Imaging performance of amorphous selenium based flat-panel detectors for digital mammography: characterization of a small area prototype detector

Technical note: Characterization, validation, and spectral optimization of a dedicated breast CT system for contrast-enhanced imaging

BACKGROUND

The development of a new imaging modality, such as 4D dynamic contrast-enhanced dedicated breast CT (4D DCE-bCT), requires optimization of the acquisition technique, particularly within the 2D contrast-enhanced imaging modality. Given the extensive parameter space, cascade-systems analysis is commonly used for such optimization.

PURPOSE

To implement and validate a parallel-cascaded model for bCT, focusing on optimizing and characterizing system performance in the projection domain to enhance the quality of input data for image reconstruction.

METHODS

A parallel-cascaded system model of a state-of-the-art bCT system was developed and model predictions of the presampled modulation transfer function (MTF) and the normalized noise power spectrum (NNPS) were compared with empirical data collected in the projection domain. Validation was performed using the default settings of 49 kV with 1.5 mm aluminum filter and at 65 kV and 0.257 mm copper filter. A 10 mm aluminum plate was added to replicate the breast attenuation. Air kerma at the isocenter was measured at different tube current levels. Discrepancies between the measured projection domain metrics and model-predicted values were quantified using percentage error and coefficient of variation (CoV) for MTF and NNPS, respectively. The optimal filtration was for a 5 mm iodine disk detection task at 49, 55, 60, and 65 kV. The detectability index was calculated for the default aluminum filtration and for copper thicknesses ranging from 0.05 to 0.4 mm.

RESULTS

At 49 kV, MTF errors were +5.1% and -5.1% at 1 and 2 cycles/mm, respectively; NNPS CoV was 5.3% (min = 3.7%; max = 8.5%). At 65 kV, MTF errors were -0.8% and -3.2%; NNPS CoV was 13.1% (min = 11.4%; max = 16.9%). Air kerma output was linear, with 11.67 µGy/mA (R2 = 0.993) and 19.14 µGy/mA (R2 = 0.996) at 49 and 65 kV, respectively. For iodine detection, a 0.25 mm-thick copper filter at 65 kV was found optimal, outperforming the default technique by 90%.

CONCLUSION

The model accurately predicts bCT system performance, specifically in the projection domain, under varied imaging conditions, potentially contributing to the enhancement of 2D contrast-enhanced imaging in 4D DCE-bCT.

Minimization of image lag in polycrystalline mercuric iodide converters through incorporation of Frisch grid structures for digital breast tomosynthesis

Objective. Polycrystalline mercuric iodide photoconductive converters fabricated using particle-in-binder techniques (PIB HgI₂) provide significantly more detected charge per x-ray interaction than from a-Se and CsI:Tl converters commonly used with active matrix flat-panel imagers (AMFPIs). This enhanced sensitivity makes PIB HgI₂an interesting candidate for applications involving low x-ray exposures-since the relatively high levels of additive electronic noise exhibited by AMFPIs incorporating a-Se and CsI:Tl reduce detective quantum efficiency (DQE) performance under such conditions. A theoretical study is reported on an approach for addressing a major challenge impeding practical use of PIB HgI₂converters-the high lag exhibited by the material (over 10%) which would lead to undesirable image artifacts in applications involving acquisition of consecutive images such as digital breast tomosynthesis.Approach. Charge transport modeling accounting for the trapping and release of holes (thought to be the primary contributor to lag) was used to examine signal properties, including lag, of pillar-supported Frisch grids embedded in the photoconductor for 100μm pitch AMFPI pixels. Performance was examined as a function of electrode voltage, grid pitch (center-to-center distance between neighboring grid wires) and the ratio of grid wire width to grid pitch.Main results. Optimum grid designs maximizing suppression of signal generated by hole transport, without significantly affecting the total signal due to electron and hole transport, were identified and MTF was determined. For the most favorable designs, additional modeling was used to determine DQE. The results indicate that, through judicious choice of grid design and operational conditions, first frame lag can be significantly reduced to below 1%-less than the low levels exhibited by a-Se. DQE performance is shown to be largely maintained as exposure decreases-which should help to maintain good image quality.Significance. Substantial reduction of lag in PIB HgI₂converters via incorporation of Frisch grids has been demonstrated through modeling.

Effects of Charge Carrier Trapping on Image Resolution of Multilayer Photoconductive Detectors: Application to Amorphous Selenium X-ray Detectors

The effects of charge carrier trapping on image resolution in multilayer photoconductive imaging detectors was analyzed by developing an analytical model for calculating the modulation transfer function (MTF) of the imaging detectors. The MTF model was developed by considering the charge carrier trapping/recombination in the blocking layer and the distributed trapping in the bulk photoconductor layer of multilayer photoconductive imaging detectors. The relative importance of the bulk and blocking layer trapping, as well as the K-fluorescence reabsorption on the resolution, was also analyzed. The model was applied to amorphous selenium- (a-Se) based multilayer detectors for both chest radiographic and mammographic applications. The theoretical model agreed well with experimental results. The charge carrier trapping/recombination in the blocking layer and K-fluorescence reabsorption mainly controlled the resolution of the a-Se mammographic detectors. In addition to these two effects, the bulk trapping also had a significant effect on the resolution of chest radiographic detectors. The blocking layer thickness had more of a profound effect on the resolution than the amount of trap centers in the blocking layer. The resolution deteriorated drastically with increased blocking layer thickness.

The detective quantum efficiency of cadmium telluride photon-counting x-ray detectors in breast imaging applications

PURPOSE

In breast imaging applications, cadmium telluride (CdTe) photon counting x-ray detectors (PCDs) may reduce radiation dose and enable single-shot multi-energy x-ray imaging. The purpose of this work is to determine the upper limits of the detective quantum efficiency (DQE) of CdTe PCDs for x-ray mammography and to compare them with the published DQEs of energy-integrating detectors (EIDs) and other PCDs.

METHODS

We calibrated and validated a Monte Carlo (MC) model of the DQE of CdTe PCDs using an XCounter CdTe PCD. Our model accounted for charge sharing, electronic noise, and charge summation logic. We used a 28 kVp Mo/Mo spectrum hardened by 3.9 cm of Lucite to optimize the detector thickness and energy threshold for pixel sizes of 50, 85, and 100 μ m with and without inter-pixel charge summation logic. The figure of merit used for optimization was the integral of the DQE, which is equivalent to the detectability index for a delta function task function, which represents a high-frequency task.

RESULTS

For an electronic noise level equal to that of the XCounter, the optimal DQE(0) without charge summing was 0.74. Charge summing for charge-sharing correction reduced DQE(0) by 14% due to an increase in electronic noise. Reducing the electronic noise to ∼0.5 keV per pixel in combination with charge summing resulted in DQE(0) ≈ 0.78 for 85  μ m pixels, which is approximately equal to that of a-Se and slot-scanning silicon-strip PCDs. At higher spatial frequencies, and for matched pixel sizes, the DQE was inferior to that of a-Se EIDs and superior to that of slot-scanning silicon-strip PCDs in the scan direction but inferior in the slit direction.

CONCLUSIONS

(1) CdTe PCDs have the potential to provide a zero-frequency DQE equal to that of a-Se EIDs and slot-scanning silicon-strip PCDs, but this will require electronic noise levels ∼0.5 keV per pixel. (2) At mid-to-high spatial frequencies the DQE of CdTe PCDs may be (a) inferior to that of a-Se EIDs and slot-scanning silicon-strip PCDs in the slit direction, and (b) superior to slot-scanning silicon-strip PCDs in the scan direction.

Theoretical investigation of the signal performance of HgI2x-ray converters incorporating a Frisch grid structure at mammographic energies

Active matrix, flat-panel imagers (AMFPIs) suffer from decreased detective quantum efficiency under conditions of low dose per image frame (such as for digital breast tomosynthesis, fluoroscopy and cone-beam CT) due to low signal compared to the additive electronic noise. One way to address this challenge is to introduce a high-gain x-ray converter called particle-in-binder mercuric iodide (PIB HgI₂) which exhibits 3-10 times higher x-ray sensitivity compared to that of a-Se and CsI:Tl converters employed in commercial AMFPI systems. However, a remaining challenge for practical implementation of PIB HgI₂is the high level of image lag, which is believed to largely originate from the trapping of holes. Towards addressing this challenge, this paper reports a theoretical investigation of the use of a Frisch grid structure embedded in the converter to suppress hole signal-which would be expected to reduce image lag. The grid acts as a third electrode sandwiched between a continuous top electrode and pixelated bottom electrodes having a 100μm pitch. Signal properties of such a detector are investigated as a function of VDR (the ratio of the voltage difference between the electrodes in the region below the grid to that above the grid), grid pitch (the center-to-center distance between two neighboring grid wires) andR_GRID(the ratio of grid wire width to grid pitch) for mammographic x-ray energies. The results show that smaller grid pitch suppresses hole signal to a higher degree (up to ∼96%) while a larger gap between grid wires and higher VDR provide minimally impeded electron transport. Examination of the tradeoff between maximizing electron signal and minimizing hole signal indicates that a grid design having a grid pitch of 20μm withR_GRIDof 50% and 65% provides hole signal suppression of ∼93% and ∼95% for VDR of 1 and 3, respectively.

