Holistic processing only? The role of the right fusiform face area in radiological expertise

PLoS One. 2021 Sep 1;16(9):e0256849. doi: 10.1371/journal.pone.0256849. eCollection 2021.

Abstract

Radiologists can visually detect abnormalities on radiographs within 2s, a process that resembles holistic visual processing of faces. Interestingly, there is empirical evidence using functional magnetic resonance imaging (fMRI) for the involvement of the right fusiform face area (FFA) in visual-expertise tasks such as radiological image interpretation. The speed by which stimuli (e.g., faces, abnormalities) are recognized is an important characteristic of holistic processing. However, evidence for the involvement of the right FFA in holistic processing in radiology comes mostly from short or artificial tasks in which the quick, 'holistic' mode of diagnostic processing is not contrasted with the slower 'search-to-find' mode. In our fMRI study, we hypothesized that the right FFA responds selectively to the 'holistic' mode of diagnostic processing and less so to the 'search-to-find' mode. Eleven laypeople and 17 radiologists in training diagnosed 66 radiographs in 2s each (holistic mode) and subsequently checked their diagnosis in an extended (10-s) period (search-to-find mode). During data analysis, we first identified individual regions of interest (ROIs) for the right FFA using a localizer task. Then we employed ROI-based ANOVAs and obtained tentative support for the hypothesis that the right FFA shows more activation for radiologists in training versus laypeople, in particular in the holistic mode (i.e., during 2s trials), and less so in the search-to-find mode (i.e., during 10-s trials). No significant correlation was found between diagnostic performance (diagnostic accuracy) and brain-activation level within the right FFA for both, short-presentation and long-presentation diagnostic trials. Our results provide tentative evidence from a diagnostic-reasoning task that the FFA supports the holistic processing of visual stimuli in participants' expertise domain.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain Mapping
  • Case-Control Studies
  • Clinical Competence / statistics & numerical data*
  • Female
  • Humans
  • Internship and Residency / statistics & numerical data
  • Magnetic Resonance Imaging
  • Male
  • Pattern Recognition, Visual / physiology*
  • Photic Stimulation / methods
  • Radiography / statistics & numerical data
  • Radiologists / education
  • Radiologists / statistics & numerical data*
  • Radiology / education
  • Radiology / statistics & numerical data*
  • Reaction Time / physiology
  • Time Factors
  • Visual Cortex / diagnostic imaging
  • Visual Cortex / physiology*
  • Young Adult

Grants and funding

This work was supported by an fMRI scanning grant to AdB and EK from the executive board of the Faculty of Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands. The funding covered scanning costs for this study, but not the salary of the researchers. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.