Feasibility of unconstrained three-material decomposition: imaging an excised human heart using a prototype silicon photon-counting CT detector.

RATIONALE AND OBJECTIVES: The purpose of this study was to evaluate the feasibility of unconstrained three-material decomposition in a human tissue specimen containing iodinated contrast agent, using an experimental multi-bin photon-counting silicon detector. It was further to evaluate potential added clinical value compared to a 1st-generation state-of-the-art dual-energy computed tomography system. MATERIALS AND METHODS: A prototype photon-counting silicon detector in a bench-top setup for x-ray tomographic imaging was calibrated using a multi-material calibration phantom. A heart with calcified plaque was obtained from a deceased patient, and the coronary arteries were injected with an iodinated contrast agent mixed with gelatin. The heart was imaged in the experimental setup and on a 1st-generation state-of-the-art dual-energy computed tomography system. Projection-based three-material decomposition without any constraints was performed with the photon-counting detector data, and the resulting images were compared with those obtained from the dual-energy system. RESULTS: The photon-counting detector images show better separation of iodine and calcium compared to the dual-energy images. Additional experiments confirmed that unbiased estimates of soft tissue, calcium, and iodine could be achieved without any constraints. CONCLUSION: The proposed experimental system could provide added clinical value compared to current dual-energy systems for imaging tasks where mix-up of iodine and calcium is an issue, and the anatomy is sufficiently small to allow iodine to be differentiated from calcium. Considering its previously shown count rate capability, these results show promise for future integration of this detector in a clinical CT scanner. KEY POINTS: • Spectral photon-counting detectors can solve some of the fundamental problems with conventional single-energy CT. • Dual-energy methods can be used to differentiate iodine and calcium, but to do so must rely on constraints, since solving for three unknowns with only two measurements is not possible. Photon-counting detectors can improve upon these methods by allowing unconstrained three-material decomposition. • A prototype photon-counting silicon detector with high count rate capability allows performing unconstrained three-material decomposition and qualitatively shows better differentiation of iodine and calcium than dual-energy CT.

Applying three different methods of measuring CTDIfree air to the extended CTDI formalism for wide-beam scanners (IEC 60601-2-44): A comparative study.

PURPOSE: The weighted CT dose index (CTDIw ) has been extended for a nominal total collimation width (nT) greater than 40 mm and relies on measurements of CTDIfreeair. The purpose of this work was to compare three methods of measuring CTDIfreeair and subsequent calculations of CTDIw to investigate their clinical appropriateness. METHODS: The CTDIfreeair, for multiple nTs up to 160 mm, was calculated from (1) high-resolution air kerma profiles from a step-and-shoot translation of a liquid ionization chamber (LIC) (considered to be a dosimetric reference), (2) pencil ionization chamber (PIC) measurements at multiple contiguous positions, and (3) air kerma profiles obtained through the continuous translation of a solid-state detector. The resulting CTDIfreeair was used to calculate the CTDIw , per the extended formalism, and compared. RESULTS: The LIC indicated that a 40 mm nT should not be excluded from the extension of the CTDIw formalism. The solid-state detector differed by as much as 8% compared to the LIC. The PIC was the most straightforward method and gave equivalent results to the LIC. CONCLUSIONS: The CTDIw calculated with the latest CTDI formalism will differ most for 160 mm nTs (e.g., whole-organ perfusion or coronary CT angiography) compared to the previous CTDI formalism. Inaccuracies in the measurement of CTDIfreeair will subsequently manifest themselves as erroneous calculations of the CTDIw , for nTs greater than 40 mm, with the latest CTDI formalism. The PIC was found to be the most clinically feasible method and was validated against the LIC.

First experimental evaluation of a high-resolution deep silicon photon-counting sensor.