EXPOSURE DOSE INDEX BASED ON NOISE FACTOR ANALYSIS IN DIGITAL MAMMOGRAPHY: VERIFICATION USING DIRECT-TYPE FLAT-PANEL DETECTOR SYSTEM

In this study, the development of a reasonable index of optimized exposure dose is attempted. Using a direct-type flat-panel system, noise factors contained in the image are analyzed based on the relative standard deviation method, and it is verified that the proposed index conforms with the appropriate standards regarding minimum exposure dose. The findings indicate that Poisson noise is dominant in the general clinical dose range; this noise fraction formed 90% of the total noise in the system considered in this study. Considering the results of previous surveys, it is estimated that the point at which the content rate of the Poisson noise starts to decrease can be considered as the lower limit, below which the dose cannot be reduced further without compromising on image quality. As the 'index' obtained by this method can be easily measured, it is useful as a quantitative indicator for dose determination and optimization.

Evaluation of a hybrid direct-indirect active matrix flat-panel imager using Monte Carlo simulation

Purpose: Monte Carlo simulations were used to evaluate the imaging properties of a composite direct-indirect active matrix flat-panel imager (AMFPI) with potentially more favorable tradeoffs between x-ray quantum efficiency and spatial resolution than direct or indirect AMFPIs alone. This configuration, referred to as a hybrid AMFPI, comprises a scintillator that is optically coupled to an a-Se direct AMFPI through a transparent electrode and hole blocking layer, such that a-Se acts as both a direct x-ray converter and an optical sensor. Approach: GEANT4 was used to simulate x-ray energy deposition, optical transport, and charge signal generation processes in various hybrid AMPFI configurations under RQA5 and RQA9 x-ray beam conditions. The Fujita-Lubberts-Swank method was used to quantify the impact of irradiation geometry, x-ray converter thicknesses, conversion gain of each layer, and x-ray cross talk between layers on detective quantum efficiency (DQE). Results: Each hybrid configuration had a greater DQE than its direct AMFPI layer alone. The DQE improvement was largest at low spatial frequencies in both front- and back-irradiation (BI) geometries due to increased x-ray quantum efficiency provided by the scintillator. DQE improvements persisted at higher frequencies in BI geometry due to preferential x-ray absorption in a-Se. Matching the x-ray-to-charge conversion gains of a hybrid AMFPI's direct and indirect detection layers affects its Swank factor and, thus, DQE(0). X-ray cross talk has a negligible impact on the DQE ( f ) of hybrid AMFPIs with sufficiently high optical quantum efficiency. Conclusion: An optimized hybrid AMFPI can achieve greater DQE performance than current direct or indirect AMFPIs.

Horizons of nanotechnology applications in female specific cancers

Female-specific cancers are the most common cancers in women worldwide. Early detection methods remain unavailable for most of these cancers, signifying that most of them are diagnosed at later stages. Furthermore, current treatment options for most female-specific cancers are surgery, radiation and chemotherapy. Although important milestones in molecularly targeted approaches have been achieved lately, current therapeutic strategies for female-specific cancers remain limited, ineffective and plagued by the emergence of chemoresistance, which aggravates prognosis. Recently, the application of nanotechnology to the medical field has allowed the development of novel nano-based approaches for the management and treatment of cancers, including female-specific cancers. These approaches promise to improve patient survival rates by reducing side effects, enabling selective delivery of drugs to tumor tissues and enhancing the uptake of therapeutic compounds, thus increasing anti-tumor activity. In this review, we focus on the application of nano-based technologies to the design of novel and innovative diagnostic and therapeutic strategies in the context of female-specific cancers, highlighting their potential uses and limitations.

Technical Note: Noise models for virtual clinical trials of digital breast tomosynthesis

PURPOSE

To investigate the use of an affine-variance noise model, with correlated quantum noise and spatially dependent quantum gain, for the simulation of noise in virtual clinical trials (VCT) of digital breast tomosynthesis (DBT).

METHODS

Two distinct technologies were considered: an amorphous-selenium (a-Se) detector with direct conversion and a thallium-doped cesium iodide (CsI(Tl)) detector with indirect conversion. A VCT framework was used to generate noise-free projections of a uniform three-dimensional simulated phantom, whose geometry and absorption match those of a polymethyl methacrylate (PMMA) uniform physical phantom. The noise model was then used to generate noisy observations from the simulated noise-free data, while two clinically available DBT units were used to acquire projections of the PMMA physical phantom. Real and simulated projections were then compared using the signal-to-noise ratio (SNR) and normalized noise power spectrum (NNPS).

RESULTS

Simulated images reported errors smaller than 4.4% and 7.0% in terms of SNR and NNPS, respectively. These errors are within the expected variation between two clinical units of the same model. The errors increase to 65.8% if uncorrelated models are adopted for the simulation of systems featuring indirect detection. The assumption of spatially independent quantum gain generates errors of 11.2%.

CONCLUSIONS

The investigated noise model can be used to accurately reproduce the noise found in clinical DBT. The assumption of uncorrelated noise may be adopted if the system features a direct detector with minimal pixel crosstalk.

Cascaded systems analysis of a-Se/a-Si and a-InGaZnO TFT passive and active pixel sensors for tomosynthesis

Medical imaging systems like full field digital mammography (FFDM) and digital breast tomosynthesis (DBT) commonly use amorphous selenium (a-Se) based passive pixel sensor (PPS) direct conversion x-ray detectors. On one hand, direct conversion detectors inherently offer better resolution characteristics in terms of a higher modulation transfer function (MTF), in comparison to the indirect CsI:Tl PPS x-ray imager. On the other hand, especially at lower doses, this superior performance of the direct imager is seldom retained in its detective quantum efficiency (DQE) curves. It is well known that a-Se PPS x-ray imagers suffer from high additive electronic noise originating from the from the amorphous silicon (a-Si) thin film transistor (TFT) array that is being used in the current back-plane technology. This degrades the noise power spectrum (NPS) and subsequently the overall DQE. To address this deficiency, we propose to replace the PPS back-plane by active pixel sensor (APS) back-plane technology, which has the potential to reduce the back-plane electronic noise by amplifying the input signal, especially at low doses. The proposed APS is based on amorphous In-Ga-Zn-O (a-IGZO) TFT technology, which can offer high mobility (5-20 cm² V^-1 s^-1), low leakage current (<10^-13 A) and low flicker noise (Hooge's parameter α _H ~ 1.5 [Formula: see text] 10^-3), leading to better imager noise performance. To test our hypothesis, we used linear cascaded systems analysis to model the imaging performance (MTF, NPS and DQE) of the PPS and APS a-Se direct imagers. This model was first validated using experimentally measured data obtained for a 85 µm pixel pitch a-Se/a-Si TFT PPS imager. Using this model, we analyzed the noise performance of the direct a-Se and indirect CsI:Tl x-ray a-IGZO APS imagers at different dose and electronic noise levels. Obtained results clearly showed that lowering back-plane electronic noise can significantly improve the performance of the a-Se/a-IGZO TFT APS imager. Our simulated results showed that a higher DQE at lower radiation doses (maximum DQE of 0.6 can be achieved at an exposure level of 1 µGy) can be achieved with the a-Se detector, thereby making this combination a promising candidate for low dose applications like DBT.

Non-stationary model of oblique x-ray incidence in amorphous selenium detectors: I. Point spread function

PURPOSE

In previous work, a theoretical model of the point spread function (PSF) for oblique x-ray incidence in amorphous selenium (a-Se) detectors was proposed. The purpose of this paper is to develop a complementary model that includes two additional features. First, the incidence angle and the directionality of ray incidence are calculated at each position, assuming a divergent x-ray beam geometry. This approach allows the non-stationarity of the PSF to be modeled. Second, this paper develops a framework that is applicable to a digital system, unlike previous work which did not model the presence of a thin-film transistor (TFT) array.

METHODS

At each point on the detector, the incidence angle and the ray incidence direction are determined using ray tracing. Based on these calculations, an existing model for the PSF of the x-ray converter (Med Phys. 1995;22:365-374) is generalized to a non-stationary model. The PSF is convolved with the product of two rectangle functions, which model the sampling of the TFT array. The rectangle functions match the detector element (del) size in two dimensions.

RESULTS

It is shown that the PSF can be calculated in closed form. This solution is used to simulate a digital mammography (DM) system at two x-ray energies (20 and 40 keV). Based on the divergence of the x-ray beam, the direction of ray incidence varies with position. Along this direction, the PSF is broader than the reference rect function matching the del size. The broadening is more pronounced with increasing obliquity. At high energy, the PSF deviates more strongly from the reference rect function, indicating that there is more blurring. In addition, the PSF is calculated along the polar angle perpendicular to the ray incidence direction. For this polar angle, the shape of the PSF is dependent upon whether the ray incidence direction is parallel with the sides of the detector. If the ray incidence direction is parallel with either dimension, the PSF is a perfect rectangle function, matching the del size. However, if the ray incidence direction is at an oblique angle relative to the sides of the detector, the PSF is not rectangular. These results illustrate the non-stationarity of the PSF.

