Development of high quantum efficiency, flat panel, thick detectors for megavoltage x-ray imaging: An experimental study of a single-pixel prototype

Development of a novel high quantum efficiency MV x-ray detector for image-guided radiotherapy: A feasibility study

Purpose

To develop a new scintillating fiber‐based electronic portal imaging device (EPID) with a high quantum efficiency (QE) while preserving an adequate spatial resolution.

Methods

Two prototypes were built: one with a single pixel readout and the other with an active matrix flat‐panel imager (AMFPI) for readout. The energy conversion layer of both prototypes was made of scintillating fiber layers interleaved with corrugated lead sheets to form a honeycomb pattern. The scintillating fibers have a diameter of 1 mm and the distance between the centers of neighboring fibers on the same layer is 1.35 mm. The layers have 1.22 mm spacing between them. The energy conversion layer has a thickness of 2 cm. The modulation transfer function (MTF), antiscatter properties and sensitivity of the detector with a single pixel readout were measured using a 6‐MV beam on a LINAC machine. In addition, a Monte Carlo simulation was conducted to calculate the zero‐frequency detective quantum efficiency (DQE(0)) of the proposed detector with an active matrix flat‐panel imager for readout.

Results

The DQE(0) of the proposed detector can be 11.5%, which is about an order of magnitude higher than that of current EPIDs. The frequency of 50% modulation (f50) of the measured MTF is 0.2 mm-1 at 6 MV, which is comparable to that of video‐based EPIDs. The scatter to primary ratio (SPR) measured with the detector at 10 cm air gap and 20 × 20 cm2 field size is approximately 30% lower than that of ionization chamber–based detectors with a comparable QE. The detector noise which includes the x‐ray quantum noise and absorption noise is much larger than the electronic noise per pixel of the flat‐panel imager at a dose of less than two LINAC pulses. Thus, the proposed detector is quantum noise limited down to very low doses (∼a couple of radiation pulses of the LINAC). A proof‐of‐concept image has been obtained using a 6‐MV beam.

Conclusions

This work indicates that by using scintillating fibers and lead layers it is possible to increase the thickness of the detecting materials, and therefore the QE or the DQE(0) of the detector, while maintaining an adequate spatial resolution for MV x‐ray imaging. Due to the use of lead as the spacing material, the new detector also has antiscatter property, which will help improve the signal‐to‐noise ratio of the images. Further investigation to optimize the design of the detector and achieve a better combination of DQE and spatial resolution is warranted.

Monte Carlo simulation of a quantum noise limited Čerenkov detector based on air-spaced light guiding taper for megavoltage x-ray imaging

PURPOSE

Electronic Portal Imaging Devices (EPIDs) have been widely used in radiation therapy and are still needed on linear accelerators (Linacs) equipped with kilovoltage cone beam CT (kV-CBCT) or MRI systems. Our aim is to develop a new high quantum efficiency (QE) Čerenkov Portal Imaging Device (CPID) that is quantum noise limited at dose levels corresponding to a single Linac pulse.

METHODS

Recently a new concept of CPID for MV x-ray imaging in radiation therapy was introduced. It relies on Čerenkov effect for x-ray detection. The proposed design consisted of a matrix of optical fibers aligned with the incident x-rays and coupled to an active matrix flat panel imager (AMFPI) for image readout. A weakness of such design is that too few Čerenkov light photons reach the AMFPI for each incident x-ray and an AMFPI with an avalanche gain is required in order to overcome the readout noise for portal imaging application. In this work the authors propose to replace the optical fibers in the CPID with light guides without a cladding layer that are suspended in air. The air between the light guides takes on the role of the cladding layer found in a regular optical fiber. Since air has a significantly lower refractive index (∼ 1 versus 1.38 in a typical cladding layer), a much superior light collection efficiency is achieved.

RESULTS

A Monte Carlo simulation of the new design has been conducted to investigate its feasibility. Detector quantities such as quantum efficiency (QE), spatial resolution (MTF), and frequency dependent detective quantum efficiency (DQE) have been evaluated. The detector signal and the quantum noise have been compared to the readout noise.

CONCLUSIONS

Our studies show that the modified new CPID has a QE and DQE more than an order of magnitude greater than that of current clinical systems and yet a spatial resolution similar to that of current low-QE flat-panel based EPIDs. Furthermore it was demonstrated that the new CPID does not require an avalanche gain in the AMFPI and is quantum noise limited at dose levels corresponding to a single Linac pulse.

