Empirical electro-optical and x-ray performance evaluation of CMOS active pixels sensor for low dose, high resolution x-ray medical imaging

On the Response of a Micro Non-Destructive Testing X-ray Detector

Certain imaging performance metrics are examined for a state-of-the-art 20 μm pixel pitch CMOS sensor (RadEye HR), coupled to a Gd₂O₂S:Tb scintillator screen. The signal transfer property (STP), the modulation transfer function (MTF), the normalized noise power spectrum (NNPS) and the detective quantum efficiency (DQE) were estimated according to the IEC 62220-1-1:2015 standard. The detector exhibits excellent linearity (coefficient of determination of the STP linear regression fit, R² was 0.9978), while its DQE peaks at 33% and reaches 10% at a spatial frequency of 3 cycles/mm, for the measured with a Piranha RTI dosimeter (coefficient of variation CV = 0.03%) exposure value of 28.1 μGy DAK (detector Air Kerma). The resolution capabilities of the X-ray detector under investigation were compared to other commercial CMOS sensors, and were found in every case higher, except from the previous RadEye HR model (CMOS-Gd₂O₂S:Tb screen pair with 22.5 μm pixel pitch) version which had slightly better MTF. The present digital imager is designed for industrial inspection applications, nonetheless its applicability to medical imaging, as well as dual-energy is considered and certain approaches are discussed in this respect.

Theoretical investigation of the noise performance of active pixel imaging arrays based on polycrystalline silicon thin film transistors

PURPOSE

Active matrix flat-panel imagers, which typically incorporate a pixelated array with one a-Si:H thin-film transistor (TFT) per pixel, have become ubiquitous by virtue of many advantages, including large monolithic construction, radiation tolerance, and high DQE. However, at low exposures such as those encountered in fluoroscopy, digital breast tomosynthesis and breast computed tomography, DQE is degraded due to the modest average signal generated per interacting x-ray relative to electronic additive noise levels of ~1000 e, or greater. A promising strategy for overcoming this limitation is to introduce an amplifier into each pixel, referred to as the active pixel (AP) concept. Such circuits provide in-pixel amplification prior to readout as well as facilitate correlated multiple sampling, enhancing signal-to-noise and restoring DQE at low exposures. In this study, a methodology for theoretically investigating the signal and noise performance of imaging array designs is introduced and applied to the case of AP circuits based on low-temperature polycrystalline silicon (poly-Si), a semiconductor suited to manufacture of large area, radiation tolerant arrays.

METHODS

Computer simulations employing an analog circuit simulator and performed in the temporal domain were used to investigate signal characteristics and major sources of electronic additive noise for various pixel amplifier designs. The noise sources include photodiode shot noise and resistor thermal noise, as well as TFT thermal and flicker noise. TFT signal behavior and flicker noise were parameterized from fits to measurements performed on individual poly-Si test TFTs. The performance of three single-stage and three two-stage pixel amplifier designs were investigated under conditions relevant to fluoroscopy. The study assumes a 20 × 20 cm² , 150 μm pitch array operated at 30 fps and coupled to a CsI:Tl x-ray converter. Noise simulations were performed as a function of operating conditions, including sampling mode, of the designs. The total electronic additive noise included noise contributions from each circuit component.

RESULTS

The total noise results were found to exhibit a strong dependence on circuit design and operating conditions, with TFT flicker noise generally found to be the dominant noise contributor. For the single-stage designs, significantly increasing the size of the source-follower TFT substantially reduced flicker noise - with the lowest total noise found to be ~574 e [rms]. For the two-stage designs, in addition to tuning TFT sizes and introducing a low-pass filter, replacing a p-type TFT with a resistor (under the assumption in the study that resistors make no flicker noise contribution) resulted in significant noise reduction - with the lowest total noise found to be ~336 e [rms].

CONCLUSIONS

A methodology based on circuit simulations which facilitates comprehensive explorations of signal and noise characteristics has been developed and applied to the case of poly-Si AP arrays. The encouraging results suggest that the electronic additive noise of such devices can be substantially reduced through judicious circuit design, signal amplification, and multiple sampling. This methodology could be extended to explore the noise performance of arrays employing other pixel circuitry such as that for photon counting as well as other semiconductor materials such as a-Si:H and a-IGZO.

Large area CMOS active pixel sensor x-ray imager for digital breast tomosynthesis: Analysis, modeling, and characterization

PURPOSE

Large area x-ray imagers based on complementary metal-oxide-semiconductor (CMOS) active pixel sensor (APS) technology have been proposed for various medical imaging applications including digital breast tomosynthesis (DBT). The low electronic noise (50-300 e-) of CMOS APS x-ray imagers provides a possible route to shrink the pixel pitch to smaller than 75 μm for microcalcification detection and possible reduction of the DBT mean glandular dose (MGD).

