How radiographers visually perceive X-ray images with the task of accepting or rejecting them – a pilot study
DOI:
https://doi.org/10.7577/radopen.1997Keywords:
Radiographer, X-ray imaging, quality assessment, image accept/ reject, eye-tracking.Abstract
Introduction: Radiographer´s usual role in the medical imaging chain is to acquire relevant and qualitatively good images that help the radiologist or physician to diagnose most accurately. After the image acquisition, the radiographer does a quality evaluation based on established imaging criteria to decide if the image is satisfactory, or otherwise reject it and subsequently take a new one. Contrary to expectations that the number of image rejects should decrease substantially with the introduction of digital imaging, a number of studies have shown that it has not, although the reasons for rejects has changed from exposure errors to positioning and centring errors. Very little research has been on examining how radiographers visually perceive and evaluate the X-ray images in this acceptance/rejection process.
Purpose: Investigate how radiographers and radiography students visually perceives X-ray images in the process of accepting or rejecting them on basis of radiographic imaging criteria, and see if there are differences in strategies across experience levels.
Materials and methods: Three radiography students and five radiographers with varying years of experience were given the task of accepting or rejecting shoulder and knee projection images based on positioning criteria. Using eye tracking, we measured the participants’ number and duration of gaze fixations within 1) the field of view defined by the monitor display, 2) the part of the monitor displaying the X-ray image only, and 3) the region within the X-ray images considered to be most relevant given the imaging criteria task. The quantitative eye-tracking measurements were followed-up by four qualitative questions.
Results: Some differences in fixation patterns between the groups were found; the medium experienced radiographers spent statistically significant lesser number of fixations and lesser average single fixation durations than both the radiography students and the most experienced radiographers did, whereas the two latter groups scored almost equally.
Conclusion: The study revealed that work experience might have some influence on how radiographers and radiography students assess X-ray images, but in subtler ways than expected. The study also revealed, however, quite large individual differences across experience.
References
2. Honea R, Elissa Blado M, Ma Y. Is reject analysis necessary after converting to computed radiography? Journal of Digital Imaging. 2002; 15: 41-52. https://doi.org/10.1007/s10278-002-5028-7
3. Nol J, Isouard G, Mirecki J. Digital repeat analysis; setup and operation. Journal of Digital Imaging. 2006; 19 (2):159-66. https://doi.org/10.1007/s10278-005-8733-1
4. Waaler D, Hofmann B. Image rejects/retakes-radiographic challenges. Radiation Protection Dosimetry. 2010; 139 (1-3):375-9. https://doi.org/10.1093/rpd/ncq032
5. Jones AK, Polman R, Willis CE, Shepard SJ. One year's results from a server-based system for performing reject analysis and exposure analysis in computed radiography. Journal of Digital Imaging. 2011; 24 (2):243-55. https://doi.org/10.1007/s10278-009-9236-2
6. Andersen ER, Jorde J, Taoussi N, Yaqoob SH, Konst B, Seierstad T. Reject analysis in direct digital radiography. Acta Radiologica. 2012; 53(2):174-8. https://doi.org/10.1258/ar.2011.110350
7. Hofmann B, Rosanowsky TB, Jensen C, Wah KHC. Image rejects in general direct digital radiography. Acta Radiologica Open. 2015;4(10):2058460115604339. https://doi.org/10.1177/2058460115604339
8. Krupinski EA, Samei E. The handbook of medical image perception and techniques: Cambridge University Press; 2010.
9. Manning D. Evaluation of diagnostic performance in radiography. Radiography. 1998; 4(1):49-60. https://doi.org/10.1016/S1078-8174(98)80030-8
10. Manning D, Gale A, Krupinski E. Perception research in medical imaging. The British Journal of Radiology. 2014. https://doi.org/10.1016/j.radi.2005.02.003
11. Bertram R, Helle L, Kaakinen JK, Svedström E. The effect of expertise on eye movement behaviour in medical image perception. PLoS ONE 2013; 8(6): e66169. https://doi.org/10.1371/journal.pone.0066169
12. Manning D, Ethell S, Donovan T, Crawford T. How do radiologists do it? The influence of experience and training on searching for chest nodules. Radiography. 2006; 12(2):134-42. https://doi.org/10.1016/j.radi.2005.02.003
13. Anderson B, Shyu C-R, editors. Studying Visual Behaviors from Multiple Eye Tracking Features Across Levels of Information Representation. AMIA Annual Symposium Proceedings; 2011: American Medical Informatics Association.
14. Wood G, Knapp KM, Rock B, Cousens C, Roobottom C, Wilson MR. Visual expertise in detecting and diagnosing skeletal fractures. Skeletal Radiology. 2013; 42(2):165-72. https://doi.org/10.1007/s00256-012-1503-5
15. Piper KJ, Paterson A. Initial image interpretation of appendicular skeletal radiographs: a comparison between nurses and radiographers. Radiography. 2009; 15(1):40-8. https://doi.org/10.1016/j.radi.2007.10.006
16. Holmqvist K, Nyström M, Andersson R, Dewhurst R, Jarodzka H, Van de Weijer J. Eye tracking: A comprehensive guide to methods and measures: Oxford University Press; 2011.
17. Donovan T, Manning DJ. Successful reporting by non-medical practitioners such as radiographers, will always be task-specific and limited in scope. Radiography. 2006; 12(1):7-12. https://doi.org/10.1016/j.radi.2005.01.004
18. Pannasch S, Helmert JR, Roth K, Herbold A-K, Walter H. Visual fixation durations and saccade amplitudes: Shifting relationship in a variety of conditions. Journal of Eye Movement Research. 2008; 2(2):4. http://dx.doi.org/10.16910/jemr.2.2.4
19. Bontrager KL, Lampignano J. Textbook of radiographic positioning and related anatomy: Elsevier Health Sciences; 2013.
20. Movin A, Karlsson U. Skelettröntgenundersökningar. Handbok for röntgenpersonal. Scandinavian University Books, Läromedelsförlagen, Stockholm, Göteborg, Lund; 1969.
21. Goldberg JH, Stimson MJ, Lewenstein M, Scott N, Wichansky AM, editors. Eye tracking in web search tasks: design implications. Proceedings of the 2002 symposium on Eye tracking research & applications; 2002: ACM. http://dx.doi.org/10.1145/507072.507082
22. Goldberg JH, Kotval XP. Computer interface evaluation using eye movements: methods and constructs. International Journal of Industrial Ergonomics. 1999; 24(6):631-45.
https://doi.org/10.1016/S0169-8141(98)00068-7
23. Just MA, Carpenter PA. Eye fixations and cognitive processes. Cognitive psychology. 1976; 8(4):441-80. https://doi.org/10.1016/0010-0285(76)90015-3
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication, with the work after publication simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).