We used eye-position data to develop Computer-Assisted Visual Search (CAVS) as an aid to mammographic interpretation. CAVS feeds back regions of interest that receive prolonged visual dwell (greater than or equal to 1000 ms) by highlighting them on the mammogram. These regions are then reevaluated for possible missed breast cancers. Six radiology residents and fellows interpreted a test set of 40 mammograms twice, once with CAVS feedback (FB), and once without CAVS FB in a crossover, repeated- measures design. Eye position was monitored. LROC performance (area) was compared with and without CAVS FB. Detection and localization of malignant lesions improved 12% with CAVS FB. This was not significant. The test set contained subtle malignant lesions. 65% (176/272) of true lesions were fixated. Of those fixated, 49% (87/176) received prolonged attention resulting in CAVS FB, and 54% (47/87) of FBs resulted in TPs. Test-set difficulty and the lack of reading experience of the readers may have contributed to the relatively low overall performance, and may have also limited the effectiveness of CAVS FB which could only play a role in localizing potential lesions if the reader fixated and dwelled on them.
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