CONCLUSIONS

This paper demonstrates that an existing model of the PSF of a-Se detectors can be generalized to include the effects of non-stationarity and digitization. The PSF is determined in closed form. This solution offers the advantage of shorter computation time relative to approaches that use numerical methods. This model is a tool for simulating a-Se detectors in future work, such as in virtual clinical trials with computational phantoms.

Predicting image properties in penalized-likelihood reconstructions of flat-panel CBCT

PURPOSE

Model-based iterative reconstruction (MBIR) algorithms such as penalized-likelihood (PL) methods exhibit data-dependent and shift-variant properties. Image quality predictors have been derived to prospectively estimate local noise and spatial resolution, facilitating both system hardware design and tuning of reconstruction methods. However, current MBIR image quality predictors rely on idealized system models, ignoring physical blurring effects and noise correlations found in real systems. In this work, we develop and validate a new set of predictors using a physical system model specific to flat-panel cone-beam CT (FP-CBCT).

METHODS

Physical models appropriate for integration with MBIR analysis are developed and parameterized to represent nonidealities in FP projection data including focal spot blur, scintillator blur, detector aperture effect, and noise correlations. Flat-panel-specific predictors for local spatial resolution and local noise properties in PL reconstructions are developed based on these realistic physical models. Estimation accuracy of conventional (idealized) and FP-specific predictors is investigated and validated against experimental CBCT measurements using specialized phantoms.

RESULTS

Validation studies show that flat-panel-specific predictors can accurately estimate the local spatial resolution and noise properties, while conventional predictors show significant deviations in the magnitude and scale of the spatial resolution and local noise. The proposed predictors show accurate estimations over a range of imaging conditions including varying x-ray technique and regularization strength. The conventional spatial resolution prediction is sharper than ground truth. Using conventional spatial resolution predictor, the full width at half maximum (FWHM) of local point spread function (PSF) is underestimated by 0.2 mm. This mismatch is mostly eliminated in FP-specific prediction. The general shape and amplitude of local noise power spectrum (NPS) FP-specific predictions are consistent with measurement, while the conventional predictions underestimated the noise level by 70%.

CONCLUSION

The proposed image quality predictors permit accurate estimation of local spatial resolution and noise properties for PL reconstruction, accounting for dependencies on the system geometry, x-ray technique, and patient-specific anatomy in real FP-CBCT. Such tools enable prospective analysis of image quality for a range of goals including novel system and acquisition design, adaptive and task-driven imaging, and tuning of MBIR for robust and reliable behavior.

Direct Thermal Growth of Large Scale Cl-doped CdTe Film for Low Voltage High Resolution X-ray Image Sensor

Polycrystalline cadmium telluride (CdTe) X-ray photodetector with advanced performance was fabricated in a Schottky diode form by direct thermal deposition (evaporation) on pixelized complementary metal oxide semiconductor (CMOS) readout panel. Our CdTe X-ray detector shows such a variety of benefits as relatively low process temperature, low cost, low operation voltage less than 40 V, and higher sensitivity and spatial resolution than those of commercial a-Se detectors. CdTe has cubic Zinc Blende structure and maintains p-type conduction after growth in general. For low voltage operation, we succeeded in Cl doping at all stage of CdTe film deposition, and as a result, hole concentration of p-type CdTe was reduced to ~10¹² cm⁻³ from ~10¹⁵ cm⁻³, and such concentration reduction could enable our Schottky diode with Ti electrode to operate at a reverse bias of less than 40 V. Our CdTe Schottky diode/CMOS pixel array as a direct conversion type imager demonstrates much higher resolution X-ray imaging in 7 × 9 cm² large scale than that of CsI/CMOS array, an indirect conversion imager. To our limited knowledge, our results on polycrystalline CdTe Schottky diode/CMOS array would be very novel as a first demonstration of active pixel sensor system equipped with directly deposited large scale X-ray detector.

High sensitivity organic inorganic hybrid X-ray detectors with direct transduction and broadband response

X-ray detectors are critical to healthcare diagnostics, cancer therapy and homeland security, with many potential uses limited by system cost and/or detector dimensions. Current X-ray detector sensitivities are limited by the bulk X-ray attenuation of the materials and consequently necessitate thick crystals (~1 mm–1 cm), resulting in rigid structures, high operational voltages and high cost. Here we present a disruptive, flexible, low cost, broadband, and high sensitivity direct X-ray transduction technology produced by embedding high atomic number bismuth oxide nanoparticles in an organic bulk heterojunction. These hybrid detectors demonstrate sensitivities of 1712 µC mGy⁻¹ cm⁻³ for “soft” X-rays and ~30 and 58 µC mGy⁻¹ cm⁻³ under 6 and 15 MV “hard” X-rays generated from a medical linear accelerator; strongly competing with the current solid state detectors, all achieved at low bias voltages (−10 V) and low power, enabling detector operation powered by coin cell batteries.

X-ray detectors based on low-cost organic semiconductors have inherently low detector sensitivity due to poor X-ray to charge conversion and charge collection. Here, the authors demonstrate a flexible, high-sensitivity X-ray detector based on an organic bulk heterojunction-nanoparticle composite.

Toward Scintillator High-Gain Avalanche Rushing Photoconductor Active Matrix Flat Panel Imager (SHARP-AMFPI): Initial fabrication and characterization

PURPOSE

We present the first prototype Scintillator High-Gain Avalanche Rushing Photoconductor Active Matrix Flat Panel Imager (SHARP-AMFPI). This detector includes a layer of avalanche amorphous Selenium (a-Se) (HARP) as the photoconductor in an indirect detector to amplify the signal and reduce the effects of electronic noise to obtain quantum noise-limited images for low-dose applications. It is the first time avalanche a-Se has been used in a solid-state imaging device and poses as a possible solution to eliminate the effects of electronic noise, which is crucial for low-dose imaging performance of AMFPI.

METHODS

We successfully deposited a solid-state HARP structure onto a 24 × 30 cm² array of thin-film transistors (TFT array) with a pixel pitch of 85 μm. The HARP layer consists of 16 μm of a-Se with a hole-blocking and electron-blocking layer to prevent charge injection from the high-voltage bias and pixel electrodes, respectively. An electric field (E_Se ) up to 105 V μm^-1 was applied across the a-Se layer without breakdown. A 150 μm thick-structured CsI:Tl scintillator was used to form SHARP-AMFPI. The x-ray imaging performance is characterized using a 30 kVp Mo/Mo beam. We evaluate the spatial resolution, noise power, and detective quantum efficiency at zero frequency of the system with and without avalanche gain. The results are analyzed using cascaded linear system model (CLSM).

RESULTS

An avalanche gain of 76 ± 5 was measured at E_Se = 105 V μm^-1 . We demonstrate that avalanche gain can amplify the signal to overcome electronic noise. As avalanche gain is increased, image quality improves for a constant (0.76 mR) exposure until electronic noise is overcome. Our system is currently limited by poor optical transparency of our high-voltage electrode and long integrating time which results in dark current noise. These two effects cause high-spatial frequency noise to dominate imaging performance.

CONCLUSIONS

We demonstrate the feasibility of a solid-state HARP x-ray imager and have fabricated the largest active area HARP sensor to date. Procedures to reduce secondary quantum and dark noise are outlined. Future work will improve optical coupling and charge transport which will allow for frequency DQE and temporal metrics to be obtained.

MTF and DQE enhancement using an apodized-aperture x-ray detector design

PURPOSE

Acquisition of high-quality x-ray images using low patient exposures requires detectors with high detective quantum efficiency (DQE). We describe a novel apodized-aperture pixel (AAP) design that increases high-frequency modulation transfer function (MTF) and DQE values. The AAP design makes a separation of physical sensor elements from image pixels by using very small sensor elements (e.g., 0.010-0.025 mm) to synthesize desired larger image pixels (e.g., 0.1-0.2 mm).

METHODS

A cascaded systems model of signal and noise propagation is developed to describe the benefits of the AAP approach in terms of the MTF, Wiener noise power spectrum (NPS), and DQE. The theoretical model was validated experimentally using a CMOS/CsI detector with 0.05 mm sensor elements to synthesize 0.20 mm image pixels and a clinical Se detector with 0.07 mm sensor elements to synthesize 0.28 mm pixels. A Monte Carlo study and x-ray images of a star-pattern and rat leg are used to visually compare AAP images.

RESULTS

When used with a high-resolution converter layer and sensor elements one quarter the size of image pixels, the MTF is increased by 53% and the DQE by a factor of 2.3× at the image sampling cut-off frequency. Both simulated and demonstration images show improved detectability of high-frequency content and removal of aliasing artifacts. Evidence of Gibbs ringing is sometimes seen near high-contrast edges.

CONCLUSIONS

It is shown that the AAP approach preserves the MTF of the small sensor elements and attenuates frequencies above the image sampling cut-off frequency. This has the double benefit of improving the MTF while reducing both signal and noise aliasing, resulting in an increase of the DQE at high spatial frequencies. For optimal implementation, the converter layer must have very high spatial resolution and the detector must have low readout noise.