Purpose: Current photon-counting computed tomography detectors are limited to a pixel size of around 0.3 to 0.5 mm due to excessive charge sharing degrading the dose efficiency and energy resolution as the pixels become smaller. In this work, we present measurements of a prototype photon-counting detector that leverages the charge sharing to reach a theoretical sub-pixel resolution in the order of 1 µm. The goal of the study is to validate our Monte-Carlo simulation using measurements, enabling further development. Approach: We measure the channel response at the MAX IV Lab, in the DanMAX beamline, with a 35 keV photon beam, and compare the measurements with a 2D Monte Carlo simulation combined with a charge transport model. Only a few channels on the prototype are connected to keep the number of wire bonds low. Results: The measurements agree generally well with the simulations with the beam close to the electrodes but diverge as the beam is moved further away. The induced charge cloud signals also seem to increase linearly as the beam is moved away from the electrodes. Conclusions: The agreement between measurements and simulations indicates that the Monte-Carlo simulation can accurately model the channel response of the detector with the photon interactions close to the electrodes, which indicates that the unconnected electrodes introduce unwanted effects that need to be further explored. With the same Monte-Carlo simulation previously indicating a resolution of around 1 µm with similar geometry, the results are promising that an ultra-high resolution detector is not far in the future.

First experimental evaluation of count-rate performance for micrometre resolution deep silicon detector.

Objective.An ultra-fine-pitch deep silicon detector has been developed for clinical photon-counting computed tomography (CT). With a small pixel size of 14 × 650µm2, it has shown potential to reach micrometre spatial resolution in previous simulation studies. A detector prototype with such geometry has been manufactured, and we report on the first experimental evaluation of its count-rate performance.Approach.The measurement was carried out at MAX IV synchrotron laboratory with 35 keV monochromatic x-rays. By inserting tungsten attenuators of 50, 75, 100, 150, 200, 225, 325µm-thicknesses into the beam, the response of the detector to fluence rates from 3.3 × 107to 1.3 × 1011mm-2s-1was characterized.Main results.The measurement result showed that the detector exhibited count rate linearity up to 6.66 × 108mm-2s-1with 13% count loss and was still functional at count rate up to 2.9 × 1010mm-2s-1. A semi-nonparalyzable dead-time model was fitted to the count-rate behaviour of the detector, showing great agreement with the measured data, with an estimated nonparalyzable dead time of 2.9 ns.Significance.This is the first experimental evaluation of the count-rate performance for a deep silicon detector with such small pixel geometry. The results suggest that this type of detector shows the potential to be used at fluence rates encountered in clinical CT with little count loss due to pile-up.

Timing resolution in double-sided silicon photon-counting computed tomography detectors.

Purpose: Our purpose is to investigate the timing resolution in edge-on silicon strip detectors for photon-counting spectral computed tomography. Today, the timing for detection of individual x-rays is not measured, but in the future, timing information can be valuable to accurately reconstruct the interactions caused by each primary photon. Approach: We assume a pixel size of 12 × 500 µ m 2 and a detector with double-sided readout with low-noise CMOS electronics for pulse processing for every pixel on each side. Due to the electrode width in relation to the wafer thickness, the induced current signals are largely dominated by charge movement close to the collecting electrodes. By employing double-sided readout electrodes, at least two signals are generated for each interaction. By comparing the timing of the induced current pulses, the time of the interaction can be determined and used to identify interactions that originate from the same incident photon. Using a Monte Carlo simulation of photon interactions in combination with a charge transport model, we evaluate the performance of estimating the time of the interaction for different interaction positions. Results: Our simulations indicate that a time resolution of 1 ns can be achieved with a noise level of 0.5 keV. In a detector with no electronic noise, the corresponding time resolution is ∼ 0.1 ns . Conclusions: Time resolution in edge-on silicon strip CT detectors can potentially be used to increase the signal-to-noise-ratio and energy resolution by helping in identifying Compton scattered photons in the detector.

Constrained one-step material decomposition reconstruction of head CT data from a silicon photon-counting prototype.

