LEFT ‐RIGHT PUPIL DIAMETER DIFFERENCE‐DURING RADIOGRAPHIC READING OF BRONCOPULMONARY CARCINOMA: AN EXPLORATION WITH COGNITIVE LOAD AMONG NOVICES AND EXPERTS
Authors: ACERO-MONDRAGON EDWARD JAVIER , CHAUSTRE-NIETO LUIS CARLOS , URDANETA-PAREDES DANIEL ANTONIO , CORTES-CABRERA JORGE ARMANDO , GALLEGO-CORREA JOHN JAIRO 
Published: April 2020

INTRODUCTIONThe visual reading of an x‐ray image is a necessary process in order to find specific pathological patterns. With
Functional Near Infrared Spectroscopy study have shown that increased levels of oxy and deoxy hemoglobin in the left hemisphere are associated with greater cognitive load in visual challenges and Transcranial Doppler has shown an increase on left middle cerebral artery flow associated with cognitive tasks in the face of visual challenges. Nowdays, pupil diameter begins to be recognized as a non‐intrusive method for measuring cognitive load during radiographic, dental radiographic, and histopathological diagnosis processes. The present work’s objective, is to show the difference in left and right pupillary diameters during the radiographic reading of bronchopulmonary carcinoma, to explore the cognitive burdens of novice, intermediate and expert groups.MATERIAL AND METHODSWith a 60 Hz Gazepoint GP3 Eyetracker, the pupil diameter of 8 doctors was quantified during the chest radiographic reading postero‐anterior projection of a bronchopulmonary carcinoma, taken from RadioGrapichs Magazine; first‐to‐fourth year resident physicians with age = 30.6 were classified as novice with 8.5‐month training, intermediate years with 41‐month training and expert doctors with age = 67 years and with 462 months of experience. All the diagnostic challenge was exposed on a monitor with 300 DPI connected to an Intel Core i5 PC with 8GB RAM.RESULTSThe average found of pupil diameter was 4.05 mm to all groups, over the course of 2 minutes, and the difference in pupil diameter went from 3.66 mm to 4.08 mm. However, the expert group demonstrated a pattern of smaller right pupil diameter with 3.98 mm, while the left pupillary diameter reached 4.22 mm. In contrast, during the same diagnostic task, the intermediate and novice groups showed a more homogeneous pupillary opening between left and right eye, being 4.05 mm and 4.01 mm respectively.Differences obtained between the left and right pupillary diameters during the chest x ray reading tasked were observed in all groups. However, it was observed that this difference occurred at different times. The expert group increased left pupillary diameter immediately while novice and intermediate achieved the same pupillary effect 50 seconds after the task was initiated. Fig
1.CONCLUSIONIn the two minutes radiological diagnosis process for bronchopulmonary carcinoma, radiologist doctors express greater left pupil diameter with respect to the right. However, experts make such a statement almost from the beginning of the task; while the intermediate and novice groups reach this same pattern approximately half way through the task’s total time. This finding, suggests that differences in pupil diameter may be associated with visual cognitive processing during diagnostic processes. This possible relationship may be related to cognitive load lateralization to the left hemisphere. Therefore, studies of cognitive load laterality vs. ipsilateral pupil diameter during imaging are necessary, since their possible effects on academic and labor scenarios are yet to be established.Support or Funding InformationPROSEIMLEFT ‐RIGHT PUPIL DIAMETER DIFFERENCE‐ DURING 2 MINUTES OF RADIOGRAPHIC READING OF BRONCHOPULMONARY CARCINOMA AMONG NOVICES AND EXPERTSFigure 1