally more tractable than multislice CHO. However, using images from a homogeneous phantom can result in overestimating image quality as CHO performance tends to be higher in uniform than anatomical backgrounds, while human observers have similar detection performances.
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