Grant Number:	2R01CA207490-06A1 Interpret this number
Primary Investigator:	Wolfe, Jeremy
Organization:	Brigham And Women'S Hospital
Project Title:	Improving Perception in Digital Breast Tomography
Fiscal Year:	2022

Digital Breast Tomosynthesis (DBT) is a breast cancer screening methodology in which radiologists search for cancer in 3D volumes of virtual slices through the breast. DBT performs better than classic, 2D mammography but it takes more time. Our goal is to compare different methods that could reduce the time required while maintaining or improving performance. Beyond the specific goal of improving DBT, we will uncover general principles of attention and perception that can be applied whenever the volume of images threatens to overwhelm the ability of observers to consume those images. We are particularly interested in conditions of “low target prevalence” (low percentage of positive cases). In tasks like breast cancer screening, with many images and very few clinically significant targets, interventions that are effective when tested at high prevalence in the lab may fail in the field when prevalence is much lower. There are three projects: Project 1: Self-Triage by 2D Full-field digital mammography or synthetic images: In screening for breast cancer, there will be some cases that a reader could safely declare ‘normal’ on the basis of the 2D image, alone. Is it reasonable to develop a protocol where some DBT images would be acquired but would not be examined? This “self-triage” would require a very conservative triage criterion in order to avoid triage of any positive cases, but if proven to be safe, self-triage could save significant time and might reduce false negative errors. Project 2: DBT as “hybrid search”: Breast cancer screening involves search for more than one type of target (masses and calcifications, at minimum). Research shows instances where such ‘hybrid’ search for multiple targets leads to elevated errors. We will test the hypothesis that readers are more efficient and/or more accurate if they perform separate searches for each target type. We will measure eye movements to compare search for each target type alone to search for both types together. Experiments with non-experts will investigate basic principles of search in 3D volumes of image data. Project 3: AI Targeted ‘drilling’: Eye tracking has identified two modes of search in 3D stacks of images: “drilling”, where readers move rapidly through depth (Z) while the eyes stay relatively stable in the XY plane, and “scanning”, where readers search widely in XY while moving slowly in Z. We will use eye tracking to evaluate a CAD system developed by iCAD that marks specific locations in the 2D XY image and invites readers to drill in these specific areas. Does that improve CAD performance? Summary: This program of research will produce recommendations for increasing the efficiency of breast cancer screening. Moreover, each study will produce basic science that will be generalizable to other settings and will deepen our understanding of visual search through 3D volumes of image data.




In simple but challenging search tasks, most errors are stochastic.
Authors: Wolfe J.M. , Hulleman J. , Mitra A. , Si W. .
Source: Attention, Perception & Psychophysics, 2024-08-19 00:00:00.0; , .
EPub date: 2024-08-19 00:00:00.0.
PMID: 39160388
Related Citations

Toward viewing behavior for aerial scene categorization.
Authors: Jiang C. , Chen Z. , Wolfe J.M. .
Source: Cognitive Research: Principles And Implications, 2024-03-26 00:00:00.0; 9(1), p. 17.
EPub date: 2024-03-26 00:00:00.0.
PMID: 38530617
Related Citations

Errors in visual search: Are they stochastic or deterministic?
Authors: Li A. , Hulleman J. , Wolfe J.M. .
Source: Cognitive Research: Principles And Implications, 2024-03-19 00:00:00.0; 9(1), p. 15.
EPub date: 2024-03-19 00:00:00.0.
PMID: 38502280
Related Citations

Mirror blindness: Our failure to recognize the target in search for mirror-reversed shapes.
Authors: Becker S.I. , Retell J.D. , Wolfe J.M. .
Source: Attention, Perception & Psychophysics, 2023 Feb; 85(2), p. 418-437.
EPub date: 2023-01-18 00:00:00.0.
PMID: 36653521
Related Citations

Reliability of radiologists' first impression when interpreting a screening mammogram.
Authors: Gandomkar Z. , Siviengphanom S. , Suleiman M. , Wong D. , Reed W. , Ekpo E.U. , Xu D. , Lewis S.J. , Evans K.K. , Wolfe J.M. , et al. .
Source: Plos One, 2023; 18(4), p. e0284605.
EPub date: 2023-04-25 00:00:00.0.
PMID: 37098013
Related Citations

