Abstract
The interpretation of medical images is a primary task for radiologists. Besides two-dimensional (2D) images, current imaging technologies allow for volumetric display of medical images. Whereas current radiology practice increasingly uses volumetric images, the majority of studies on medical image interpretation is conducted on 2D images. The current study aimed to gain deeper insight into the volumetric image interpretation process by examining this process in twenty radiology trainees who all completed four volumetric image cases. Two types of data were obtained concerning scroll behaviors and think-aloud data. Types of scroll behavior concerned oscillations, half runs, full runs, image manipulations, and interruptions. Think-aloud data were coded by a framework of knowledge and skills in radiology including three cognitive processes: perception, analysis, and synthesis. Relating scroll behavior to cognitive processes showed that oscillations and half runs coincided more often with analysis and synthesis than full runs, whereas full runs coincided more often with perception than oscillations and half runs. Interruptions were characterized by synthesis and image manipulations by perception. In addition, we investigated relations between cognitive processes and found an overall bottom-up way of reasoning with dynamic interactions between cognitive processes, especially between perception and analysis. In sum, our results highlight the dynamic interactions between these processes and the grounding of cognitive processes in scroll behavior. It suggests, that the types of scroll behavior are relevant to describe how radiologists interact with and manipulate volumetric images.
Highlights
Radiology is a medical discipline in which images visualizing human bodies are examined for abnormalities
Volumetric imaging is daily practice in radiology, there is little understanding of the volumetric image interpretation process since prior research into the understanding of the image interpretation process in radiology has been conducted on 2D images (e.g., Kok et al 2012; Kundel and Nodine 1983; Lesgold et al 1988)
The first part of the current study focused on human–computer interactions in terms of scroll behavior as a fundamental aspect of volumetric image interpretation and showed that cognitive processes differ during different types of scroll behavior
Summary
Radiology is a medical discipline in which images visualizing human bodies are examined for abnormalities The interpretation of these images is considered a highly complex task since medical images are not self-explanatory (Drew et al 2013a, b; Van der Gijp et al 2014). Research is needed because a deep understanding of volumetric image interpretation, involving the human–computer interactions such as scrolling, changing window settings, and viewing directions, is essential to improve training programs and feedback which are required to develop complex image interpretation skills (Nodine and Mello-Thomas 2010). We aim to distinguish different cognitive processes that are involved during different types of scroll behavior In this way, we can reveal how scroll behavior and cognitive processes are related in volumetric image interpretation. Since little research studied relations between cognitive processes in volumetric image interpretation we aim to provide detailed insight into the relations between cognitive processes by focusing on transitions in cognitive processes
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