Development of an Eye-Tracking Image Manipulation System for Angiography: A Comparative Study

Rationale and Objectives: Appropriate image manipulation of angiographic image display systems during interventional radiology is performed by radiological technologists and/or nurses given instructions from radiologists. However, appropriate images might not be displayed because of communication errors. Therefore, we developed a manipulation system that uses an eye tracker. The study aimed to determine if an angiographic image display system can be manipulated as well by using an eye tracker as by using a mouse. Materials and Methods: An angiographic image display system using an eye tracker to calculate the gaze position on the screen and state of fixation was developed. Fourteen radiological technologists participated in an observer study by manipulating 10 images for each of 5 typical cases frequently performed in angiography, such as renal tumor, cerebral aneurysm, liver tumor, uterine bleeding, and hypersplenism. We measured the time from the start to the end of manipulating a series of images required when using the eye tracker and the conventional mouse. In this study, the statistical processing was done using Excel and R and R studio. Results: The average time required for all observers for completing all cases was significantly shorter when using the eye tracker than when using the mouse (10.4 +/- 2.1 s and 16.9 +/- 2.6 s, respectively; p < 0.001 by paired t test). Conclusion: Radiologists were able to manipulate an angiographic image display system directly by using the newly developed eye tracker system without touching contact devices, such as a mouse or angiography console. Therefore, communication error could be avoided.