Optimization of contrast-enhanced breast imaging: Analysis using a cascaded linear system model

PURPOSE

Contrast-enhanced (CE) breast imaging involves the injection contrast agents (i.e., iodine) to increase conspicuity of malignant lesions. CE imaging may be used in conjunction with digital mammography (DM) or digital breast tomosynthesis (DBT) and has shown promise in improving diagnostic specificity. Both CE-DM and CE-DBT techniques require optimization as clinical diagnostic tools. Physical factors including x-ray spectra, subtraction technique, and the signal from iodine contrast, must be considered to provide the greatest object detectability and image quality. We developed a cascaded linear system model (CLSM) for the optimization of CE-DM and CE-DBT employing dual energy (DE) subtraction or temporal (TE) subtraction.

METHODS

We have previously developed a CLSM for DBT implemented with an a-Se flat panel imager (FPI) and filtered backprojection (FBP) reconstruction algorithm. The model is used to track image quality metrics - modulation transfer function (MTF) and noise power spectrum (NPS) - at each stage of the imaging chain. In this study, the CLSM is extended for CE breast imaging. The effect of x-ray spectrum (varied by changing tube potential and the filter) and DE and TE subtraction techniques on breast structural noise was measured was studied and included as a deterministic source of noise in the CLSM. From the two-dimensional (2D) and three-dimensional (3D) MTF and NPS, the ideal observer signal-to-noise ratio (SNR), also known as the detectability index (d'), may be calculated. Using d' as a FOM, we discuss the optimization of CE imaging for the task of iodinated contrast object detection within structured backgrounds.

RESULTS

Increasing x-ray energy was determined to decrease the magnitude of structural noise and not its correlation. By performing DE subtraction, the magnitude of the structural noise was further reduced at the expense of increased stochastic (quantum and electronic) noise. TE subtraction exhibited essentially no residual structural noise at the expense of increased quantum noise, even over that of the DE case. For DE subtraction, optimization of dose weighting to the HE view (f_h ) results in the minimization of quantum noise. Both subtraction weighting factor (w_Sub ) and the iodine contrast signal were dependent on the LE and HE x-ray spectra. To best detect a 5 mm Gaussian lesion with 5 mg/ml of iodine within a 4 cm thick breast, it was found that the high energy (HE) view should be acquired with a tube potential of 47 kVp (W/Ti spectrum) and the low energy (LE) view with a potential of 23 kVp (W/Rh spectrum). Due to the complete removal of structural noise, TE subtraction produced much higher d' than DE subtraction both as a function of mean glandular dose and iodine concentration.

CONCLUSIONS

We have shown the effect of increasing x-ray energy as well as projection domain subtraction on breast structural noise. Further, we have exhibited the utility of the CLSM for DE and TE subtraction CE imaging in the optimization of imaging parameters such as x-ray energy, f_h , and w_Sub as well as guiding the understanding of their effects on image contrast and noise.

Development of solid-state avalanche amorphous selenium for medical imaging

PURPOSE

Active matrix flat panel imagers (AMFPI) have limited performance in low dose applications due to the electronic noise of the thin film transistor (TFT) array. A uniform layer of avalanche amorphous selenium (a-Se) called high gain avalanche rushing photoconductor (HARP) allows for signal amplification prior to readout from the TFT array, largely eliminating the effects of the electronic noise. The authors report preliminary avalanche gain measurements from the first HARP structure developed for direct deposition onto a TFT array.

METHODS

The HARP structure is fabricated on a glass substrate in the form of p-i-n, i.e., the electron blocking layer (p) followed by an intrinsic (i) a-Se layer and finally the hole blocking layer (n). All deposition procedures are scalable to large area detectors. Integrated charge is measured from pulsed optical excitation incident on the top electrode (as would in an indirect AMFPI) under continuous high voltage bias. Avalanche gain measurements were obtained from samples fabricated simultaneously at different locations in the evaporator to evaluate performance uniformity across large area.

RESULTS

An avalanche gain of up to 80 was obtained, which showed field dependence consistent with previous measurements from n-i-p HARP structures established for vacuum tubes. Measurements from multiple samples demonstrate the spatial uniformity of performance using large area deposition methods. Finally, the results were highly reproducible during the time course of the entire study.

CONCLUSIONS

We present promising avalanche gain measurement results from a novel HARP structure that can be deposited onto a TFT array. This is a crucial step toward the practical feasibility of AMFPI with avalanche gain, enabling quantum noise limited performance down to a single x-ray photon per pixel.

A comprehensive model for quantum noise characterization in digital mammography

A version of cascaded systems analysis was developed specifically with the aim of studying quantum noise propagation in x-ray detectors. Signal and quantum noise propagation was then modelled in four types of x-ray detectors used for digital mammography: four flat panel systems, one computed radiography and one slot-scan silicon wafer based photon counting device. As required inputs to the model, the two dimensional (2D) modulation transfer function (MTF), noise power spectra (NPS) and detective quantum efficiency (DQE) were measured for six mammography systems that utilized these different detectors. A new method to reconstruct anisotropic 2D presampling MTF matrices from 1D radial MTFs measured along different angular directions across the detector is described; an image of a sharp, circular disc was used for this purpose. The effective pixel fill factor for the FP systems was determined from the axial 1D presampling MTFs measured with a square sharp edge along the two orthogonal directions of the pixel lattice. Expectation MTFs were then calculated by averaging the radial MTFs over all possible phases and the 2D EMTF formed with the same reconstruction technique used for the 2D presampling MTF. The quantum NPS was then established by noise decomposition from homogenous images acquired as a function of detector air kerma. This was further decomposed into the correlated and uncorrelated quantum components by fitting the radially averaged quantum NPS with the radially averaged EMTF(2). This whole procedure allowed a detailed analysis of the influence of aliasing, signal and noise decorrelation, x-ray capture efficiency and global secondary gain on NPS and detector DQE. The influence of noise statistics, pixel fill factor and additional electronic and fixed pattern noises on the DQE was also studied. The 2D cascaded model and decompositions performed on the acquired images also enlightened the observed quantum NPS and DQE anisotropy.

Small-dose-sensitive X-ray image pixel with HgI2 photoconductor and amorphous oxide thin-film transistor

A new X-ray image sensor is demonstrated with an oxide thin-film transistor backplane and HgI2 sensing material. It displays outstanding image quality under a low X-ray exposure and a low electric field. It is promising as a state-of-the-art device to realize highly resolved images at a low X-ray dose for a variety of medical X-ray imaging applications.

Cascaded systems analysis of photon counting detectors

PURPOSE

Photon counting detectors (PCDs) are an emerging technology with applications in spectral and low-dose radiographic and tomographic imaging. This paper develops an analytical model of PCD imaging performance, including the system gain, modulation transfer function (MTF), noise-power spectrum (NPS), and detective quantum efficiency (DQE).

METHODS

A cascaded systems analysis model describing the propagation of quanta through the imaging chain was developed. The model was validated in comparison to the physical performance of a silicon-strip PCD implemented on an experimental imaging bench. The signal response, MTF, and NPS were measured and compared to theory as a function of exposure conditions (70 kVp, 1-7 mA), detector threshold, and readout mode (i.e., the option for coincidence detection). The model sheds new light on the dependence of spatial resolution, charge sharing, and additive noise effects on threshold selection and was used to investigate the factors governing PCD performance, including the fundamental advantages and limitations of PCDs in comparison to energy-integrating detectors (EIDs) in the linear regime for which pulse pileup can be ignored.

RESULTS

The detector exhibited highly linear mean signal response across the system operating range and agreed well with theoretical prediction, as did the system MTF and NPS. The DQE analyzed as a function of kilovolt (peak), exposure, detector threshold, and readout mode revealed important considerations for system optimization. The model also demonstrated the important implications of false counts from both additive electronic noise and charge sharing and highlighted the system design and operational parameters that most affect detector performance in the presence of such factors: for example, increasing the detector threshold from 0 to 100 (arbitrary units of pulse height threshold roughly equivalent to 0.5 and 6 keV energy threshold, respectively), increased the f50 (spatial-frequency at which the MTF falls to a value of 0.50) by ∼30% with corresponding improvement in DQE. The range in exposure and additive noise for which PCDs yield intrinsically higher DQE was quantified, showing performance advantages under conditions of very low-dose, high additive noise, and high fidelity rejection of coincident photons.

CONCLUSIONS

The model for PCD signal and noise performance agreed with measurements of detector signal, MTF, and NPS and provided a useful basis for understanding complex dependencies in PCD imaging performance and the potential advantages (and disadvantages) in comparison to EIDs as well as an important guide to task-based optimization in developing new PCD imaging systems.

