Journal of Digital Imaging

, Volume 24, Issue 5, pp 778–786 | Cite as

A Pilot Study on Using Eye Tracking to Understand Assessment of Surgical Outcomes from Clinical Photography

  • Min Soon Kim
  • Angela Burgess
  • Andrew J. Waters
  • Gregory P. Reece
  • Elisabeth K. Beahm
  • Melissa A. Crosby
  • Karen M. Basen-Engquist
  • Mia K. Markey


Appearance changes resulting from breast cancer treatment impact the quality of life of breast cancer survivors, but current approaches to evaluating breast characteristics are very limited. It is challenging, even for experienced plastic surgeons, to describe how different aspects of breast morphology impact overall assessment of esthetics. Moreover, it is difficult to describe what they are looking for in a manner that facilitates quantification. The goal of this study is to assess the potential of using eye-tracking technology to understand how plastic surgeons assess breast morphology by recording their gaze path while they rate physical characteristics of the breasts, e.g., symmetry, based on clinical photographs. In this study, dwell time, transition frequency, dwell sequence conditional probabilities, and dwell sequence joint probabilities were analyzed across photographic poses and three observers. Dwell-time analysis showed that all three surgeons spent the majority of their time on the anterior–posterior (AP) views. Similarly, transition frequency analysis between regions showed that there were substantially more transitions between the breast regions in the AP view, relative to the number of transitions between other views. The results of both the conditional and joint probability analyses between the breast regions showed that the highest probabilities of transitions were observed between the breast regions in the AP view (APRB, APLB) followed by the oblique views and the lateral views to complete evaluation of breast surgical outcomes.


Breast neoplasm Eye movements Biomedical image analysis Decision support Evaluation research 


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Copyright information

© Society for Imaging Informatics in Medicine 2010

Authors and Affiliations

  • Min Soon Kim
    • 1
  • Angela Burgess
    • 2
  • Andrew J. Waters
    • 3
  • Gregory P. Reece
    • 4
  • Elisabeth K. Beahm
    • 4
  • Melissa A. Crosby
    • 4
  • Karen M. Basen-Engquist
    • 5
  • Mia K. Markey
    • 6
  1. 1.Department of Health Management and InformaticsUniversity of Missouri School of MedicineColumbiaUSA
  2. 2.The Psychology DepartmentWichita State UniversityWichitaUSA
  3. 3.Uniformed Services University of the Health SciencesBethesdaUSA
  4. 4.Department of Plastic SurgeryThe University of Texas M. D. Anderson Cancer CenterHoustonUSA
  5. 5.Department of Behavioral ScienceThe University of Texas M. D. Anderson Cancer CenterHoustonUSA
  6. 6.The University of Texas Department of Biomedical EngineeringAustinUSA

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