Informatics in Radiology: What Can You See in a Single Glance and How Might This Guide Visual Search in Medical Images?

Published Online:https://doi.org/10.1148/rg.331125023

Radiologists’ rapid appreciation of the gestalt of a medical image-a specialization of the ability of naive observers to grasp the gist of a scene in a fraction of a second-is discussed, with emphasis on learning to perform rapid global visual processing of medical images in development of radiologic expertise.

Diagnostic accuracy for radiologists is above that expected by chance when they are exposed to a chest radiograph for only one-fifth of a second, a period too brief for more than a single voluntary eye movement. How do radiologists glean information from a first glance at an image? It is thought that this expert impression of the gestalt of an image is related to the everyday, immediate visual understanding of the gist of a scene. Several high-speed mechanisms guide our search of complex images. Guidance by basic features (such as color) requires no learning, whereas guidance by complex scene properties is learned. It is probable that both hardwired guidance by basic features and learned guidance by scene structure become part of radiologists’ expertise. Search in scenes may be best explained by a two-pathway model: Object recognition is performed via a selective pathway in which candidate targets must be individually selected for recognition. A second, nonselective pathway extracts information from global or statistical information without selecting specific objects. An appreciation of the role of nonselective processing may be particularly useful for understanding what separates novice from expert radiologists and could help establish new methods of physician training based on medical image perception.

© RSNA, 2012

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Article History

Received: Feb 29 2012
Revision requested: May 7 2012
Revision received: Aug 17 2012
Accepted: Aug 21 2012
Published online: Jan 1 2013
Published in print: Jan 2013