Development of active matrix flat panel imagers incorporating thin layers of polycrystalline HgI(2) for mammographic x-ray imaging

Active matrix flat-panel imagers (AMFPIs) offer many advantages and have become ubiquitous across a wide variety of medical x-ray imaging applications. However, for mammography, the imaging performance of conventional AMFPIs incorporating CsI:Tl scintillators or a-Se photoconductors is limited by their relatively modest signal-to-noise ratio (SNR), particularly at low x-ray exposures or high spatial resolution. One strategy for overcoming this limitation involves the use of a high gain photoconductor such as mercuric iodide (HgI(2)) which has the potential to improve the SNR by virtue of its low effective work function (W(EFF)). In this study, the performance of direct-detection AMFPI prototypes employing relatively thin layers of polycrystalline HgI(2) operated under mammographic irradiation conditions over a range of 0.5 to 16.0 mR is presented. High x-ray sensitivity (corresponding to W(EFF) values of ∼19 eV), low dark current (<0.1 pA mm(-2)) and good spatial resolution, largely limited by the size of the pixel pitch, were observed. For one prototype, a detective quantum efficiency of ∼70% was observed at an x-ray exposure of ∼0.5 mR at 26 kVp.

Measured and calculated K-fluorescence effects on the MTF of an amorphous-selenium based CCD x-ray detector

PURPOSE

Theoretical reasoning suggests that direct conversion digital x-ray detectors based upon photoconductive amorphous-selenium (a-Se) could attain very high values of the MTF (modulation transfer function) at spatial frequencies well beyond 20 cycles mm(-1). One of the fundamental factors affecting resolution loss, particularly at x-ray energies just above the K-edge of selenium (12.66 keV), is the K-fluorescence reabsorption mechanism, wherein energy can be deposited in the detector at locations laterally displaced from the initial x-ray interaction site. This paper compares measured MTF changes above and below the Se K-edge of a CCD based a-Se x-ray detector with theoretical expectations.

METHODS

A prototype 25 μm sampling pitch (Nyquist frequency = 20 cycles mm(-1), 200 μm thick a-Se layer based x-ray detector, utilizing a specialized CCD readout device (200 × 400 area array), was used to make edge images with monochromatic x-rays above and below the K-edge of Se. A vacuum double crystal monochromator, exposed to polychromatic x-rays from a synchrotron, formed the monochromatic x-ray source. The monochromaticity of the x-rays was 99% or better. The presampling MTF was determined using the slanted edge method. The theory modeling the MTF performance of the detector includes the basic x-ray interaction physics in the a-Se layer as well as effects related to the operation of the CCD and charge trapping at a blocking layer present at the CCD/a-Se interface.

RESULTS

The MTF performance of the prototype a-Se CCD was reduced from the theoretical value prescribed by the basic Se x-ray interaction physics, principally by the presence of a blocking layer. Nevertheless, the K-fluorescence reduction in the MTF was observed, approximately as predicted by theory. For the CCD prototype detector, at five cycles mm(-1), there was a 14% reduction of the MTF, from a value of 0.7 below the K-edge of Se, to 0.6 just above the K-edge.

CONCLUSIONS

The MTF of an a-Se x-ray detector has been measured using monochromatic x-rays above and below the K-edge of selenium. The MTF is poorer above the K-edge by an amount consistent with theoretical expectations.

Cone-Beam CT with a Flat-Panel Detector: From Image Science to Image-Guided Surgery

The development of large-area flat-panel x-ray detectors (FPDs) has spurred investigation in a spectrum of advanced medical imaging applications, including tomosynthesis and cone-beam CT (CBCT). Recent research has extended image quality metrics and theoretical models to such applications, providing a quantitative foundation for the assessment of imaging performance as well as a general framework for the design, optimization, and translation of such technologies to new applications. For example, cascaded systems models of Fourier domain metrics, such as noise-equivalent quanta (NEQ), have been extended to these modalities to describe the propagation of signal and noise through the image acquisition and reconstruction chain and to quantify the factors that govern spatial resolution, image noise, and detectability. Moreover, such models have demonstrated basic agreement with human observer performance for a broad range of imaging conditions and imaging tasks. These developments in image science have formed a foundation for the knowledgeable development and translation of CBCT to new applications in image-guided interventions - for example, CBCT implemented on a mobile surgical C-arm for intraoperative 3D imaging. The ability to acquire high-quality 3D images on demand during surgical intervention overcomes conventional limitations of surgical guidance in the context of preoperative images alone. A prototype mobile C-arm developed in academic-industry partnership demonstrates CBCT with low radiation dose, sub-mm spatial resolution, and soft-tissue visibility potentially approaching that of diagnostic CT. Integration of the 3D imaging system with real-time tracking, deformable registration, endoscopic video, and 3D visualization offers a promising addition to the surgical arsenal in interventions ranging from head-and-neck / skull base surgery to spine, orthopaedic, thoracic, and abdominal surgeries. Cadaver studies show the potential for significant boosts in surgical performance under CBCT guidance, and early clinical trials demonstrate feasibility, workflow, and image quality within the surgical theatre.

Analysis of Fourier-domain task-based detectability index in tomosynthesis and cone-beam CT in relation to human observer performance

PURPOSE

Design and optimization of medical imaging systems benefit from accurate theoretical modeling that identifies the physical factors governing image quality, particularly in the early stages of system development. This work extends Fourier metrics of imaging performance and detectability index (d') to tomosynthesis and cone-beam CT (CBCT) and investigates the extent to which d' is a valid descriptor of task-based imaging performance as assessed by human observers,

METHODS

The detectability index for tasks presented in 2D slices (d'(slice)) was derived from 3D cascaded systems analysis of tomosynthesis and CBCT. Anatomical background noise measured in a physical phantom presenting power-law spectral density was incorporated in the "generalized" noise-equivalent quanta. Theoretical calculations of d'(slice) were performed as a function of total angular extent (theta(tot)) of source-detector orbit ranging 10 degrees - 360 degrees under two acquisition schemes: (i) Constant angular separation between projections (constant-delta theta), giving variable number of projections (N(proj)) and dose vs theta(tot) and (ii) constant number of projections (constant-N(proj)), giving constant dose (but variable angular sampling) with theta(tot). Five simple observer models were investigated: Prewhitening (PW), prewhitening with eye filter and internal noise (PWEi), nonprewhitening (NPW), nonprewhitening with eye filter (NPWE), and nonprewhitening with eye filter and internal noise (NPWEi). Human observer performance was measured in 9AFC tests for five simple imaging tasks presented within uniform and power-law clutter backgrounds. Measurements (from 9AFC tests) and theoretical calculations (from cascaded systems analysis of d'(slice)) were compared in terms of area under the ROC curve (A(z))

RESULTS

Reasonable correspondence between theoretical calculations and human observer performance was achieved for all imaging tasks over the broad range of experimental conditions and acquisition schemes. The PW and PWEi observer models tended to overestimate detectability, while the various NPW models predicted observer performance fairly well, with NPWEi giving the best overall agreement. Detectability was shown to increase with theta(tot) due to the reduction of out-of-plane clutter, reaching a plateau after a particular theta(tot) that depended on the imaging task. Depending on the acquisition scheme, however (i.e., constant-N(proj) or delta theta), detectability was seen in some cases to decline at higher theta(tot) due to tradeoffs among quantum noise, background clutter, and view sampling.

CONCLUSIONS

Generalized detectability index derived from a 3D cascaded systems model shows reasonable correspondence with human observer performance over a fairly broad range of imaging tasks and conditions, although discrepancies were observed in cases relating to orbits intermediate to 180 degrees and 360 degrees. The basic correspondence of theoretical and measured performance supports the application of such a theoretical framework for system design and optimization of tomosynthesis and CBCT.

Amorphous and polycrystalline photoconductors for direct conversion flat panel x-ray image sensors

In the last ten to fifteen years there has been much research in using amorphous and polycrystalline semiconductors as x-ray photoconductors in various x-ray image sensor applications, most notably in flat panel x-ray imagers (FPXIs). We first outline the essential requirements for an ideal large area photoconductor for use in a FPXI, and discuss how some of the current amorphous and polycrystalline semiconductors fulfill these requirements. At present, only stabilized amorphous selenium (doped and alloyed a-Se) has been commercialized, and FPXIs based on a-Se are particularly suitable for mammography, operating at the ideal limit of high detective quantum efficiency (DQE). Further, these FPXIs can also be used in real-time, and have already been used in such applications as tomosynthesis. We discuss some of the important attributes of amorphous and polycrystalline x-ray photoconductors such as their large area deposition ability, charge collection efficiency, x-ray sensitivity, DQE, modulation transfer function (MTF) and the importance of the dark current. We show the importance of charge trapping in limiting not only the sensitivity but also the resolution of these detectors. Limitations on the maximum acceptable dark current and the corresponding charge collection efficiency jointly impose a practical constraint that many photoconductors fail to satisfy. We discuss the case of a-Se in which the dark current was brought down by three orders of magnitude by the use of special blocking layers to satisfy the dark current constraint. There are also a number of polycrystalline photoconductors, HgI₂ and PbO being good examples, that show potential for commercialization in the same way that multilayer stabilized a-Se x-ray photoconductors were developed for commercial applications. We highlight the unique nature of avalanche multiplication in a-Se and how it has led to the development of the commercial HARP video-tube. An all solid state version of the HARP has been recently demonstrated with excellent avalanche gains; the latter is expected to lead to a number of novel imaging device applications that would be quantum noise limited. While passive pixel sensors use one TFT (thin film transistor) as a switch at the pixel, active pixel sensors (APSs) have two or more transistors and provide gain at the pixel level. The advantages of APS based x-ray imagers are also discussed with examples.

