Abstract
PURPOSE: Human perception and decisions are biased toward previously seen stimuli. This phenomenon is known as serial dependence and has been extensively studied for the last decade. Recent evidence suggests that clinicians' judgments of mammograms might also be impacted by serial dependence. However, the stimuli used in previous psychophysical experiments on this question, consisting of artificial geometric shapes and healthy tissue backgrounds, were unrealistic. We utilized realistic and controlled generative adversarial network (GAN)-generated radiographs to mimic images that clinicians typically encounter. APPROACH: Mammograms from the digital database for screening mammography (DDSM) were utilized to train a GAN. This pretrained GAN was then adopted to generate a large set of authentic-looking simulated mammograms: 20 circular morph continuums, each with 147 images, for a total of 2940 images. Using these stimuli in a standard serial dependence experiment, participants viewed a random GAN-generated mammogram on each trial and subsequently matched the GAN-generated mammogram encountered using a continuous report. The characteristics of serial dependence from each continuum were analyzed. RESULTS: We found that serial dependence affected the perception of all naturalistic GAN-generated mammogram morph continuums. In all cases, the perceptual judgments of GAN-generated mammograms were biased toward previously encountered GAN-generated mammograms. On average, perceptual decisions had 7% categorization errors that were pulled in the direction of serial dependence. CONCLUSIONS: Serial dependence was found even in the perception of naturalistic GAN-generated mammograms created by a GAN. This supports the idea that serial dependence could, in principle, contribute to decision errors in medical image perception tasks.