BACKGROUND: Spectral CT material decomposition provides quantitative information but is challenged by the instability of the inversion into basis materials. We have previously proposed the constrained One-Step Spectral CT Image Reconstruction (cOSSCIR) algorithm to stabilize the material decomposition inversion by directly estimating basis material images from spectral CT data. cOSSCIR was previously investigated on phantom data. PURPOSE: This study investigates the performance of cOSSCIR using head CT datasets acquired on a clinical photon-counting CT (PCCT) prototype. This is the first investigation of cOSSCIR for large-scale, anatomically complex, clinical PCCT data. The cOSSCIR decomposition is preceded by a spectrum estimation and nonlinear counts correction calibration step to address nonideal detector effects. METHODS: Head CT data were acquired on an early prototype clinical PCCT system using an edge-on silicon detector with eight energy bins. Calibration data of a step wedge phantom were also acquired and used to train a spectral model to account for the source spectrum and detector spectral response, and also to train a nonlinear counts correction model to account for pulse pileup effects. The cOSSCIR algorithm optimized the bone and adipose basis images directly from the photon counts data, while placing a grouped total variation (TV) constraint on the basis images. For comparison, basis images were also reconstructed by a two-step projection-domain approach of Maximum Likelihood Estimation (MLE) for decomposing basis sinograms, followed by filtered backprojection (MLE + FBP) or a TV minimization algorithm (MLE + TVmin ) to reconstruct basis images. We hypothesize that the cOSSCIR approach will provide a more stable inversion into basis images compared to two-step approaches. To investigate this hypothesis, the noise standard deviation in bone and soft-tissue regions of interest (ROIs) in the reconstructed images were compared between cOSSCIR and the two-step methods for a range of regularization constraint settings. RESULTS: cOSSCIR reduced the noise standard deviation in the basis images by a factor of two to six compared to that of MLE + TVmin , when both algorithms were constrained to produce images with the same TV. The cOSSCIR images demonstrated qualitatively improved spatial resolution and depiction of fine anatomical detail. The MLE + TVmin algorithm resulted in lower noise standard deviation than cOSSCIR for the virtual monoenergetic images (VMIs) at higher energy levels and constraint settings, while the cOSSCIR VMIs resulted in lower noise standard deviation at lower energy levels and overall higher qualitative spatial resolution. There were no statistically significant differences in the mean values within the bone region of images reconstructed by the studied algorithms. There were statistically significant differences in the mean values within the soft-tissue region of the reconstructed images, with cOSSCIR producing mean values closer to the expected values. CONCLUSIONS: The cOSSCIR algorithm, combined with our previously proposed spectral model estimation and nonlinear counts correction method, successfully estimated bone and adipose basis images from high resolution, large-scale patient data from a clinical PCCT prototype. The cOSSCIR basis images were able to depict fine anatomical details with a factor of two to six reduction in noise standard deviation compared to that of the MLE + TVmin two-step approach.

Two-view and single-view tomosynthesis versus full-field digital mammography: high-resolution X-ray imaging observer study.

PURPOSE: To compare the diagnostic accuracy of two-dimensional (2D) full-field digital mammography with that of two-view (mediolateral and craniocaudal) and single-view (mediolateral oblique) tomosynthesis in an observer study involving two institutions. MATERIALS AND METHODS: Ethical committee approval was obtained. All participating women gave informed consent. Two hundred twenty women (mean age, 56.3; range, 40-80 years) with breast density of 2-4 according to American College of Radiology criteria were recruited between November 2008 and September 2009 and underwent standard treatment plus tomosynthesis with a prototype photon-counting machine. After exclusion criteria were met, this resulted in a final test set of 130 women. Ten accredited readers classified the 130 cases (40 cancers, 24 benign lesions, and 66 normal images) using 2D mammography and two-view tomosynthesis. Another 10 readers reviewed the same cases using 2D mammography but single-view tomosynthesis. The multireader, multicase receiver operating characteristic (ROC) method was applied. The significance of the observed difference in accuracy between 2D mammography and tomosynthesis was calculated. RESULTS: For diagnostic accuracy, 2D mammography performed significantly worse than two-view tomosynthesis (average area under ROC curve [AUC] = 0.772 for 2D, AUC = 0.851 for tomosynthesis, P = .021). Significant differences were found for both masses and microcalcification (P = .037 and .049). The difference in AUC between the two modalities of -0.110 was significant (P = .03) only for the five readers with the least experience (<10 years of reading); with AUC of -0.047 for the five readers with 10 years or more experience (P = .25). No significant difference (P = .79) in reader performance was seen when 2D mammography (average AUC = 0.774) was compared with single-view tomosynthesis (average AUC = 0.775). CONCLUSION: Two-view tomosynthesis outperforms 2D mammography but only for readers with the least experience. The benefits were seen for both masses and microcalcification. No differences in classification accuracy was seen between and 2D mammography and single-view tomosynthesis.

Ideal-observer detectability in photon-counting differential phase-contrast imaging using a linear-systems approach.