METHODS

In this study, imaging performance of a large area (29×23 cm2) CMOS APS x-ray imager [Dexela 2923 MAM (PerkinElmer, London)] with a pixel pitch of 75 μm was characterized and modeled. The authors developed a cascaded system model for CMOS APS x-ray imagers using both a broadband x-ray radiation and monochromatic synchrotron radiation. The experimental data including modulation transfer function, noise power spectrum, and detective quantum efficiency (DQE) were theoretically described using the proposed cascaded system model with satisfactory consistency to experimental results. Both high full well and low full well (LFW) modes of the Dexela 2923 MAM CMOS APS x-ray imager were characterized and modeled. The cascaded system analysis results were further used to extract the contrast-to-noise ratio (CNR) for microcalcifications with sizes of 165-400 μm at various MGDs. The impact of electronic noise on CNR was also evaluated.

RESULTS

The LFW mode shows better DQE at low air kerma (Ka<10 μGy) and should be used for DBT. At current DBT applications, air kerma (Ka∼10 μGy, broadband radiation of 28 kVp), DQE of more than 0.7 and ∼0.3 was achieved using the LFW mode at spatial frequency of 0.5 line pairs per millimeter (lp/mm) and Nyquist frequency ∼6.7 lp/mm, respectively. It is shown that microcalcifications of 165-400 μm in size can be resolved using a MGD range of 0.3-1 mGy, respectively. In comparison to a General Electric GEN2 prototype DBT system (at MGD of 2.5 mGy), an increased CNR (by ∼10) for microcalcifications was observed using the Dexela 2923 MAM CMOS APS x-ray imager at a lower MGD (2.0 mGy).

CONCLUSIONS

The Dexela 2923 MAM CMOS APS x-ray imager is capable to achieve a high imaging performance at spatial frequencies up to 6.7 lp/mm. Microcalcifications of 165 μm are distinguishable based on reported data and their modeling results due to the small pixel pitch of 75 μm. At the same time, potential dose reduction is expected using the studied CMOS APS x-ray imager.

Dual Energy Method for Breast Imaging: A Simulation Study

Dual energy methods can suppress the contrast between adipose and glandular tissues in the breast and therefore enhance the visibility of calcifications. In this study, a dual energy method based on analytical modeling was developed for the detection of minimum microcalcification thickness. To this aim, a modified radiographic X-ray unit was considered, in order to overcome the limited kVp range of mammographic units used in previous DE studies, combined with a high resolution CMOS sensor (pixel size of 22.5 μm) for improved resolution. Various filter materials were examined based on their K-absorption edge. Hydroxyapatite (HAp) was used to simulate microcalcifications. The contrast to noise ratio (CNR tc ) of the subtracted images was calculated for both monoenergetic and polyenergetic X-ray beams. The optimum monoenergetic pair was 23/58 keV for the low and high energy, respectively, resulting in a minimum detectable microcalcification thickness of 100 μm. In the polyenergetic X-ray study, the optimal spectral combination was 40/70 kVp filtered with 100 μm cadmium and 1000 μm copper, respectively. In this case, the minimum detectable microcalcification thickness was 150 μm. The proposed dual energy method provides improved microcalcification detectability in breast imaging with mean glandular dose values within acceptable levels.

Design considerations for a new, high resolution Micro-Angiographic Fluoroscope based on a CMOS sensor (MAF-CMOS)

The detectors that are used for endovascular image-guided interventions (EIGI), particularly for neurovascular interventions, do not provide clinicians with adequate visualization to ensure the best possible treatment outcomes. Developing an improved x-ray imaging detector requires the determination of estimated clinical x-ray entrance exposures to the detector. The range of exposures to the detector in clinical studies was found for the three modes of operation: fluoroscopic mode, high frame-rate digital angiographic mode (HD fluoroscopic mode), and DSA mode. Using these estimated detector exposure ranges and available CMOS detector technical specifications, design requirements were developed to pursue a quantum limited, high resolution, dynamic x-ray detector based on a CMOS sensor with 50 μm pixel size. For the proposed MAF-CMOS, the estimated charge collected within the full exposure range was found to be within the estimated full well capacity of the pixels. Expected instrumentation noise for the proposed detector was estimated to be 50-1,300 electrons. Adding a gain stage such as a light image intensifier would minimize the effect of the estimated instrumentation noise on total image noise but may not be necessary to ensure quantum limited detector operation at low exposure levels. A recursive temporal filter may decrease the effective total noise by 2 to 3 times, allowing for the improved signal to noise ratios at the lowest estimated exposures despite consequent loss in temporal resolution. This work can serve as a guide for further development of dynamic x-ray imaging prototypes or improvements for existing dynamic x-ray imaging systems.

