Eye-Tracking Analysis in Surface-Guided Radiation Therapy Positioning: A Comparative Study of Experienced and Novice Radiation Therapists

The patient setup using the surface-guided radiation therapy (SGRT) system differs from conventional surface marker procedures. Owing to the abundance of three-dimensional information, there may be operator variability in where to focus during the patient setup. This study aimed to clarify the differences between expert and novice operators in SGRT positioning for head and neck cases by tracking their eye movements, thereby providing data for developing efficient patient setup procedures. Six radiation therapists set up a simulated patient on the SGRT system while recording eye movements on the screen using the QG-PLUS eye-tracking system. The positioning time and number of gaze fixations on the screen were analysed, and the relationship between years of experience with SGRT, positioning time and number of gaze fixations was evaluated. No significant correlation was found between SGRT experience and positioning time (r = −0.67, p = 0.15). However, more experienced radiation therapists exhibited fewer gaze fixations per positioning session (r = −0.81, p < 0.05), indicating that they efficiently identified key positioning points. Additionally, experienced radiation therapists focused more intently on a specific screen during the latter half of positioning, suggesting a refined approach for final patient alignment verification. More experienced radiation therapists showed fewer gaze fixations and demonstrated increased attention to a specific screen during the latter half of the patient setup process, suggesting that eye-tracking technology may provide useful data for standardising patient setup procedures in SGRT patient setups.