Design and optimization of large area thin-film CdTe detector for radiation therapy imaging applications

PURPOSE

The authors investigate performance of thin-film cadmium telluride (CdTe) in detecting high-energy (6 MV) x rays. The utilization of this material has become technologically feasible only in recent years due to significant development in large area photovoltaic applications.

METHODS

The CdTe film is combined with a metal plate, facilitating conversion of incoming photons into secondary electrons. The system modeling is based on the Monte Carlo simulations performed to determine the optimized CdTe layer thickness in combination with various converter materials.

RESULTS

The authors establish a range of optimal parameters producing the highest DQE due to energy absorption, as well as signal and noise spatial spreading. The authors also analyze the influence of the patient scatter on image formation for a set of detector configurations. The results of absorbed energy simulation are used in device operation modeling to predict the detector output signal. Finally, the authors verify modeling results experimentally for the lowest considered device thickness.

CONCLUSIONS

The proposed CdTe-based large area thin-film detector has a potential of becoming an efficient low-cost electronic portal imaging device for radiation therapy applications.

Quantitative imaging in breast tomosynthesis and CT: comparison of detection and estimation task performance

PURPOSE

This work investigates a framework for modeling volumetric breast imaging to compare detection and estimation task performance and optimize quantitative breast imaging.

METHODS

Volumetric reconstructions of a breast phantom, which incorporated electronic, quantum, and anatomical noise with embedded spherical lesions, were simulated over a range of acquisition angles varying from 4 degrees to 204 degrees with a constant total acquisition dose of 1.5 mGy. A maximum likelihood estimator was derived in terms of the noise power spectrum, which yielded figures of merit for quantitative imaging performance in terms of accuracy and precision. These metrics were computed for estimation of lesion area, volume, and location. Estimation task performance was optimized as a function of acquisition angle and compared to the performance of a more conventional lesion detection task.

RESULTS

Results revealed tradeoffs between electronic, quantum, and anatomical noise. The detection of a 4 mm sphere was optimal at an acquisition angle of 84 degrees, where reconstructed images using a smaller acquisition angle exhibited increased anatomical noise and reconstructed images using a larger acquisition angle exhibited increased quantum and electronic noise. For all estimation tasks, accuracy was found to be fairly constant as a function acquisition angle indicating adequate system calibration, whereas a more significant dependence on acquisition angle was observed for precision performance. Precision for the 2D area estimation task was optimal at approximately 104 degrees, while precision of the 3D volume estimation task was optimal at larger angles (approximately 124 degrees). Precision for the localization task showed orientation dependence where localization was significantly inferior in the depth direction. Overall, precision for localization was optimal at larger angles (i.e., > 125 degrees) compared to the size estimation tasks. Results suggested that for quantitative imaging tasks, the acquisition angle should be larger than currently used in conventional breast tomosynthesis for lesion detection.

CONCLUSIONS

Analysis of quantitative imaging performance using Fourier-based metrics highlights the difference between estimation and detection task in volumetric breast imaging and provides a meaningful framework for optimizing the performance of breast imaging systems for quantitative imaging applications.

Effect of repeated x-ray exposure on the resolution of amorphous selenium based x-ray imagers

PURPOSE

A numerical model and the experimental methods to study the x-ray exposure dependent change in the modulation transfer function (MTF) of amorphous selenium (a-Se) based active matrix flat panel imagers (AMFPIs) are described. The physical mechanisms responsible for the x-ray exposure dependent change in MTF are also investigated.

METHODS

A numerical model for describing the x-ray exposure dependent MTF of a-Se based AMFPIs has been developed. The x-ray sensitivity and MTF of an a-Se AMFPI have been measured as a function of exposure. The instantaneous electric field and free and trapped carrier distributions in the photoconductor layer are obtained by numerically solving the Poisson's equation, continuity equations, and trapping rate equations using the backward Euler finite difference method. From the trapped carrier distributions, a method for calculating the MTF due to incomplete charge collection is proposed.

RESULTS

The model developed in this work and the experimental data show a reasonably good agreement. The model is able to simultaneously predict the dependence of the sensitivity and MTF on accumulated exposure at different applied fields and bias polarities, with the same charge transport parameters that are typical of the particular a-Se photoconductive layer that is used in these AMFPIs. Under negative bias, the MTF actually improves with the accumulated x-ray exposure while the sensitivity decreases. The MTF enhancement with exposure decreases with increasing applied field.

CONCLUSIONS

The most prevalent processes that control the MTF under negative bias are the recombination of drifting holes with previously trapped electrons (electrons remain in deep traps due to their long release times compared with the time scale of the experiments) and the deep trapping of drifting holes and electrons.

A method for the determination of the two-dimensional MTF of digital radiography systems using only the noise response

We present a new method that enables the determination of the two-dimensional MTF of digital radiography systems using the noise response measured from flat-field images. Unlike commonly-used methods that measure the one-dimensional MTF, this new method does not require precision-made test-objects (slits/edges) or precise tool alignment. Although standard methods are dependent upon data processing that can result in inaccuracies and inconsistencies, this method based on the intrinsic noise response of the imager is highly accurate and less susceptible to such problems. A cascaded-linear-systems analysis was used to derive an exact relationship between the noise power spectrum (NPS) and the presampled MTF of a generalized detector system. The NPS was then used to determine the two-dimensional MTF for three systems: a simulated detector in which the "true" MTF was known exactly, a commercial indirect flat-panel detector (FPD), and a new solid-state x-ray image intensifier (SSXII). For the simulated detector, excellent agreement was observed between the "true" MTF and that determined using the noise response method, with an averaged deviation of 0.3%. The FPD MTF was shown to increase on the diagonals and was measured at 2.5 cycles/mm to be 0.086±0.007, 0.12±0.01, and 0.087±0.007 at 0, 45, and 90°, respectively. No statistically significant variation was observed for the SSXII as a function of angle. Measuring the two-dimensional MTF should lead to more accurate characterization of the detector resolution response, incorporating any potential non-isotropy which may result from the physical characteristics of the sensor, including the active-area shape of the pixel array.

Generalized two-dimensional (2D) linear system analysis metrics (GMTF, GDQE) for digital radiography systems including the effect of focal spot, magnification, scatter, and detector characteristics

The MTF, NNPS, and DQE are standard linear system metrics used to characterize intrinsic detector performance. To evaluate total system performance for actual clinical conditions, generalized linear system metrics (GMTF, GNNPS and GDQE) that include the effect of the focal spot distribution, scattered radiation, and geometric unsharpness are more meaningful and appropriate. In this study, a two-dimensional (2D) generalized linear system analysis was carried out for a standard flat panel detector (FPD) (194-micron pixel pitch and 600-micron thick CsI) and a newly-developed, high-resolution, micro-angiographic fluoroscope (MAF) (35-micron pixel pitch and 300-micron thick CsI). Realistic clinical parameters and x-ray spectra were used. The 2D detector MTFs were calculated using the new Noise Response method and slanted edge method and 2D focal spot distribution measurements were done using a pin-hole assembly. The scatter fraction, generated for a uniform head equivalent phantom, was measured and the scatter MTF was simulated with a theoretical model. Different magnifications and scatter fractions were used to estimate the 2D GMTF, GNNPS and GDQE for both detectors. Results show spatial non-isotropy for the 2D generalized metrics which provide a quantitative description of the performance of the complete imaging system for both detectors. This generalized analysis demonstrated that the MAF and FPD have similar capabilities at lower spatial frequencies, but that the MAF has superior performance over the FPD at higher frequencies even when considering focal spot blurring and scatter. This 2D generalized performance analysis is a valuable tool to evaluate total system capabilities and to enable optimized design for specific imaging tasks.

Accurate MTF measurement in digital radiography using noise response

PURPOSE

The authors describe a new technique to determine the system presampled modulation transfer function (MTF) in digital radiography using only the detector noise response.

METHODS

A cascaded-linear systems analysis was used to develop an exact relationship between the two-dimensional noise power spectrum (NPS) and the presampled MTF for a generalized detector system. This relationship was then utilized to determine the two-dimensional presampled MTF. For simplicity, aliasing of the correlated noise component of the NPS was assumed to be negligible. Accuracy of this method was investigated using simulated images from a simple detector model in which the "true" MTF was known exactly. Measurements were also performed on three detector technologies (an x-ray image intensifier, an indirect flat panel detector, and a solid state x-ray image intensifier), and the results were compared using the standard edge-response method. Flat-field and edge images were acquired and analyzed according to guidelines set forth by the International Electrotechnical Commission, using the RQA 5 spectrum.