A theoretical and experimental evaluation of the microangiographic fluoroscope: A high-resolution region-of-interest x-ray imager

PURPOSE

The increasing need for better image quality and high spatial resolution for successful endovascular image-guided interventions (EIGIs) and the inherent limitations of the state-of-the-art detectors provide motivation to develop a detector system tailored to the specific, demanding requirements of neurointerventional applications.

METHOD

A microangiographic fluoroscope (MAF) was developed to serve as a high-resolution, region-of-interest (ROI) x-ray imaging detector in conjunction with large lower-resolution full field-of-view (FOV) state-of-the-art x-ray detectors. The newly developed MAF is an indirect x-ray imaging detector capable of providing real-time images (30 frames per second) with high-resolution, high sensitivity, no lag and low instrumentation noise. It consists of a CCD camera coupled to a Gen 2 dual-stage microchannel plate light image intensifier (LII) through a fiber-optic taper. A 300 microm thick CsI(T1) phosphor serving as the front end is coupled to the LII. The LII is the key component of the MAF and the large variable gain provided by it enables the MAF to operate as a quantum-noise-limited detector for both fluoroscopy and angiography.

RESULTS

The linear cascade model was used to predict the theoretical performance of the MAF, and the theoretical prediction showed close agreement with experimental findings. Linear system metrics such as MTF and DQE were used to gauge the detector performance up to 10 cycles/mm. The measured zero frequency DQE(0) was 0.55 for an RQA5 spectrum. A total of 21 stages were identified for the whole imaging chain and each stage was characterized individually.

CONCLUSIONS

The linear cascade model analysis provides insight into the imaging chain and may be useful for further development of the MAF detector. The preclinical testing of the prototype detector in animal procedures is showing encouraging results and points to the potential for significant impact on EIGIs when used in conjunction with a state-of-art flat panel detector (FPD).

Quantitative contrast-enhanced mammography for contrast medium kinetics studies

Quantitative contrast-enhanced mammography, based on a dual-energy approach, aims to extract quantitative and temporal information of the tumour enhancement after administration of iodinated vascular contrast media. Simulations using analytical expressions and optimization of critical parameters essential for the development of quantitative contrast-enhanced mammography are presented. The procedure has been experimentally evaluated using a tissue-equivalent phantom and an amorphous silicon active matrix flat panel imager. The x-ray beams were produced by a tungsten target tube and spectrally shaped using readily available materials. Measurement of iodine projected thickness in mg cm(-2) has been performed. The effect of beam hardening does not introduce nonlinearities in the measurement of iodine projected thickness for values of thicknesses found in clinical investigations. However, scattered radiation introduces significant deviations from slope equal to unity when compared with the actual iodine projected thickness. Scatter correction before the analysis of the dual-energy images provides accurate iodine projected thickness measurements. At 10% of the exposure used in clinical mammography, signal-to-noise ratios in excess of 5 were achieved for iodine projected thicknesses less than 3 mg cm(-2) within a 4 cm thick phantom. For the extraction of temporal information, a limited number of low-dose images were used with the phantom incorporating a flow of iodinated contrast medium. The results suggest that spatial and temporal information of iodinated contrast media can be used to indirectly measure the tumour microvessel density and determine its uptake and washout from breast tumours. The proposed method can significantly improve tumour detection in dense breasts. Its application to perform in situ x-ray biopsy and assessment of the oncolytic effect of anticancer agents is foreseeable.

Active pixel imagers incorporating pixel-level amplifiers based on polycrystalline-silicon thin-film transistors

