Background and study aims: Narrow-band imaging (NBI) is a new imaging methodology for improving the detection
rate of gastrointestinal lesions. We aimed to evaluate perception of images by NBI
and corresponding standard white-light-endoscopy (WLE) using a computer-guided eye-tracking
system.
Methods: A total of 23 NBI images of various lesions with the 23 corresponding WLE images
were assessed in random order by 18 subjects with various endoscopy experience. Before
evaluation, a teaching set of three NBI and corresponding WLE images was shown to
highlight the characteristics of lesions. An eye-tracking system (Tobii X series with
integrated 17-inch monitor) was used to record the eye movements of the subjects while
they examined respective images. The following parameters were measured: total time
spent on image, time until first fixation of lesion, total number of fixations per
image and per lesion, and number of fixations until finding the lesion.
Results: In total, 828 experiments were conducted. Lesions could not be detected in 6.5 %
(NBI) and 4.1 % (WLE) of images (P = NS). The total number of fixations and total time spent on respective figures as
a whole were significantly greater for NBI images compared with WLE images (P < 0.003). However, the number of fixations until the lesion was found, the number
of fixations on the lesion, and the time until first fixation of the lesion did not
differ between the two image groups (P > 0.1).
Conclusion: This is the first study using eye tracking to evaluate image perception in gastrointestinal
endoscopy. Significant differences in the interpretation of NBI and WLE images were
observed, which may be relevant for the detection and characterization of lesions
during endoscopy.
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A. MeiningMD
Technical University of Munich
II Medizinische Klinik am Klinikum rechts der Isar
TU München Munich 81675
Germany
Fax: +49-89-41404905
eMail: Alexander.Meining@lrz.tum.de