PURPOSE: To provide a cascaded-systems framework based on the noise-power spectrum (NPS), modulation transfer function (MTF), and noise-equivalent number of quanta (NEQ) for quantitative evaluation of differential phase-contrast imaging (Talbot interferometry) in relation to conventional absorption contrast under equal-dose, equal-geometry, and, to some extent, equal-photon-economy constraints. The focus is a geometry for photon-counting mammography. METHODS: Phase-contrast imaging is a promising technology that may emerge as an alternative or adjunct to conventional absorption contrast. In particular, phase contrast may increase the signal-difference-to-noise ratio compared to absorption contrast because the difference in phase shift between soft-tissue structures is often substantially larger than the absorption difference. We have developed a comprehensive cascaded-systems framework to investigate Talbot interferometry, which is a technique for differential phase-contrast imaging. Analytical expressions for the MTF and NPS were derived to calculate the NEQ and a task-specific ideal-observer detectability index under assumptions of linearity and shift invariance. Talbot interferometry was compared to absorption contrast at equal dose, and using either a plane wave or a spherical wave in a conceivable mammography geometry. The impact of source size and spectrum bandwidth was included in the framework, and the trade-off with photon economy was investigated in some detail. Wave-propagation simulations were used to verify the analytical expressions and to generate example images. RESULTS: Talbot interferometry inherently detects the differential of the phase, which led to a maximum in NEQ at high spatial frequencies, whereas the absorption-contrast NEQ decreased monotonically with frequency. Further, phase contrast detects differences in density rather than atomic number, and the optimal imaging energy was found to be a factor of 1.7 higher than for absorption contrast. Talbot interferometry with a plane wave increased detectability for 0.1-mm tumor and glandular structures by a factor of 3-4 at equal dose, whereas absorption contrast was the preferred method for structures larger than ∼0.5 mm. Microcalcifications are small, but differ from soft tissue in atomic number more than density, which is favored by absorption contrast, and Talbot interferometry was barely beneficial at all within the resolution limit of the system. Further, Talbot interferometry favored detection of "sharp" as opposed to "smooth" structures, and discrimination tasks by about 50% compared to detection tasks. The technique was relatively insensitive to spectrum bandwidth, whereas the projected source size was more important. If equal photon economy was added as a restriction, phase-contrast efficiency was reduced so that the benefit for detection tasks almost vanished compared to absorption contrast, but discrimination tasks were still improved close to a factor of 2 at the resolution limit. CONCLUSIONS: Cascaded-systems analysis enables comprehensive and intuitive evaluation of phase-contrast efficiency in relation to absorption contrast under requirements of equal dose, equal geometry, and equal photon economy. The benefit of Talbot interferometry was highly dependent on task, in particular detection versus discrimination tasks, and target size, shape, and material. Requiring equal photon economy weakened the benefit of Talbot interferometry in mammography.

Compton coincidence in silicon photon-counting CT detectors.

Purpose: Compton interactions amount to a significant fraction of the registered counts in a silicon detector. In a Compton interaction, only a part of the photon energy is deposited and a single incident photon can result in multiple counts unless tungsten shielding is used. Deep silicon has proved to be a competitive material for photon-counting CT detectors, but to improve the performance further, one possibility is to use coincidence techniques to identify Compton-scattered photons and reconstruct their incident energies. Approach: In a detector with no tungsten shielding, incident photons can interact through a series of interactions. Based on the position and energy of each interaction, probability-based methods can be used to estimate the incident photon energy. Here, we present a maximum likelihood estimation framework along with an alternative method to estimate the incident photon energy and position in a silicon detector. Results: Assuming one incident photon per time frame, we show that the incident photon energy can be estimated with a mean error of - 0.07 ± 0.03 keV and an RMS error of 3.36 ± 0.02 keV for a realistic case in which we assume a detector with limited energy and spatial resolution. The interaction position was estimated with a mean error of - 2 ± 11 µ m in x direction and 7 ± 11 µ m in y direction. Corresponding RMS errors of 1.09 ± 0.01 and 1.10 ± 0.01 mm were achieved in x and y , respectively. Conclusions: The presented results show the potential of using probability-based methods to improve the performance of silicon detectors for CT.

Science and practice of imaging physics through 50 years of SPIE Medical Imaging conferences.

