Eye Motion Tracking for Medical Image Interpretation Training.

INTRODUCTION: The significance of Eye Motion Tracking in aiding learners in training search patterns, pattern recognition, and efficiently using their gaze in terms of time and scanning distribution has been highlighted in the USAF Pilot Training Next initiative. METHODS: The innovation described further builds on this concept in the realm of medical imaging and the provision of real-time feedback of eye direction and gaze duration. RESULTS: This real-time indicator enables the trainer to adapt verbal queueing of the trainee in a personalized manner to improve knowledge transfer, and to increase the confidence of the trainer and trainee in the competency of the trainee. The initial experiment data set included bone radiographs, digital subtraction angiograms, and computed tomography images. DISCUSSION: Preliminary results and formative feedback from participants was encouraging with expert viewers able to use Eye Motion Tracking to successfully guide novice readers through search and gaze protocol patterns of the medical images.

Lymph node imaging in initial staging of prostate cancer: An overview and update.

Accurate nodal staging at the time of diagnosis of prostate cancer is crucial in determining a treatment plan for the patient. Pelvic lymph node dissection is the most reliable method, but is less than perfect and has increased morbidity. Cross sectional imaging with computed tomography (CT) and magnetic resonance imaging (MRI) are non-invasive tools that rely on morphologic characteristics such as shape and size of the lymph nodes. However, lymph nodes harboring metastatic disease may be normal sized and non-metastatic lymph nodes may be enlarged due to reactive hyperplasia. The optimal strategy for preoperative staging remains a topic of ongoing research. Advanced imaging techniques to assess lymph nodes in the setting of prostate cancer utilizing novel MRI contrast agents as well as positron emission tomography (PET) tracers have been developed and continue to be studied. Magnetic resonance lymphography utilizing ultra-small super paramagnetic iron oxide has shown promising results in detection of metastatic lymph nodes. Combining MRL with diffusion-weighted imaging may also improve accuracy. Considerable efforts are being made to develop effective PET radiotracers that are performed using hybrid-imaging systems that combine PET with CT or MRI. PET tracers that will be reviewed in this article include [18F]fluoro-D-glucose, sodium [18F]fluoride, [18F]choline, [11C]choline, prostate specific membrane antigen binding ligands, [11C]acetate, [18F]fluciclovine, gastrin releasing peptide receptor ligands, and androgen binding receptors. This article will review these advanced imaging modalities and ability to detect prostate cancer metastasis to lymph nodes. While more research is needed, these novel techniques to image lymph nodes in the setting of prostate cancer show a promising future in improving initial lymph node staging.