Active matrix, flat-panel imagers (AMFPIs) employing a 2D matrix of a-Si addressing TFTs have become ubiquitous in many x-ray imaging applications due to their numerous advantages. However, under conditions of low exposures and/or high spatial resolution, their signal-to-noise performance is constrained by the modest system gain relative to the electronic additive noise. In this article, a strategy for overcoming this limitation through the incorporation of in-pixel amplification circuits, referred to as active pixel (AP) architectures, using polycrystalline-silicon (poly-Si) TFTs is reported. Compared to a-Si, poly-Si offers substantially higher mobilities, enabling higher TFT currents and the possibility of sophisticated AP designs based on both n- and p-channel TFTs. Three prototype indirect detection arrays employing poly-Si TFTs and a continuous a-Si photodiode structure were characterized. The prototypes consist of an array (PSI-1) that employs a pixel architecture with a single TFT, as well as two arrays (PSI-2 and PSI-3) that employ AP architectures based on three and five TFTs, respectively. While PSI-1 serves as a reference with a design similar to that of conventional AMFPI arrays, PSI-2 and PSI-3 incorporate additional in-pixel amplification circuitry. Compared to PSI-1, results of x-ray sensitivity demonstrate signal gains of approximately 10.7 and 20.9 for PSI-2 and PSI-3, respectively. These values are in reasonable agreement with design expectations, demonstrating that poly-Si AP circuits can be tailored to provide a desired level of signal gain. PSI-2 exhibits the same high levels of charge trapping as those observed for PSI-1 and other conventional arrays employing a continuous photodiode structure. For PSI-3, charge trapping was found to be significantly lower and largely independent of the bias voltage applied across the photodiode. MTF results indicate that the use of a continuous photodiode structure in PSI-1, PSI-2, and PSI-3 results in optical fill factors that are close to unity. In addition, the greater complexity of PSI-2 and PSI-3 pixel circuits, compared to that of PSI-1, has no observable effect on spatial resolution. Both PSI-2 and PSI-3 exhibit high levels of additive noise, resulting in no net improvement in the signal-to-noise performance of these early prototypes compared to conventional AMFPIs. However, faster readout rates, coupled with implementation of multiple sampling protocols allowed by the nondestructive nature of pixel readout, resulted in a significantly lower noise level of approximately 560 e (rms) for PSI-3.

Signal and noise transfer properties of CMOS based active pixel flat panel imager coupled to structured CsI:Tl

Complementary metal-oxide-semiconductors (CMOS) active pixel sensors can be optically coupled to CsI:Tl phosphors forming a indirect active pixel flat panel imager (APFPI) for high performance medical imaging. The aim of this work is to determine the x-ray imaging capabilities of CMOS-based APFPI and study the signal and noise transfer properties of CsI:Tl phosphors. Three different CsI:Tl phosphors from two different vendors have been used to produce three system configurations. The performance of each system configuration has been studied in terms of the modulation transfer function (MTF), noise power spectra, and detective quantum efficiency (DQE) in the mammographic energy range. A simple method to determine quantum limited systems in this energy range is also presented. In addition, with aid of monochromatic synchrotron radiation, the effect of iodine characteristic x-rays of the CsI:Tl on the MTF has been determined. A Monte Carlo simulation of the signal transfer properties of the imager is also presented in order to study the stages that degrade the spatial resolution of our current system. The effect of using substrate patterning during the growth of CsI:Tl columnar structure was also studied, along with the effect of CsI:Tl fixed pattern noise due to local variations in the scintillation light. CsI:Tl fixed pattern noise appears to limit the performance of our current system configurations. All the system configurations are quantum limited at 0.23 microC/kg with two of them having DQE (0) equal to 0.57. Active pixel flat panel imagers are shown to be digital x-ray imagers with almost constant DQE throughout a significant part of their dynamic range and in particular at very low exposures.

Physical characterization and performance comparison of active- and passive-pixel CMOS detectors for mammography

We investigated the physical characteristics of two complementary metal oxide semiconductor (CMOS) mammography detectors. The detectors featured 14-bit image acquisition, 50 microm detector element (del) size and an active area of 5 cm x 5 cm. One detector was a passive-pixel sensor (PPS) with signal amplification performed by an array of amplifiers connected to dels via data lines. The other detector was an active-pixel sensor (APS) with signal amplification performed at each del. Passive-pixel designs have higher read noise due to data line capacitance, and the APS represents an attempt to improve the noise performance of this technology. We evaluated the detectors' resolution by measuring the modulation transfer function (MTF) using a tilted edge. We measured the noise power spectra (NPS) and detective quantum efficiencies (DQE) using mammographic beam conditions specified by the IEC 62220-1-2 standard. Our measurements showed the APS to have much higher gain, slightly higher MTF, and higher NPS. The MTF of both sensors approached 10% near the Nyquist limit. DQE values near dc frequency were in the range of 55-67%, with the APS sensor DQE lower than the PPS DQE for all frequencies. Our results show that lower read noise specifications in this case do not translate into gains in the imaging performance of the sensor. We postulate that the lower fill factor of the APS is a possible cause for this result.