Abstract

Radiologists must classify and interpret medical images on the basis of visual inspection. We examined how the perception of radiological scans might be affected by common processes of adaptation in the visual system. Adaptation selectively adjusts sensitivity to the properties of the stimulus in current view, inducing an aftereffect in the appearance of stimuli viewed subsequently. These perceptual changes have been found to affect many visual attributes, but whether they are relevant to medical image perception is not well understood. To examine this we tested whether aftereffects could be generated by the characteristic spatial structure of radiological scans, and whether this could bias their appearance along dimensions that are routinely used to classify them. Measurements were focused on the effects of adaptation to images of normal mammograms, and were tested in observers who were not radiologists. Tissue density in mammograms is evaluated visually and ranges from "dense" to "fatty." Arrays of images varying in intermediate levels between these categories were created by blending dense and fatty images with different weights. Observers first adapted by viewing image samples of dense or fatty tissue, and then judged the appearance of the intermediate images by using a texture matching task. This revealed pronounced perceptual aftereffects – prior exposure to dense images caused an intermediate image to appear more fatty and vice versa. Moreover, the appearance of the adapting images themselves changed with prolonged viewing, so that they became less distinctive as textures. These aftereffects could not be accounted for by the contrast differences or power spectra of the images, and instead tended to follow from the phase spectrum. Our results suggest that observers can selectively adapt to the properties of radiological images, and that this selectivity could strongly impact the perceived textural characteristics of the images.

Highlights

  • Despite advances in assistive technologies such as computer-aided detection algorithms, the evaluation and interpretation of medical images still relies on visual inspection by humans, and remains fundamentally constrained by the perceptual and cognitive capacities of the observer [1]

  • We have shown that brief exposures to different categories of mammogram images can lead to robust aftereffects in the appearance of the images

  • As noted at the outset, the visual system can selectively adapt to a wide array of image properties from simple features to high-level attributes, and these adjustments can lead to very salient changes in appearance

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Summary

Introduction

Despite advances in assistive technologies such as computer-aided detection algorithms, the evaluation and interpretation of medical images still relies on visual inspection by humans, and remains fundamentally constrained by the perceptual and cognitive capacities of the observer [1]. A wide variety of studies have explored the sensory processes that impact visual judgments about medical images. These include analyses of the factors affecting the detection and discrimination of patterns [5,6], the properties of visual search and salience [7,8,9], and the role of perceptual learning and expertise [10]. We explore the role of a further wellknown perceptual process that is intimately linked to the visual structure defining the image – visual adaptation. The sensitivity and response properties of the visual system are constantly adjusted through adaptation to match visual coding to the attributes of the stimuli we are currently viewing [13,14,15]. We ask whether these adjustments occur for attributes of medical images in ways that could influence how such images are perceived and classified

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