Normal blindness: when we Look But Fail To See.
Authors: Wolfe J.M. , Kosovicheva A. , Wolfe B. .
Source: Trends In Cognitive Sciences, 2022 Sep; 26(9), p. 809-819.
EPub date: 2022-07-21 00:00:00.0.
PMID: 35872002
Related Citations

Priming effects in inefficient visual search: Real, but transient.
Authors: Wolfe J.M. , Suresh S.B. , Dewulf A.W. , Lyu W. .
Source: Attention, Perception & Psychophysics, 2022 Jul; 84(5), p. 1417-1431.
EPub date: 2022-05-16 00:00:00.0.
PMID: 35578002
Related Citations

What eye tracking can tell us about how radiologists use automated breast ultrasound.
Authors: Wolfe J.M. , Lyu W. , Dong J. , Wu C.C. .
Source: Journal Of Medical Imaging (bellingham, Wash.), 2022 Jul; 9(4), p. 045502.
EPub date: 2022-07-26 00:00:00.0.
PMID: 35911209
Related Citations

How one block of trials influences the next: persistent effects of disease prevalence and feedback on decisions about images of skin lesions in a large online study.
Authors: Wolfe J.M. .
Source: Cognitive Research: Principles And Implications, 2022-02-02 00:00:00.0; 7(1), p. 10.
EPub date: 2022-02-02 00:00:00.0.
PMID: 35107667
Related Citations

The Functional Visual Field(s) in simple visual search.
Authors: Wu C.C. , Wolfe J.M. .
Source: Vision Research, 2022 01; 190, p. 107965.
EPub date: 2021-11-11 00:00:00.0.
PMID: 34775158
Related Citations

Comparable prediction of breast cancer risk from a glimpse or a first impression of a mammogram.
Authors: Raat E.M. , Farr I. , Wolfe J.M. , Evans K.K. .
Source: Cognitive Research: Principles And Implications, 2021-11-06 00:00:00.0; 6(1), p. 72.
EPub date: 2021-11-06 00:00:00.0.
PMID: 34743266
Related Citations

Global processing provides malignancy evidence complementary to the information captured by humans or machines following detailed mammogram inspection.
Authors: Gandomkar Z. , Siviengphanom S. , Ekpo E.U. , Suleiman M. , Taba S.T. , Li T. , Xu D. , Evans K.K. , Lewis S.J. , Wolfe J.M. , et al. .
Source: Scientific Reports, 2021-10-11 00:00:00.0; 11(1), p. 20122.
EPub date: 2021-10-11 00:00:00.0.
PMID: 34635726
Related Citations

Target value and prevalence influence visual foraging in younger and older age.
Authors: Wiegand I. , Wolfe J.M. .
Source: Vision Research, 2021 09; 186, p. 87-102.
EPub date: 2021-05-29 00:00:00.0.
PMID: 34062375
Related Citations

Guided Search 6.0: An updated model of visual search.
Authors: Wolfe J.M. .
Source: Psychonomic Bulletin & Review, 2021 Aug; 28(4), p. 1060-1092.
EPub date: 2021-02-05 00:00:00.0.
PMID: 33547630
Related Citations

Order, please! Explicit sequence learning in hybrid search in younger and older age.
Authors: Wiegand I. , Westenberg E. , Wolfe J.M. .
Source: Memory & Cognition, 2021 08; 49(6), p. 1220-1235.
EPub date: 2021-04-19 00:00:00.0.
PMID: 33876402
Related Citations

What do experts look at and what do experts find when reading mammograms?
Authors: Wolfe J.M. , Wu C.C. , Li J. , Suresh S.B. .
Source: Journal Of Medical Imaging (bellingham, Wash.), 2021 Jul; 8(4), p. 045501.
EPub date: 2021-07-13 00:00:00.0.
PMID: 34277890
Related Citations

Visual search errors are persistent in a laboratory analog of the incidental finding problem.
Authors: Nartker M.S. , Alaoui-Soce A. , Wolfe J.M. .
Source: Cognitive Research: Principles And Implications, 2020-07-29 00:00:00.0; 5(1), p. 32.
EPub date: 2020-07-29 00:00:00.0.
PMID: 32728864
Related Citations