Purpose: For 50 years now, SPIE Medical Imaging (MI) conferences have been the premier forum for disseminating and sharing new ideas, technologies, and concepts on the physics of MI. Approach: Our overarching objective is to demonstrate and highlight the major trajectories of imaging physics and how they are informed by the community and science present and presented at SPIE MI conferences from its inception to now. Results: These contributions range from the development of image science, image quality metrology, and image reconstruction to digital x-ray detectors that have revolutionized MI modalities including radiography, mammography, fluoroscopy, tomosynthesis, and computed tomography (CT). Recent advances in detector technology such as photon-counting detectors continue to enable new capabilities in MI. Conclusion: As we celebrate the past 50 years, we are also excited about what the next 50 years of SPIE MI will bring to the physics of MI.

Development of low-dose photon-counting contrast-enhanced tomosynthesis with spectral imaging.

PURPOSE: To demonstrate the feasibility of low-dose photon-counting tomosynthesis in combination with a contrast agent (contrast material-enhanced tomographic mammography) for the differentiation of breast cancer. MATERIALS AND METHODS: All studies were approved by the institutional review board, and all patients provided written informed consent. A phantom model with wells of iodinated contrast material (3 mg of iodine per milliliter) 1, 2, 5, 10, and 15 mm in diameter was assessed. Nine patients with malignant lesions and one with a high-risk lesion (atypical papilloma) were included (all women; mean age, 60.7 years). A multislit photon-counting tomosynthesis system was utilized (spectral imaging) to produce both low- and high-energy tomographic data (below and above the k edge of iodine, respectively) in a single scan, which allowed for dual-energy visualization of iodine. Images were obtained prior to contrast material administration and 120 and 480 seconds after contrast material administration. Four readers independently assessed the images along with conventional mammograms, ultrasonographic images, and magnetic resonance images. Glandular dose was estimated. RESULTS: Contrast agent was visible in the phantom model with simulated spherical tumor diameters as small as 5 mm. The average glandular dose was measured as 0.42 mGy per complete spectral imaging tomosynthesis scan of one breast. Because there were three time points (prior to contrast medium administration and 120 and 480 seconds after contrast medium administration), this resulted in a total dose of 1.26 mGy for the whole procedure in the breast with the abnormality. Seven of 10 cases were categorized as Breast Imaging Reporting and Data System score of 4 or higher by all four readers when reviewing spectral images in combination with mammograms. One lesion near the chest wall was not captured on the spectral image because of a positioning problem. CONCLUSION: The use of contrast-enhanced tomographic mammography has been demonstrated successfully in patients with promising diagnostic benefit. Further studies are necessary to fully assess diagnostic sensitivity and specificity.

Large-aperture focusing of high-energy x rays with a rolled polyimide film.

We describe a point-focusing x-ray lens made of a rolled polyimide film with etched prisms. The resulting lens is a cylinder with a large number of prisms forming an internal conic structure. The method allows for the manufacturing of lenses with large apertures and short focal lengths, for energies up to at least 100 keV. In order to evaluate the concept, we have hand-rolled a few lenses and evaluated them at a synchrotron source. The measured performance of the prototype is promising, and deviations from the theoretical limits are quantitatively explained.

Photon-counting x-ray detectors for CT.

The introduction of photon-counting detectors is expected to be the next major breakthrough in clinical x-ray computed tomography (CT). During the last decade, there has been considerable research activity in the field of photon-counting CT, in terms of both hardware development and theoretical understanding of the factors affecting image quality. In this article, we review the recent progress in this field with the intent of highlighting the relationship between detector design considerations and the resulting image quality. We discuss detector design choices such as converter material, pixel size, and readout electronics design, and then elucidate their impact on detector performance in terms of dose efficiency, spatial resolution, and energy resolution. Furthermore, we give an overview of data processing, reconstruction methods and metrics of imaging performance; outline clinical applications; and discuss potential future developments.

1-µm spatial resolution in silicon photon-counting CT detectors.