RESULTS

The presampled MTF determined using the noise-response method for the simulated detector system was in close agreement with the true MTF with an averaged percent difference of 0.3% and a maximum difference of 1.1% observed at the Nyquist frequency (fN). The edge-response method of the simulated detector system also showed very good agreement at lower spatial frequencies (less than 0.5 fN) with an averaged percent difference of 1.6% but showed significant discrepancies at higher spatial frequencies (greater than 0.5 fN) with an averaged percent difference of 17%. Discrepancies were in part a result of noise in the edge image and phasing errors. For all three detector systems, the MTFs obtained using the two methods were found to be in good agreement at spatial frequencies less than 0.5 fN with an averaged percent difference of 3.4%. Above 0.5 fN, differences increased to an average of 20%. Deviations of the experimental results largely followed the trend seen in the simulation results, suggesting that differences between the two methods could be explained as resulting from the inherent inaccuracies of the edge-response measurement technique used in this study. Aliasing of the correlated noise component was shown to have a minimal effect on the measured MTF for the three detectors studied. Systems with significant aliasing of the correlated noise component (e.g., a-Se based detectors) would likely require a more sophisticated fitting scheme to provide accurate results.

CONCLUSIONS

Results indicate that the noise-response method, a simple technique, can be used to accurately measure the MTF of digital x-ray detectors, while alleviating the problems and inaccuracies associated with use of precision test objects, such as a slit or an edge.

Three-dimensional linear system analysis for breast tomosynthesis

The optimization of digital breast tomosynthesis (DBT) geometry and reconstruction is crucial for the clinical translation of this exciting new imaging technique. In the present work, the authors developed a three-dimensional (3D) cascaded linear system model for DBT to investigate the effects of detector performance, imaging geometry, and image reconstruction algorithm on the reconstructed image quality. The characteristics of a prototype DBT system equipped with an amorphous selenium flat-panel detector and filtered backprojection reconstruction were used as an example in the implementation of the linear system model. The propagation of signal and noise in the frequency domain was divided into six cascaded stages incorporating the detector performance, imaging geometry, and reconstruction filters. The reconstructed tomosynthesis imaging quality was characterized by spatial frequency dependent presampling modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE) in 3D. The results showed that both MTF and NPS were affected by the angular range of the tomosynthesis scan and the reconstruction filters. For image planes parallel to the detector (in-plane), MTF at low frequencies was improved with increase in angular range. The shape of the NPS was affected by the reconstruction filters. Noise aliasing in 3D could be introduced by insufficient voxel sampling, especially in the z (slice-thickness) direction where the sampling distance (slice thickness) could be more than ten times that for in-plane images. Aliasing increases the noise at high frequencies, which causes degradation in DQE. Application of a reconstruction filter that limits the frequency components beyond the Nyquist frequency in the z direction, referred to as the slice thickness filter, eliminates noise aliasing and improves 3D DQE. The focal spot blur, which arises from continuous tube travel during tomosynthesis acquisition, could degrade DQE significantly because it introduces correlation in signal only, not NPS.

Breast cancer imaging: a perspective for the next decade

Breast imaging is largely indicated for detection, diagnosis, and clinical management of breast cancer and for evaluation of the integrity of breast implants. In this work, a prospective view of techniques for breast cancer detection and diagnosis is provided based on an assessment of current trends. The potential role of emerging techniques that are under various stages of research and development is also addressed. It appears that the primary imaging tool for breast cancer screening in the next decade will be high-resolution, high-contrast, anatomical x-ray imaging with or without depth information. MRI and ultrasonography will have an increasingly important adjunctive role for imaging high-risk patients and women with dense breasts. Pilot studies with dedicated breast CT have demonstrated high-resolution three-dimensional imaging capabilities, but several technological barriers must be overcome before clinical adoption. Radionuclide based imaging techniques and x-ray imaging with intravenously injected contrast offer substantial potential as a diagnostic tools and for evaluation of suspicious lesions. Developing optical and electromagnetic imaging techniques hold significant potential for physiologic information and they are likely to be of most value when integrated with or adjunctively used with techniques that provide anatomic information. Experimental studies with breast specimens suggest that phase-sensitive x-ray imaging techniques can provide edge enhancement and contrast improvement but more research is needed to evaluate their potential role in clinical breast imaging. From the technological perspective, in addition to improvements within each modality, there is likely to be a trend towards multi-modality systems that combine anatomic with physiologic information. We are also likely to transition from a standardized screening, where all women undergo the same imaging exam (mammography), to selection of a screening modality or modalities based an individual-risk or other classification.

The effect of breast compression on mass conspicuity in digital mammography

This study analyzed how the inherent quality of diagnostic information in digital mammography could be affected by breast compression. A digital mammography system was modeled using a Monte Carlo algorithm based on the Penelope program, which has been successfully used to model several medical imaging systems. First, the Monte Carlo program was validated against previous measurements and simulations. Once validated, the Monte Carlo software modeled a digital mammography system by tracking photons through a voxelized software breast phantom, containing anatomical structures and breast masses, and following photons until they were absorbed by a selenium-based flat-panel detector. Simulations were performed for two compression conditions (standard compression and 12.5% reduced compression) and three photon flux conditions (constant flux, constant detector signal, and constant glandular dose). The results showed that reduced compression led to higher scatter fractions, as expected. For the constant photon flux condition, decreased compression also reduced glandular dose. For constant glandular dose, the SdNR for a 4 cm breast was 0.60 +/- 0.11 and 0.62 +/- 0.11 under standard and reduced compressions, respectively. For the 6 cm case with constant glandular dose, the SdNR was 0.50 +/- 0.11 and 0.49 +/- 0.10 under standard and reduced compressions, respectively. The results suggest that if a particular imaging system can handle an approximately 10% increase in total tube output and 10% decrease in detector signal, breast compression can be reduced by about 12% in terms of breast thickness with little impact on image quality or dose.

Fundamental x-ray interaction limits in diagnostic imaging detectors: spatial resolution

The practice of diagnostic x-ray imaging has been transformed with the emergence of digital detector technology. Although digital systems offer many practical advantages over conventional film-based systems, their spatial resolution performance can be a limitation. The authors present a Monte Carlo study to determine fundamental resolution limits caused by x-ray interactions in four converter materials: Amorphous silicon (a-Si), amorphous selenium, cesium iodide, and lead iodide. The "x-ray interaction" modulation transfer function (MTF) was determined for each material and compared in terms of the 50% MTF spatial frequency and Wagner's effective aperture for incident photon energies between 10 and 150 keV and various converter thicknesses. Several conclusions can be drawn from their Monte Carlo study. (i) In low-Z (a-Si) converters, reabsorption of Compton scatter x rays limits spatial resolution with a sharp MTF drop at very low spatial frequencies (< 0.3 cycles/mm), especially above 60 keV; while in high-Z materials, reabsorption of characteristic x rays plays a dominant role, resulting in a mid-frequency (1-5 cycles/mm) MTF drop. (ii) Coherent scatter plays a minor role in the x-ray interaction MTF. (iii) The spread of energy due to secondary electron (e.g., photoelectrons) transport is significant only at very high spatial frequencies. (iv) Unlike the spread of optical light in phosphors, the spread of absorbed energy from x-ray interactions does not significantly degrade spatial resolution as converter thickness is increased. (v) The effective aperture results reported here represent fundamental spatial resolution limits of the materials tested and serve as target benchmarks for the design and development of future digital x-ray detectors.

SAPHIRE (scintillator avalanche photoconductor with high resolution emitter readout) for low dose x-ray imaging: spatial resolution

An indirect flat panel imager (FPI) with programmable avalanche gain and field emitter array (FEA) readout is being investigated for low-dose and high resolution x-ray imaging. It is made by optically coupling a structured x-ray scintillator, e.g., thallium (Tl) doped cesium iodide (CsI), to an amorphous selenium (a-Se) avalanche photoconductor called high-gain avalanche rushing amorphous photoconductor (HARP). The charge image created by the scintillator/HARP (SHARP) combination is read out by the electron beams emitted from the FEA. The proposed detector is called scintillator avalanche photoconductor with high resolution emitter readout (SAPHIRE). The programmable avalanche gain of HARP can improve the low dose performance of indirect FPI while the FEA can be made with pixel sizes down to 50 microm. Because of the avalanche gain, a high resolution type of CsI (Tl), which has not been widely used in indirect FPI due to its lower light output, can be used to improve the high spatial frequency performance. The purpose of the present article is to investigate the factors affecting the spatial resolution of SAPHIRE. Since the resolution performance of the SHARP combination has been well studied, the focus of the present work is on the inherent resolution of the FEA readout method. The lateral spread of the electron beam emitted from a 50 microm x 50 microm pixel FEA was investigated with two different electron-optical designs: mesh-electrode-only and electrostatic focusing. Our results showed that electrostatic focusing can limit the lateral spread of electron beams to within the pixel size of down to 50 microm. Since electrostatic focusing is essentially independent of signal intensity, it will provide excellent spatial uniformity.

