Missing an image: perception in Radiology

Many clinical decisions are based nowdays in a radiological report. Radiologist have a difficult task when they have to search for metastases in a patient with a disseminated tumor. The most common errors are satisfaction of search (after you find something you don´t look for more) or “tunnel vision” (an incomplete study of the image).

How many lesions you see in this video, quite similar to the radiologist environment?

[wpvideo taoavJ3u]

Detected lesion in the right parieto-occipital area protruding to the brain
Second lesion in the jaw undetected initially



  1. Clinical information is basic for radiologist to paid more attention to specific areas.
  2. Some anatomical areas can be easily missed due to the uncommon involvement or to the small anatomical size.
  3. The finding of a first lesion can influence the ability of perception to detect a second lesion.
  4. Fatigue and distraction are in the origin of many radiological errors
  5. Satisfaction of search is a common error in diagnostic radiology. It occurs when the reporting radiologist fails to continue to search for subsequent abnormalities after identifying an initial one. This initial detection of an abnormalities satisfies the “search for meaning” and the reporting of the case is prematurely ended.