Eye tracking in catheter-based cardiovascular interventions: early results.

Peter Lanzer,Syed Saqib Bukhari,Mohammad Al-Naser,Andreas Dengel,Elizabeth A Krupinski

doi:10.1117/1.jmi.4.3.035502

Abstract

.Visual x-ray image processing (XRIP) represents a fundamental component of catheter-based cardiovascular interventions (CBCVIs). To date, no data are available to define XRIP in this setting. To characterize CBCVI XRIP, we developed a computer-based method allowing continuous temporal–spatial analysis of data recorded by a head-mounted eye-tracking device. Quantitative analysis of gaze duration of an expert operator (EO) revealed that the average time in minutes spent viewing the images on the display screen was and of the total recorded time in coronary angiography (CA) and in CA followed by CBCVI, respectively. Qualitative analysis of gaze data of the EO revealed consistent focus on the center point of the screen. Only if suspicious findings were detected did gaze move toward the target. In contrast, a novice operator (NO) observing a subset of cases viewed coronary artery segments separately and sequentially. The developed methodology allows continuous registration and analysis of gaze data for analysis of XRIP strategies of EOs in live-cases scenarios and may assist in the transfer of experts’ reading skills to novices.

Highlights

Catheter-based cardiovascular interventions (CBCVIs) are primarily guided by the human observer’s rapid x-ray image processing (XRIP) and interpretation processes
Image-based guidance in CBCVI requires optimum image acquisition, as well as optimum image interpretation. The latter is based on reading skills of the operators and their ability to identify and interpret pathological findings rapidly, reliably, and efficiently, in emergency settings.[5]
All interventional procedures were performed without any complications; no study-related side effects occurred

Summary

Introduction

Catheter-based cardiovascular interventions (CBCVIs) are primarily guided by the human observer’s rapid x-ray image processing (XRIP) and interpretation processes. While x-ray image quality is steadily improving due to better image acquisition[1] and postprocessing techniques,[2] the principal limitations, the two dimensional projectional character and inability to visualize arterial walls, remain.[3,4] Image-based guidance in CBCVI requires optimum image acquisition (e.g., appropriate angulation, zooming, and shielding), as well as optimum image interpretation The latter is based on reading skills of the operators and their ability to identify and interpret pathological findings rapidly, reliably, and efficiently, in emergency settings.[5] To date, CBCVI image reading skills are largely acquired empirically. Characterization, externalization, and transfer of these fast and frugal strategies could reduce the length of learning curves and improve their reproducibility when compared with the current poorly defined and often incidental learning

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