CdTe Based Energy Resolving, X-ray Photon Counting Detector Performance Assessment: The Effects of Charge Sharing Correction Algorithm Choice

[A comprehensive review on photon-counting computed tomography: Principles, technical hurdles and analysis of clinical applications]

In recent years, photon-counting computed tomography (PCD-CT) based on photon-counting detectors (PCDs) has become increasingly utilized in clinical practice. Compared with conventional CT, PCD-CT has the potential to achieve micron-level spatial resolution, lower radiation dose, negligible electronic noise, multi-energy imaging, and material identification, etc. This advancement facilitates the promotion of ultra-low dose scans in clinical scenarios, potentially detecting minimal and hidden lesions, thus significantly improving image quality. However, the current state of the art is limited and issues such as charge sharing, pulse pileup, K-escape and count rate drift remain unresolved. These issues could lead to a decrease in image resolution and energy resolution, while an increasing in image noise and ring artifact and so on. This article systematically reviewed the physical principles of PCD-CT, and outlined the structural differences between PCDs and energy integration detectors (EIDs), and the current challenges in the development of PCD-CT. In addition, the advantages and disadvantages of three detector materials were analysed. Then, the clinical benefits of PCD-CT were presented through the clinical application of PCD-CT in the three diseases with the highest mortality rate in China (cardiovascular disease, tumour and respiratory disease). The overall aim of the article is to comprehensively assist medical professionals in understanding the technological innovations and current technical limitations of PCD-CT, while highlighting the urgent problems that PCD-CT needs to address in the coming years.

Demonstrating a Novel, Hidden Source of Spectral Distortion in X-ray Photon Counting Detectors and Assessing Novel Trigger Schemes Proposed to Avoid It

X-ray photon counting spectral imaging (x-CSI) determines a detected photon's energy by comparing the charge it induces with several thresholds, counting how many times each is crossed (the standard method, STD). This paper is the first to demonstrate that this approach can unexpectedly delete counts from the recorded energy spectrum under some clinically relevant conditions: a process we call negative counting. Four alternative counting schemes are proposed and simulated for a wide range of sensor geometries (pixel pitch 100-600 µm, sensor thickness 1-3 mm), number of thresholds (3, 5, 8, 24 and 130) and medically relevant X-ray fluxes (10⁶-10⁹ photons mm^-2 s^-1). Spectral efficiency and counting efficiency are calculated for each simulation. Performance gains are explained mechanistically and correlated well with the improved suppression of "negative counting". The best performing scheme (Shift Register, SR) entirely eliminates negative counting, remaining close to an ideal scheme at fluxes of up to 10⁸ photons mm^-2 s^-1. At the highest fluxes considered, the deviation from ideal behaviour is reduced by 2/3 in SR compared with STD. The results have significant implications both for generally improving spectral fidelity and as a possible path toward the 10⁹ photons mm^-2 s^-1 goal in photon-counting CT.

Ballistic Deficit Pulse Processing in Cadmium-Zinc-Telluride Pixel Detectors for High-Flux X-ray Measurements

High-flux X-ray measurements with high-energy resolution and high throughput require the mitigation of pile-up and dead time effects. The reduction of the time width of the shaped pulses is a key approach, taking into account the distortions from the ballistic deficit, non-linearity, and time instabilities. In this work, we will present the performance of cadmium−zinc−telluride (CdZnTe or CZT) pixel detectors equipped with digital shapers faster than the preamplifier peaking times (ballistic deficit pulse processing). The effects on energy resolution, throughput, energy-linearity, time stability, charge sharing, and pile-up are shown. The results highlight the absence of time instabilities and high-energy resolution (<4% FWHM at 122 keV) when ballistic deficit pulse processing (dead time of 90 ns) was used in CZT pixel detectors. These activities are in the framework of an international collaboration on the development of spectroscopic imagers for medical applications (mammography, computed tomography) and non-destructive testing in the food industry.

An Overview of X-ray Photon Counting Spectral Imaging (x-CSI) with a Focus on Gold Nanoparticle Quantification in Oncology

This review article offers an overview of the differences between traditional energy integrating (EI) X-ray imaging and the new technique of X-ray photon counting spectral imaging (x-CSI). The review is motivated by the need to image gold nanoparticles (AuNP) in vivo if they are to be used clinically to deliver a radiotherapy dose-enhancing effect (RDEE). The aim of this work is to familiarise the reader with x-CSI as a technique and to draw attention to how this technique will need to develop to be of clinical use for the described oncological applications. This article covers the conceptual differences between x-CSI and EI approaches, the advantages of x-CSI, constraints on x-CSI system design, and the achievements of x-CSI in AuNP quantification. The results of the review show there are still approximately two orders of magnitude between the AuNP concentrations used in RDEE applications and the demonstrated detection limits of x-CSI. Two approaches to overcome this were suggested: changing AuNP design or changing x-CSI system design. Optimal system parameters for AuNP detection and general spectral performance as determined by simulation studies were different to those used in the current x-CSI systems, indicating potential gains that may be made with this approach.