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(Remington
2012b)
stimuli
facilitates
visual
perception
and
interpretation.
While the cone cells in the retina make the human eye sensitive to
colour, medical images are instead displayed in grey scale, as
individuals perceive colours in different ways. Hence in radiology,
colour is not beneficial in terms of identifying normal versus
abnormal anatomy. A broad range of grey shades is required to
avoid the brain seeing adjacent shades as one level of grey (Kimpe
& Tuytschaever 2007).
VISUAL ILLUSIONS IN RADIOLOGIC IMAGE INTERPRETATION
Visual illusions occur when reality is represented in a distorted or
altered way (Figure 2). When imaged, the human body is a complex
combination of overlapping shadows and differing radiographic
densities. Sensory and perceptual aspects of our visual system can
give rise to artefacts that can be mistaken as pathology. Illusions
can be categorized into either sensory or perceptual illusions, where
sensation illusions occur during the phototransduction process and
perceptual illusions emerge from the interpretation phase after
sensory input has been analysed (Buckle et al. 2013). One of the
most common illusions of sensation in radiology is the Mach band
effect (Panikkath & Panikkath 2014).
(Buckle et al.
2013)
Figure 2. (a) Typical ambiguous image in the form of a visual illusion; Mother or
Wife? which can either be interpreted as (b) a young woman looking away (blue
circle) or (c) as an old woman looking downwards (red circle)
(a)
(b)
Figure 3. (a) Mach band seen (arrows) where the posterior arch of the atlas is projected over C2 and mimics a dens fra
Disease present
Disease absent
Disease absent
REDUCING ERROR
To reduce perception errors in radiologic reporting, continued
education and training of radiologists is important (Sabih et al.
Figure 4. Decision matrix illustrating how TPs, FPs, FNs and TNs are determined by
comparing
2011). Understanding
the radiologiststhe
interpretations
physiologywith
of visual
the realillusions
situation.such
Sensitivity
as Mach
gives
the proportion of true positives and is calculated by TP/(TP + FN), while specificity
bands
a vital aspect
of image
not+ only
because
gives
theisproportion
of true negatives
andinterpretation,
is given by TN/(TN
FP). Accuracy
can
then be determined by TN + TP/(TN + TP + FP + FN).
they can aid in making diagnoses, but also because they can be
mistaken for pathology (Buckle et al. 2013). If radiologists are aware