title: Visual search in abdominopelvic CT interpretation: accuracy and time efficiency between coronal MPR and axial images.
abstract: OBJECTIVE
  The objective of this study was to compare reader accuracy and time efficiency between coronal reformats of abdominopelvic computed tomography (CT) and axial images, by means of a visual search task.
  
  
  METHODS
  In this experimental crossover study, a novel visual search task, containing targets placed on actual CT images, was constructed to assess reader performance on both planes. Six trials were shown to participants in each plane, at a fixed time of 0.5 seconds per slice. The task was presented to 43 junior doctors. On each trial, participants were assessed for accuracy and confidence in finding the target on a five-point scale. Statistical analysis was performed using the Wilcoxon signed rank test, and Fleiss kappa.
  
  
  RESULTS
  Coronal images took 40% less time to view overall. No significant difference was found in reader accuracy or reader confidence between the two planes. Interrater agreement was observed as fair, across a very large number of raters (43).
  
  
  CONCLUSIONS
  Target identification in the coronal plane is extremely similar to the axial plane on abdominopelvic CT in this study and offers a substantial time benefit. A perceptual limit to visual processing of CT images may contribute to this similarity. Greater use of coronal reformats in day-to-day practice could substantially improve radiologist workflow.
authors.affiliation: Lightbox Radiology Education, Noosaville, Queensland, Australia.
authors.forename: Drew
authors.initials: D
authors.lastname: Mcmenamin
authors.affiliation: The Queen Elizabeth Hospital, Woodville Rd, Woodville South, Adelaide, South Australia, Australia 5011. Electronic address: alex.pearce@health.sa.gov.au.
authors.forename: Alex
authors.initials: A
authors.lastname: Pearce
authors.affiliation: Lightbox Radiology Education, Noosaville, Queensland, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Klassen
mesh_terms: D006801:Humans; D015588:Observer Variation; D010364:Pattern Recognition, Visual / Q000502:physiology*; D010388:Pelvis / Q000000981:diagnostic imaging*; D011860:Radiography, Abdominal / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013647:Task Performance and Analysis; D013996:Time and Motion Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: MDCT; Multiplanar reformations; abdominal CT; coronal plane imaging; visual search