Purpose: Spatial resolution for current scintillator-based computed tomography (CT) detectors is limited by the pixel size of about 1 mm. Direct conversion photon-counting detector prototypes with silicon- or cadmium-based detector materials have lately demonstrated spatial resolution equivalent to about 0.3 mm. We propose a development of the deep silicon photon-counting detector which will enable a resolution of 1 µ m , a substantial improvement compared to the state of the art. Approach: With the deep silicon sensor, it is possible to integrate CMOS electronics and reduce the pixel size at the same time as significant on-sensor data processing capability is introduced. A Gaussian curve can then be fitted to the charge cloud created in each interaction.We evaluate the feasibility of measuring the charge cloud shape of Compton interactions for deep silicon to increase the spatial resolution. By combining a Monte Carlo photon simulation with a charge transport model, we study the charge cloud distributions and induced currents as functions of the interaction position. For a simulated deep silicon detector with a pixel size of 12 µ m , we present a method for estimating the interaction position. Results: Using estimations for electronic noise and a lowest threshold of 0.88 keV, we obtain a spatial resolution equivalent to 1.37 µ m in the direction parallel to the silicon wafer and 78.28 µ m in the direction orthogonal to the wafer. Conclusions: We have presented a simulation study of a deep silicon detector with a pixel size of 12 × 500 µ m 2 and a method to estimate the x-ray interaction position with ultra-high resolution. Higher spatial resolution can in general be important to detect smaller details in the image. The very high spatial resolution in one dimension could be a path to a practical implementation of phase contrast imaging in CT.

Contrast-enhanced spectral mammography with a photon-counting detector.

PURPOSE: Spectral imaging is a method in medical x-ray imaging to extract information about the object constituents by the material-specific energy dependence of x-ray attenuation. The authors have investigated a photon-counting spectral imaging system with two energy bins for contrast-enhanced mammography. System optimization and the potential benefit compared to conventional non-energy-resolved absorption imaging was studied. METHODS: A framework for system characterization was set up that included quantum and anatomical noise and a theoretical model of the system was benchmarked to phantom measurements. RESULTS: Optimal combination of the energy-resolved images corresponded approximately to minimization of the anatomical noise, which is commonly referred to as energy subtraction. In that case, an ideal-observer detectability index could be improved close to 50% compared to absorption imaging in the phantom study. Optimization with respect to the signal-to-quantum-noise ratio, commonly referred to as energy weighting, yielded only a minute improvement. In a simulation of a clinically more realistic case, spectral imaging was predicted to perform approximately 30% better than absorption imaging for an average glandularity breast with an average level of anatomical noise. For dense breast tissue and a high level of anatomical noise, however, a rise in detectability by a factor of 6 was predicted. Another approximately 70%-90% improvement was found to be within reach for an optimized system. CONCLUSIONS: Contrast-enhanced spectral mammography is feasible and beneficial with the current system, and there is room for additional improvements. Inclusion of anatomical noise is essential for optimizing spectral imaging systems.

Silicon photon-counting detector for full-field CT using an ASIC with adjustable shaping time.

Purpose: Photon-counting silicon strip detectors are attracting interest for use in next-generation CT scanners. For CT detectors in a clinical environment, it is desirable to have a low power consumption. However, decreasing the power consumption leads to higher noise. This is particularly detrimental for silicon detectors, which require a low noise floor to obtain a good dose efficiency. The increase in noise can be mitigated using a longer shaping time in the readout electronics. This also results in longer pulses, which requires an increased deadtime, thereby degrading the count-rate performance. However, as the photon flux varies greatly during a typical CT scan, not all projection lines require a high count-rate capability. We propose adjusting the shaping time to counteract the increased noise that results from decreasing the power consumption. Approach: To show the potential of increasing the shaping time to decrease the noise level, synchrotron measurements were performed using a detector prototype with two shaping time settings. From the measurements, a simulation model was developed and used to predict the performance of a future channel design. Results: Based on the synchrotron measurements, we show that increasing the shaping time from 28.1 to 39.4 ns decreases the noise and increases the signal-to-noise ratio with 6.5% at low count rates. With the developed simulation model, we predict that a 50% decrease in power can be attained in a proposed future detector design by increasing the shaping time with a factor of 1.875. Conclusion: Our results show that the shaping time can be an important tool to adapt the pulse length and noise level to the photon flux and thereby optimize the dose efficiency of photon-counting silicon detectors.

A low-absorption x-ray energy filter for small-scale applications.