A practical exposure-equivalent metric for instrumentation noise in x-ray imaging systems

The performance of high-sensitivity x-ray imagers may be limited by additive instrumentation noise rather than by quantum noise when operated at the low exposure rates used in fluoroscopic procedures. The equipment-invasive instrumentation noise measures (in terms of electrons) are generally difficult to make and are potentially not as helpful in clinical practice as would be a direct radiological representation of such noise that may be determined in the field. In this work, we define a clinically relevant representation for instrumentation noise in terms of noise-equivalent detector entrance exposure, termed the instrumentation noise-equivalent exposure (INEE), which can be determined through experimental measurements of noise-variance or signal-to-noise ratio (SNR). The INEE was measured for various detectors, thus demonstrating its usefulness in terms of providing information about the effective operating range of the various detectors. A simulation study is presented to demonstrate the robustness of this metric against post-processing, and its dependence on inherent detector blur. These studies suggest that the INEE may be a practical gauge to determine and compare the range of quantum-limited performance for clinical x-ray detectors of different design, with the implication that detector performance at exposures below the INEE will be instrumentation-noise limited rather than quantum-noise limited.

The usefulness of three-dimensional angiography with a flat panel detector of direct conversion type in a transcatheter arterial chemoembolization procedure for hepatocellular carcinoma: initial experience

The purpose of this study was to assess the usefulness of a three-dimensional (3D) angiography system using a flat panel detector of direct conversion type in treatments with subsegmental transcatheter arterial chemoembolization (TACE) for hepatocellular carcinomas (HCCs). Thirty-six consecutive patients who underwent hepatic angiography were prospectively examined. First, two radiologists evaluated the degree of visualization of the peripheral branches of the hepatic arteries on 3D digital subtraction angiography (DSA). Then the radiologists evaluated the visualization of tumor staining and feeding arteries in 25 patients (30 HCCs) who underwent subsegmental TACE. The two radiologists who performed the TACE assessed whether the additional information provided by 3D DSA was useful for treatments. In 34 (94.4%) of 36 patients, the subsegmental branches of the hepatic arteries were sufficiently visualized. The feeding arteries of HCCs were sufficiently visualized in 28 (93%) of 30 HCCs, whereas tumor stains were sufficiently visualized in 18 (60%). Maximum intensity projection images were significantly superior to volume recording images for visualization of the tumor staining and feeding arteries of HCCs. In 27 (90%) of 30 HCCs, 3D DSA provided additional useful information for subsegmental TACE. The high-quality 3D DSA with flat panel detector angiography system provided a precise vascular road map, which was useful for performing subsegmental TACE of HCCs.

Investigation of the signal behavior at diagnostic energies of prototype, direct detection, active matrix, flat-panel imagers incorporating polycrystalline HgI2

Active matrix, flat-panel x-ray imagers based on a-Si:H thin-film transistors offer many advantages and are widely utilized in medical imaging applications. Unfortunately, the detective quantum efficiency (DQE) of conventional flat-panel imagers incorporating scintillators or a-Se photoconductors is significantly limited by their relatively modest signal-to-noise ratio, particularly in applications involving low x-ray exposures or high spatial resolution. For this reason, polycrystalline HgI2 is of considerable interest by virtue of its low effective work function, high atomic number and the possibility of large-area deposition. In this study, a detailed investigation of the properties of prototype, flat-panel arrays coated with two forms of this high-gain photoconductor are reported. Encouragingly, high x-ray sensitivity, low dark current and spatial resolution close to the theoretical limits were observed from a number of prototypes. In addition, input-quantum-limited DQE performance was measured from one of the prototypes at relatively low exposures. However, high levels of charge trapping, lag and polarization, as well as pixel-to-pixel variations in x-ray sensitivity are of concern. While the results of the current study are promising, further development will be required to realize prototypes exhibiting the characteristics necessary to allow practical implementation of this approach.

Does image quality matter? Impact of resolution and noise on mammographic task performance

The purpose of this study was to examine the effects of different resolution and noise levels on task performance in digital mammography. This study created an image set with images at three different resolution levels, corresponding to three digital display devices, and three different noise levels, with noise magnitudes similar to full clinical dose, half clinical dose, and quarter clinical dose. The images were read by five experienced breast imaging radiologists. The data were then analyzed to compute two accuracy statistics (overall classification accuracy and lesion detection accuracy) and performance at four diagnostic tasks (detection of microcalcifications, benign masses, malignant masses, and discrimination of benign and malignant masses). Human observer results showed decreasing display resolution had little effect on overall classification accuracy and individual diagnostic task performance, but increasing noise caused overall classification accuracy to decrease by a statistically significant 21% as the breast dose went to one quarter of its normal clinical value. The noise effects were most prominent for the tasks of microcalcification detection and mass discrimination. When the noise changed from full clinical dose to quarter clinical dose, the microcalcification detection performance fell from 89% to 67% and the mass discrimination performance decreased from 93% to 79%, while malignant mass detection performance remained relatively constant with values of 88% and 84%, respectively. As a secondary aim, the image set was also analyzed by two observer models to examine whether their performance was similar to humans. Observer models differed from human observers and each other in their sensitivity to resolution degradation and noise. The primary conclusions of this study suggest that quantum noise appears to be the dominant image quality factor in digital mammography, affecting radiologist performance much more profoundly than display resolution.

The dependence of the modulation transfer function on the blocking layer thickness in amorphous selenium x-ray detectors

Blocking layers are used to reduce leakage current in amorphous selenium detectors. The effect of the thickness of the blocking layer on the presampling modulation transfer function (MTF) and on dark current was experimentally determined in prototype single-line CCD-based amorphous selenium (a-Se) x-ray detectors. The sampling pitch of the detectors evaluated was 25 microm and the blocking layer thicknesses varied from 1 to 51 microm. The blocking layers resided on the signal collection electrodes which, in this configuration, were used to collect electrons. The combined thickness of the blocking layer and a-Se bulk in each detector was approximately 200 microm. As expected, the dark current increased monotonically as the thickness of the blocking layer was decreased. It was found that if the blocking layer thickness was small compared to the sampling pitch, it caused a negligible reduction in MTF. However, the MTF was observed to decrease dramatically at spatial frequencies near the Nyquist frequency as the blocking layer thickness approached or exceeded the electrode sampling pitch. This observed reduction in MTF is shown to be consistent with predictions of an electrostatic model wherein the image charge from the a-Se is trapped at a characteristic depth within the blocking layer, generally near the interface between the blocking layer and the a-Se bulk.

Physical characterization of a scanning photon counting digital mammography system based on Si-strip detectors

The physical performance of a scanning multislit full field digital mammography system was determined using basic image quality parameters. The system employs a direct detection detector comprised of linear silicon strip sensors in an edge-on geometry connected to photon counting electronics. The pixel size is 50 microm and the field of view 24 x 26 cm2. The performance was quantified using the presampled modulation transfer function, the normalized noise power spectrum and the detective quantum efficiency (DQE). Compared to conventional DQE methods, the scanning geometry with its intrinsic scatter rejection poses additional requirements on the measurement setup, which are investigated in this work. The DQE of the photon counting system was found to be independent of the dose level to the detector in the 7.6-206 microGy range. The peak DQE was 72% and 73% in the scan and slit direction, respectively, measured with a 28 kV W-0.5 mm Al anode-filter combination with an added 2 mm Al filtration.

Advances in Digital Radiography: Physical Principles and System Overview

During the past two decades, digital radiography has supplanted screen-film radiography in many radiology departments. Today, manufacturers provide a variety of digital imaging solutions based on various detector and readout technologies. Digital detectors allow implementation of a fully digital picture archiving and communication system, in which images are stored digitally and are available anytime. Image distribution in hospitals can now be achieved electronically by means of web-based technology with no risk of losing images. Other advantages of digital radiography include higher patient throughput, increased dose efficiency, and the greater dynamic range of digital detectors with possible reduction of radiation exposure to the patient. The future of radiography will be digital, and it behooves radiologists to be familiar with the technical principles, image quality criteria, and radiation exposure issues associated with the various digital radiography systems that are currently available.

Progress in electron-multiplying CCD (EMCCD) based, high-resolution, high-sensitivity x-ray detector for fluoroscopy and radiography

A new high-resolution, high-sensitivity, low-noise x-ray detector based on EMCCDs has been developed. The EMCCD detector module consists of a 1kx1k, 8μm pixel EMCCD camera coupled to a CsI(Tl) scintillating phosphor via a fiber optic taper (FOT). Multiple modules can be used to provide the desired field-of-view (FOV). The detector is capable of acquisitions over 30fps. The EMCCD's variable gain of up to 2000x for the pixel signal enables high sensitivity for fluoroscopic applications. With a 3:1 FOT, the detector can operate with a 144μm effective pixel size, comparable to current flat-panel detectors. Higher resolutions of 96 and 48μm pixel size can also be achieved with various binning modes. The detector MTFs and DQEs were calculated using a linear-systems analysis. The zero frequency DQE was calculated to be 59% at 74 kVp. The DQE for the 144μm pixel size was shown to exhibit quantum-noise limited behavior down to ~0.1μR using a conservative 30x gain. At this low exposure, gains above 30x showed limited improvements in DQE suggesting such increased gains may not be necessary. For operation down to 48μm pixel sizes, the detector instrumentation noise equivalent exposure (INEE), defined as the exposure where the instrumentation noise equals the quantum-noise, was <0.1μR for a 20x gain. This new technology may provide improvements over current flat-panel detectors for applications such as fluoroscopy and angiography requiring high frame rates, resolution, dynamic range and sensitivity while maintaining essentially no lag and very low INEE. Initial images from a prototype detector are also presented.