title: Where do neurologists look when viewing brain CT images? An eye-tracking study involving stroke cases.
abstract: The aim of this study was to investigate where neurologists look when they view brain computed tomography (CT) images and to evaluate how they deploy their visual attention by comparing their gaze distribution with saliency maps. Brain CT images showing cerebrovascular accidents were presented to 12 neurologists and 12 control subjects. The subjects' ocular fixation positions were recorded using an eye-tracking device (Eyelink 1000). Heat maps were created based on the eye-fixation patterns of each group and compared between the two groups. The heat maps revealed that the areas on which control subjects frequently fixated often coincided with areas identified as outstanding in saliency maps, while the areas on which neurologists frequently fixated often did not. Dwell time in regions of interest (ROI) was likewise compared between the two groups, revealing that, although dwell time on large lesions was not different between the two groups, dwell time in clinically important areas with low salience was longer in neurologists than in controls. Therefore it appears that neurologists intentionally scan clinically important areas when reading brain CT images showing cerebrovascular accidents. Both neurologists and control subjects used the "bottom-up salience" form of visual attention, although the neurologists more effectively used the "top-down instruction" form.
authors.affiliation: Department of Neurology, University of Tokyo, Tokyo, Japan. hideyukimatsumoto.jp@gmail.com
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Terao
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yugeta
authors.forename: Hideki
authors.initials: H
authors.lastname: Fukuda
authors.forename: Masaki
authors.initials: M
authors.lastname: Emoto
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Furubayashi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Okano
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Hanajima
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ugawa
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D020520:Brain Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D004617:Embolism / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D005403:Fixation, Ocular / Q000502:physiology*; D006801:Humans; D007837:Latency Period, Psychological; D008875:Middle Aged; D020146:Putaminal Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D020521:Stroke / Q000000981:diagnostic imaging* / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*