Gist processing in digital breast tomosynthesis.
Authors: Wu C.C. , D'Ardenne N.M. , Nishikawa R.M. , Wolfe J.M. .
Source: Journal Of Medical Imaging (bellingham, Wash.), 2020 Mar; 7(2), p. 022403.
EPub date: 2019-12-18 00:00:00.0.
PMID: 31853462
Related Citations

Looking ahead: When do you find the next item in foraging visual search?
Authors: Kosovicheva A. , Alaoui-Soce A. , Wolfe J.M. .
Source: Journal Of Vision, 2020-02-10 00:00:00.0; 20(2), p. 3.
PMID: 32040162
Related Citations

What is a preattentive feature?
Authors: Wolfe J.M. , Utochkin I.S. .
Source: Current Opinion In Psychology, 2019 10; 29, p. 19-26.
EPub date: 2018-11-13 00:00:00.0.
PMID: 30472539
Related Citations

Assessing Cancer Risk from Mammograms: Deep Learning Is Superior to Conventional Risk Models.
Authors: Sitek A. , Wolfe J.M. .
Source: Radiology, 2019 Jul; 292(1), p. 67-68.
EPub date: 2019-05-07 00:00:00.0.
PMID: 31066627
Related Citations

Eye Movements in Medical Image Perception: A Selective Review of Past, Present and Future.
Authors: Wu C.C. , Wolfe J.M. .
Source: Vision (basel, Switzerland), 2019-06-20 00:00:00.0; 3(2), .
EPub date: 2019-06-20 00:00:00.0.
PMID: 31735833
Related Citations

Guidance and selection history in hybrid foraging visual search.
Authors: Wolfe J.M. , Cain M.S. , Aizenman A.M. .
Source: Attention, Perception & Psychophysics, 2019 Apr; 81(3), p. 637-653.
PMID: 30603990
Related Citations

Inversion effects in the expert classification of mammograms and faces.
Authors: Chin M.D. , Evans K.K. , Wolfe J.M. , Bowen J. , Tanaka J.W. .
Source: Cognitive Research: Principles And Implications, 2018 Dec; 3, p. 31.
EPub date: 2018-08-15 00:00:00.0.
PMID: 30148205
Related Citations

Even if I showed you where you looked, remembering where you just looked is hard.
Authors: Kok E.M. , Aizenman A.M. , Võ M.L. , Wolfe J.M. .
Source: Journal Of Vision, 2017-10-01 00:00:00.0; 17(12), p. 2.
PMID: 28973112
Related Citations

Comparing search patterns in digital breast tomosynthesis and full-field digital mammography: an eye tracking study.
Authors: Aizenman A. , Drew T. , Ehinger K.A. , Georgian-Smith D. , Wolfe J.M. .
Source: Journal Of Medical Imaging (bellingham, Wash.), 2017 Oct; 4(4), p. 045501.
EPub date: 2017-10-27 00:00:00.0.
PMID: 29098168
Related Citations

Five Factors that Guide Attention in Visual Search.
Authors: Wolfe J.M. , Horowitz T.S. .
Source: Nature Human Behaviour, 2017 Mar; 1(3), .
EPub date: 2017-03-08 00:00:00.0.
PMID: 36711068
Related Citations

Analog Computer-Aided Detection (CAD) information can be more effective than binary marks.
Authors: Cunningham C.A. , Drew T. , Wolfe J.M. .
Source: Attention, Perception & Psychophysics, 2017 Feb; 79(2), p. 679-690.
PMID: 27928658
Related Citations

How did I miss that? Developing mixed hybrid visual search as a 'model system' for incidental finding errors in radiology.
Authors: Wolfe J.M. , Alaoui Soce A. , Schill H.M. .
Source: Cognitive Research: Principles And Implications, 2017; 2(1), p. 35.
EPub date: 2017-08-23 00:00:00.0.
PMID: 28890920
Related Citations

Let's Use Cognitive Science to Create Collaborative Workstations.
Authors: Reicher M.A. , Wolfe J.M. .
Source: Journal Of The American College Of Radiology : Jacr, 2016 May; 13(5), p. 571-5.
EPub date: 2016-02-09 00:00:00.0.
PMID: 26873029
Related Citations

Use-inspired basic research in medical image perception.
Authors: Wolfe J.M. .
Source: Cognitive Research: Principles And Implications, 2016; 1(1), p. 17.
EPub date: 2016-11-14 00:00:00.0.
PMID: 28180168
Related Citations