Comparable prediction of breast cancer risk from a glimpse or a first impression of a mammogram

E M Raat,I Farr,K K Evans,J M Wolfe

doi:10.1186/s41235-021-00339-5

E M Raat, I Farr + Show 2 more

Open Access

https://doi.org/10.1186/s41235-021-00339-5

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Abstract

Expert radiologists can discern normal from abnormal mammograms with above-chance accuracy after brief (e.g. 500 ms) exposure. They can even predict cancer risk viewing currently normal images (priors) from women who will later develop cancer. This involves a rapid, global, non-selective process called “gist extraction”. It is not yet known whether prolonged exposure can strengthen the gist signal, or if it is available solely in the early exposure. This is of particular interest for the priors that do not contain any localizable signal of abnormality. The current study compared performance with brief (500 ms) or unlimited exposure for four types of mammograms (normal, abnormal, contralateral, priors). Groups of expert radiologists and untrained observers were tested. As expected, radiologists outperformed naïve participants. Replicating prior work, they exceeded chance performance though the gist signal was weak. However, we found no consistent performance differences in radiologists or naïves between timing conditions. Exposure time neither increased nor decreased ability to identify the gist of abnormality or predict cancer risk. If gist signals are to have a place in cancer risk assessments, more efforts should be made to strengthen the signal.

Highlights

The visual system has the remarkable capability to extract information about our environment in the proverbial blink of an eye
Kundel has argued for a model of radiologist performance that has a prominent role for an “initial holistic, gestalt-like” stage of processing that is conceptually quite similar to global gist processing as we have described here (Kundel et al, 2008)
Radiologists were tested as part of the Medical Image Perception “pop-up” laboratory supported by the US NIH: National Cancer Institute at the annual meeting of the Radiological Society of North America (RSNA) in 2018 and 2019

Summary

Introduction

The visual system has the remarkable capability to extract information about our environment in the proverbial blink of an eye. Within a 100 ms, humans can identify the general meaning (or “gist”) of what they are seeing (Potter, 1975) They can extract information about the scene category (Greene & Oliva, 2009) or detect the presence of certain object categories (Bacon-Macé et al, 2005). The global, non-selective nature of the process means that the observer might be quite sure something like an This rapid gist extraction occurs with specialized scenes like radiological images. Experimental studies typically use exposures of 250 to 500 ms Reliable detection of this gist of abnormality has been found for different types of medical images, for example chest radiographs (Kundel & Nodine, 1975), prostate images (Treviño et al, 2020), cervical micrographs in cytology as well as 2D mammograms (Evans, et al, 2013a, 2013b) and 3D breast tomosynthesis (Wu et al, 2019)

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