High-DQE EPIDs based on thick, segmented BGO and CsI:Tl scintillators: performance evaluation at extremely low dose

PURPOSE

Electronic portal imaging devices (EPIDs) based on active matrix, flat-panel imagers (AMFPIs) have become the gold standard for portal imaging and are currently being investigated for megavoltage cone-beam computed tomography (CBCT) and cone-beam digital tomosynthesis (CBDT). However, the practical realization of such volumetric imaging techniques is constrained by the relatively low detective quantum efficiency (DQE) of AMFPI-based EPIDs at radiotherapy energies, approximately 1% at 6 MV. In order to significantly improve DQE, the authors are investigating thick, segmented scintillators, consisting of 2D matrices of scintillating crystals separated by septal walls.

METHODS

A newly constructed segmented BGO scintillator (11.3 mm thick) and three segmented CsI:Tl scintillators (11.4, 25.6, and 40.0 mm thick) were evaluated using a 6 MV photon beam. X-ray sensitivity, modulation transfer function, noise power spectrum, DQE, and phantom images were obtained using prototype EPIDs based on the four scintillators.

RESULTS

The BGO and CsI:Tl prototypes were found to exhibit improvement in DQE ranging from approximately 12 to 25 times that of a conventional AMFPI-based EPID at zero spatial frequency. All four prototype EPIDs provide significantly improved contrast resolution at extremely low doses, extending down to a single beam pulse. In particular, the BGO prototype provides contrast resolution comparable to that of the conventional EPID, but at 20 times less dose, with spatial resolution sufficient for identifying the boundaries of low-contrast objects. For this prototype, however, the BGO scintillator exhibited an undesirable radiation-induced variation in x-ray sensitivity.

CONCLUSIONS

Prototype EPIDs based on thick, segmented BGO and CsI:T1 scintillators provide significantly improved portal imaging performance at extremely low dose (i.e., down to 1 beam pulse corresponding to approximately 0.022 cGy), creating the possibility of soft-tissue visualization using MV CBCT and CBDT at clinically practical dose.

A Monte Carlo investigation of Swank noise for thick, segmented, crystalline scintillators for radiotherapy imaging

Thick, segmented scintillating detectors, consisting of 2D matrices of scintillator crystals separated by optically opaque septal walls, hold considerable potential for significantly improving the performance of megavoltage (MV) active matrix, flat-panel imagers (AMFPIs). Initial simulation studies of the radiation transport properties of segmented detectors have indicated the possibility of significant improvement in DQE compared to conventional MV AMFPIs based on phosphor screen detectors. It is therefore interesting to investigate how the generation and transport of secondary optical photons affect the DQE performance of such segmented detectors. One effect that can degrade DQE performance is optical Swank noise (quantified by the optical Swank factor I(opt)), which is induced by depth-dependent variations in optical gain. In this study, Monte Carlo simulations of radiation and optical transport have been used to examine I(opt) and zero-frequency DQE for segmented CsI:Tl and BGO detectors at different thicknesses and element-to-element pitches. For these detectors, I(opt) and DQE were studied as a function of various optical parameters, including absorption and scattering in the scintillator, absorption at the top reflector and septal walls, as well as scattering at the side surfaces of the scintillator crystals. The results indicate that I(opt) and DQE are only weakly affected by absorption and scattering in the scintillator, as well as by absorption at the top reflector. However, in some cases, these metrics were found to be significantly degraded by absorption at the septal walls and scattering at the scintillator side surfaces. Moreover, such degradations are more significant for detectors with greater thickness or smaller element pitch. At 1.016 mm pitch and with optimized optical properties, 40 mm thick segmented CsI:Tl and BGO detectors are predicted to provide DQE values of approximately 29% and 42%, corresponding to improvement by factors of approximately 29 and 42, respectively, compared to that of conventional MV AMFPIs.