Al Hirschfeld's NINA as a prototype search task for studying perceptual error in radiology

Calvin F. Nodine; Harold L. Kundel

doi:10.1117/12.271306

16 April 1997 Al Hirschfeld's NINA as a prototype search task for studying perceptual error in radiology

Calvin F. Nodine, Harold L. Kundel

Proceedings Volume 3036, Medical Imaging 1997: Image Perception; (1997) https://doi.org/10.1117/12.271306
Event: Medical Imaging 1997, 1997, Newport Beach, CA, United States

Abstract

Artist Al Hirschfeld has been hiding the word NINA (his daughter's name) in line drawings of theatrical scenes that have appeared in the New York Times for over 50 years. This paper shows how Hirschfeld's search task of finding the name NINA in his drawings illustrates basic perceptual principles of detection, discrimination and decision-making commonly encountered in radiology search tasks. Hirschfeld's hiding of NINA is typically accomplished by camouflaging the letters of the name and blending them into scenic background details such as wisps of hair and folds of clothing. In a similar way, pulmonary nodules and breast lesions are camouflaged by anatomic features of the chest or breast image. Hirschfeld's hidden NINAs are sometimes missed because they are integrated into a Gestalt overview rather than differentiated from background features during focal scanning. This may be similar to overlooking an obvious nodule behind the heart in a chest x-ray image. Because it is a search game, Hirschfeld assigns a number to each drawing to indicate how many NINAs he has hidden so as not to frustrate his viewers. In the radiologists' task, the number of targets detected in a medical image is determined by combining perceptual input with probabilities generated from clinical history and viewing experience. Thus, in the absence of truth, searching for abnormalities in x-ray images creates opportunities for recognition and decision errors (e.g. false positives and false negatives). We illustrate how camouflage decreases the conspicuity of both artistic and radiographic targets, compare detection performance of radiologists with lay persons searching for NINAs, and, show similarities and differences between scanning strategies of the two groups based on eye-position data.

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Calvin F. Nodine and Harold L. Kundel "Al Hirschfeld's NINA as a prototype search task for studying perceptual error in radiology", Proc. SPIE 3036, Medical Imaging 1997: Image Perception, (16 April 1997); https://doi.org/10.1117/12.271306

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