Diagnostic performance in complex visual environments is strongly constrained by later perceptual stages, with decision failures accounting for the largest proportion of errors. Lesion detectability is jointly influenced by both target morphology and background complexity, revealing a critical interaction between local signal features and global anatomical noise. Increased fixation duration on spiculated lesions suggests that visual attention is differentially engaged depending on lesion structure, potentially aiding recognition. These findings highlight the importance of perceptually informed design and training of computer aided diagnosis systems.
Kavuri et al. (2026) studied this question.