A study of radiologists viewing multiple computed tomography examinations using an eyetracking device

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Abstract
Understanding the scan patterns radiologists use to view medical images is critical to the design of image viewing devices. In this study, and eyetracker, a device for recording eye and head movement, was used to determine the scan patterns during the interpretation of single and multiple computed tomographic (CT) examinations presented on a four-over-four viewbox. CT examinations were used because they represent complex viewing situations. In two separate studies, radiologists viewed patient folders containing single or multiple CT chest examinations and dictated a report. Eye movement was recorded with an eyetracker and video camera. After mounting the films in order, radiologists generally started with a sequential scan through the entire examination, followed by careful viewing of two to four clusters of three to six images, followed by dictation. These results indicate that a well designed radiology workstation should provide an image index, sufficient display area to simultaneously view 10 or more images, random and sequential movement through the examination, image comparison, and image marking.