We present an experimental and theoretical evaluation of an x-ray energy filter based on the chromatic properties of a prism-array lens (PAL). It is intended for small-scale applications such as medical imaging. The PAL approximates a Fresnel lens and allows for high efficiency compared to filters based on ordinary refractive lenses, however at the cost of a lower energy resolution. Geometrical optics was found to provide a good approximation for the performance of a flawless lens, but a field-propagation model was used for quantitative predictions. The model predicted a 0.29 E/E energy resolution and an intensity gain of 6.5 for a silicon PAL at 23.5 keV. Measurements with an x-ray tube showed good agreement with the model in energy resolution and peak energy, but a blurred focal line contributed to a 29% gain reduction. We believe the blurring to be caused mainly by lens imperfections, in particular at the periphery of the lens.

An efficient pre-object collimator based on an x-ray lens.

A multiprism lens (MPL) is a refractive x-ray lens with one-dimensional focusing properties. If used as a pre-object collimator in a scanning system for medical x-ray imaging, it reduces the divergence of the radiation and improves on photon economy compared to a slit collimator. Potential advantages include shorter acquisition times, a reduced tube loading, or improved resolution. We present the first images acquired with a MPL in a prototype for a scanning mammography system. The lens showed a gain of flux of 1.32 compared to a slit collimator at equal resolution, or a gain in resolution of 1.31-1.44 at equal flux. We expect the gain of flux in a clinical setup with an optimized MPL and a custom-made absorption filter to reach 1.67, or 1.45-1.54 gain in resolution.

Resolution characterization of a silicon-based, photon-counting computed tomography prototype capable of patient scanning.

Photon-counting detectors are expected to bring a range of improvements to patient imaging with x-ray computed tomography (CT). One is higher spatial resolution. We demonstrate the resolution obtained using a commercial CT scanner where the original energy-integrating detector has been replaced by a single-slice, silicon-based, photon-counting detector. This prototype constitutes the first full-field-of-view silicon-based CT scanner capable of patient scanning. First, the pixel response function and focal spot profile are measured and, combining the two, the system modulation transfer function is calculated. Second, the prototype is used to scan a resolution phantom and a skull phantom. The resolution images are compared to images from a state-of-the-art CT scanner. The comparison shows that for the prototype 19 lp / cm are detectable with the same clarity as 14 lp / cm on the reference scanner at equal dose and reconstruction grid, with more line pairs visible with increasing dose and decreasing image pixel size. The high spatial resolution remains evident in the anatomy of the skull phantom and is comparable to that of other photon-counting CT prototypes present in the literature. We conclude that the deep silicon-based detector used in our study could provide improved spatial resolution in patient imaging without increasing the x-ray dose.

Count statistics of nonparalyzable photon-counting detectors with nonzero pulse length.

PURPOSE: Photon-counting detectors are expected to be the next big step in the development of medical computed tomography (CT). Accurate modeling of the behavior of photon-counting detectors in both low and high count rate regimes is important for accurate image reconstruction and detector performance evaluations. The commonly used ideal nonparalyzable (delta pulse) model is built on crude assumptions that make it unsuitable for predicting the behavior of photon-counting detectors at high count rates. The aim of this work is to present an analytical count statistics model that better describes the behavior of photon-counting detectors with nonzero pulse length. METHODS: An analytical statistical count distribution model for nonparalyzable detectors with nonzero pulse length is derived using tools from statistical analysis. To validate the model, a nonparalyzable photon-counting detector is simulated using Monte Carlo methods and compared against. Image performance metrics are computed using the Fisher information metric and a comparison between the proposed model, approximations of the proposed model, and those made by the ideal nonparalyzable model is presented and analyzed. RESULTS: It is shown that the presented model agrees well with the results from the Monte Carlo simulation and is stable for varying x-ray beam qualities. It is also shown that a simple Gaussian approximation of the distribution can be used to accurately model the behavior and performance of nonparalyzable detectors with nonzero pulse length. Furthermore, the comparison of performance metrics show that the proposed model predicts a very different behavior than the ideal nonparalyzable detector model, suggesting that the proposed model can fill an important gap in the understanding of pileup effects. CONCLUSIONS: An analytical model for the count statistics of a nonparalyzable photon-counting detector with nonzero pulse length is presented. The model agrees well with results obtained from Monte Carlo simulations and can be used to improve, speed up and simplify modeling of photon-counting detectors.