Effect of mammographic breast density on radiologists' visual search pattern

Abstract

This study investigates the impact of breast density on visual searching pattern. A set of 74 one-view malignancy containing mammographic images were examined by 7 radiologists. Eye position was recorded and visual search parameters such as total time examining a case, time to hit the lesion, dwell time and number of hits per area were collected. Fixations were calculated in 3 areas of interests: background breast parenchyma, dense areas of parenchyma and lesion. Significant increases in dwell time and number of hits in dense areas of parenchyma were noted for highcompared to low- mammographic density images when the lesion overlay the fibroglandular tissue (p<0.01). When the lesion was outside the fibroglandular tissue, significant increase in dwell time and number of hits in dense areas of parenchyma in high- compared to low- mammographic density images were observed (p<0.01). No significant differences have been found in total time examining a case, time to first fixate the lesion, dwell time and number of hits in background breast parenchyma and lesion areas. In conclusion, our data suggests that dense areas of breast parenchyma attract radiologists’ visual attention. Lesions overlaying the fibroglandular tissue were detected faster, therefore lesion location, whether overlaying or outside the fibroglandular tissue, appeared to have an impact on radiologists' visual searching pattern.