Monitoring of fatigue in radiologists during prolonged image interpretation using fNIRS.

PURPOSE: To determine whether functional near-infrared spectroscopy (fNIRS) allows monitoring fatigue in radiologists during prolonged image interpretation. MATERIALS AND METHODS: Nine radiologists participated as subjects in the present study and continuously interpreted medical images and generated reports for cases for more than 4 h under real clinical work conditions. We measured changes in oxygenated hemoglobin concentrations [oxy-Hb] in the prefrontal cortex using 16-channel fNIRS (OEG16ME, Spectratech) every hour during the Stroop task to evaluate fatigue of radiologists and recorded fatigue scale (FS) as a behavior data. RESULTS: Two subjects showed a subjective feeling of fatigue and an apparent decrease in brain activity after 4 h, so the experiment was completed in 4 h. The remaining seven subjects continued the experiment up to 5 h. FS decreased with time, and a significant reduction was observed between before and the end of image interpretation. Seven out of nine subjects showed a minimum [oxy-Hb] change at the end of prolonged image interpretation. The mean change of [oxy-Hb] at the end of all nine subjects was significantly less than the maximum during image interpretation. CONCLUSION: fNIRS using the change of [oxy-Hb] may be useful for monitoring fatigue in radiologists during image interpretation.

Removal of motion artifacts originating from optode fluctuations during functional near-infrared spectroscopy measurements.

Functional near-infrared spectroscopy (fNIRS) has been increasingly utilized for detecting human cerebral activity in many disciplines because of the potential for less-restraining conditions. However, users often suffer from motion artifacts originating from optode fluctuation during task execution when the task includes motion. In such cases, the optode fluctuation induces changes both in the reflection by hair and in the transmission between the optode and scalp. If part of the reflected light is directly received by the detector optode (short-circuited light), it will contaminate the fNIRS signal. The transmittance change at the optode-scalp gap will also contaminate the signal. In this study, we proposed an optical model on the influence of optode fluctuation on the fNIRS signal and a method for removing the influence. The model revealed the following: (1) the received short-circuited light and the gap transmittance change generated a baseline change in the detected light intensity, and (2) the signal from the tissues was downscaled with increases in the receiving intensity of short-circuited light. To avoid erroneous detection of short-circuited light, we developed a method that optically eliminated hair-reflected light from the detection using linearly polarized light sources and an orthogonally polarized analyzer. The method was validated with an optical phantom possessing a haired surface. The optical absorbance change of a close source-detector (S-D) pair equipped with polarizers was very similar to that of distant S-D pairs, even though these optodes were artificially fluctuated. By combining the multidistance optode arrangement technique with the short-circuited light elimination method, the measurement could effectively eliminate motion artifacts originating from optode fluctuation.