Image-guided radiation therapy using computed tomography in radiotherapy

The sharp dose gradients in intensity-modulated radiation therapy increase the treatment sensitivity to various inter- and intra-fractional uncertainties, in which a slight anatomical change may greatly alter the actual dose delivered. Image-guided radiotherapy refers to the use of advanced imaging techniques to precisely track and correct these patient-specific variations in routine treatment. It can also monitor organ changes during a radiotherapy course. Currently, image-guided radiotherapy using computed tomography has gained much popularity in radiotherapy verification as it provides volumetric images with soft-tissue contrast for on-line tracking of tumour. This article reviews four types of computed tomography-based image guidance systems and their working principles. The system characteristics and clinical applications of the helical, megavoltage, computed tomography, and kilovoltage, cone-beam, computed tomography systems are discussed, given that they are currently the most commonly used systems for radiotherapy verification. This article also focuses on the recent techniques of soft-tissue contrast enhancement, digital tomosynthesis, four-dimensional fluoroscopic image guidance, and kilovoltage/megavoltage, in-line cone-beam imaging. These evolving systems are expected to take over the conventional two-dimensional verification system in the near future and provide the basis for implementing adaptive radiotherapy.

Low dose megavoltage cone beam computed tomography with an unflattened 4 MV beam from a carbon target

Megavoltage cone beam computed tomography (MVCBCT) is routinely used for visualizing anatomical structures and implanted fiducials for patient positioning in radiotherapy. MVCBCT using a 6 MV treatment beam with high atomic number (Z) target and flattening filter in the beamline, as done conventionally, has lower image quality than can be achieved with a MV beam due to heavy filtration of the low-energy bremsstrahlung. The unflattened beam of a low Z target has an abundance of diagnostic energy photons, detected with modern flat panel detectors with much higher efficiency given the same dose to the patient. This principle guided the development of a new megavoltage imaging beamline (IBL) for a commercial radiotherapy linear accelerator. A carbon target was placed in one of the electron primary scattering foil slots on the target-foil slide. A PROM on a function controller board was programed to put the carbon target in place for MVCBCT. A low accelerating potential of 4.2 MV was used for the IBL to restrict leakage of primary electrons through the target such that dose from x rays dominated the signal in the monitor chamber and the patient surface dose. Results from phantom and cadaver images demonstrated that the IBL had much improved image quality over the treatment beam. For similar imaging dose, the IBL improved the contrast-to-noise ratio by as much as a factor of 3 in soft tissue over that of the treatment beam. The IBL increased the spatial resolution by about a factor of 2, allowing the visualization of finer anatomical details. Images of the cadaver contained useful information with doses as low as 1 cGy. The IBL may be installed on certain models of linear accelerators without mechanical modification and results in significant improvement in the image quality with the same dose, or images of the same quality with less than one-third of the dose.

Thick, segmented CdWO4-photodiode detector for cone beam megavoltage CT: a Monte Carlo study of system design parameters

Megavoltage (MV) imaging detectors have been the focus of research by many groups in recent years. We have been working with segmented CdWO4 crystals in contact with photodiodes in our lab. The present study uses both x-ray and optical photon transport Monte Carlo simulations to analyze the effects of scintillation crystal height, septa material, beam divergence, and beam spectrum on the modulation transfer function, MTF(f) and zero frequency detective quantum efficiency, DQE(0), of a theoretical area detector. The theoretical detector is comprised of tall, segmented CdWO4 crystals and two dimensional photodiode arrays with a pitch of 1 mm and a fill factor of 72%. Increasing the crystal height above 10 mm does not result in an improvement in the DQE(0) if the reflection coefficient of the septa is less than 0.8. For a reflection coefficient of 0.975 for the septa, there is a continual gain in the DQE(0) up to 30 mm tall crystals. Similar calculations show that employing a 3.5 MV beam without a flattening filter increases the DQE(0) for 20 mm tall crystals by 9% compared to a typical 6 MV beam with a flattening filter. The severe degradations due to beam divergence on MTF(f) are quantified and suggest the use of focused detectors in MV imaging. It is found that when the effect of optical photons is considered, the presence of divergence can appear as a shift in the location of the input signal as well as loss of spatial resolution.

Electronic portal imaging based on Cerenkov radiation: A new approach and its feasibility

Most electronic portal imaging devices (EPIDs) developed so far use a Cu plate/phosphor screen to absorb x rays and convert their energies into light, and the light image is then read out. The main problem with this approach is that the Cu plate/phosphor screen must be thin (approximately 2 mm thick) in order to obtain a high spatial resolution, resulting in a low x-ray absorption or low quantum efficiency for megavoltage x rays (typically 2-4%). In addition, the phosphor screen contains high atomic number (high-Z) materials, resulting in an over-response of the detector to low-energy x rays in dosimetric verification. In this paper, we propose a new approach that uses Cerenkov radiation to convert x-ray energy absorbed by the detector into light for portal imaging applications. With our approach, a thick (approximately 10-30 cm) energy conversion layer made of a low-Z dielectric medium, such as a large-area, thick fiber-optic taper consisting of a matrix of optical fibers aligned with the incident x rays, is used to replace the thin Cu plate/phosphor screen. The feasibility of this approach has been investigated using a single optical fiber embedded in a solid material. The spatial resolution expressed by the modulation transfer function (MTF) and the sensitivity of the detector at low doses (approximately one Linac pulse) have been measured. It is predicted that, using this approach, a detective quantum efficiency of an order of magnitude higher at zero frequency can be obtained while maintaining a reasonable MTF, as compared to current EPIDs.