Portable Single-Exposure Dual-Energy X-ray Detector for Improved Point-of-Care Diagnostic Imaging.

INTRODUCTION: Dual-energy subtraction (DES) imaging is well known to reduce anatomical noise and enable material classification. The current approaches to DES imaging have trade-offs, such as motion artifacts, low sensitivity because of losses in a mid-filter, and lack of portability. Recently, a portable triple-layer flat-panel detector (FPD) was proposed for use in single-shot DES imaging that can provide improved sensitivity and removal of motion artifacts in a point-of-care setting. The purpose of this study is to evaluate the feasibility of such a detector. Various image quality metrics and clinical images are provided. MATERIALS AND METHODS: An FDA-cleared single-exposure DES FPD consisting of three stacked sensors was used for all measurements. This detector generates three images per exposure: A digital radiography (DR) image, i.e., as would be produced with a conventional detector, and two DES images, bone and soft tissue. To evaluate DR image quality, detective quantum efficiency (DQE) and modulation transfer function were measured for multiple radiation quality beams. Digital radiography and DES images obtained from this FPD were evaluated in previously reported fixed and portable clinical studies. Digital radiography and DES images from case studies are presented for qualitative assessment. RESULTS: Modulation transfer function and DQE were measured across multiple radiation quality beams for the DR image. The DES images showed good tissue separation and uniformity with no visible motion or alignment artifacts. The DES images, when read in conjunction with the DR image, resulted in increased reader confidence and revealed abnormalities or details that were sometimes overlooked in the DR image. CONCLUSIONS: The proposed panel produces high-quality DR images as indicated by the DQE and modulation transfer function. The DES images have been shown to improve sensitivity in clinical applications and increase reader confidence. This detector can enable DES in portable or otherwise difficult applications, opening new doors for improved patient care.

Self-aligned multi-layer X-ray absorption grating using large-area fabrication methods for X-ray phase-contrast imaging.

X-ray phase-contrast (XPCi) imaging methods are an emerging medical imaging approach that provide significantly better soft tissue contrast and could function as a viable extension to conventional X-ray, CT, and even some MRI. Absorption gratings play a central role in grating-based XPCi systems, especially because they enable the acquisition of three images in a single exposure: transmission, refraction, and dark-field. An impediment to commercial development and adoption of XPCi imaging systems is the lack of large area, high aspect ratio absorption gratings. Grating technology development, primarily due to technological limitations, has lagged system development and today prevents the scaling up of XPCi system into a footprint and price point acceptable to the medical market. In this work, we report on a self-aligned multi-layer grating fabrication process that can enable large-area X-ray absorption gratings with micron-scale feature sizes. We leverage large-area fabrication techniques commonly employed by the thin-film transistor (TFT) display industry. Conventional ITO-on-glass substrates are used with a patterned film of Cr/Au/Cr that serves as a self-aligned lithography mask for backside exposure. Commonly available SU-8 photoresist is patterned using the backside exposure mask followed by an electroplating step to fill the gaps in the SU-8 with X-ray attenuating material. Consequently, the electroplated patterned material acts as a self-aligned photomask for subsequent SU-8 layer patterning and so forth. The repeatability of the reported process makes it suitable for achieving higher aspect ratio structures and is advantageous over previously reported X-ray LIGA approaches. A prototype three-layer grating, with a thickness of around [Formula: see text], having a visibility of 0.28 at [Formula: see text] with a [Formula: see text] active area was fabricated on a 4-inch glass substrate and demonstrated by modifying a commercially available 3D propagation-based XPCi Microscope. The scalable and cost-effective approach to build larger area X-ray gratings reported in this work can help expedite the commercial development and adoption of previously reported Talbot-Lau, speckle-tracking, as well as coded-aperture XPCi systems for large-area clinical and industrial applications.

Direct Conversion X-ray Detector with Micron-Scale Pixel Pitch for Edge-Illumination and Propagation-Based X-ray Phase-Contrast Imaging.

In this work, we investigate the potential of employing a direct conversion integration mode X-ray detector with micron-scale pixels in two different X-ray phase-contrast imaging (XPCi) configurations, propagation-based (PB) and edge illumination (EI). Both PB-XPCi and EI-XPCi implementations are evaluated through a wave optics model-numerically simulated in MATLAB-and are compared based on their contrast, edge-enhancement, visibility, and dose efficiency characteristics. The EI-XPCi configuration, in general, demonstrates higher performance compared to PB-XPCi, considering a setup with the same X-ray source and detector. However, absorption masks quality (thickness of X-ray absorption material) and environmental vibration effect are two potential challenges for EI-XPCi employing a detector with micron-scale pixels. Simulation results confirm that the behavior of an EI-XPCi system employing a high-resolution detector is susceptible to its absorption masks thickness and misalignment. This work demonstrates the potential and feasibility of employing a high-resolution direct conversion detector for phase-contrast imaging applications where higher dose efficiency, higher contrast images, and a more compact imaging system are of interest.

High-energy micrometre-scale pixel direct conversion X-ray detector.

The objective of this work was to fabricate and characterize a new X-ray imaging detector with micrometre-scale pixel dimensions (7.8 µm) and high detection efficiency for hard X-ray energies above 20 keV. A key technology component consists of a monolithic hybrid detector built by direct deposition of an amorphous selenium film on a custom designed CMOS readout integrated circuit. Characterization was carried out at the synchrotron beamline 1-BM-B at the Advanced Photon Source of Argonne National Laboratory. The direct conversion detector demonstrated micrometre-scale spatial resolution with a 63 keV modulation transfer function of 10% at Nyquist frequency. In addition, spatial resolving power down to 8 µm was determined by imaging a transmission bar target at 21 keV. X-ray signal linearity, responsivity and lag were also characterized in the same energy range. Finally, phase contrast edge enhancement was observed in a phase object placed in the beam path. This amorphous selenium/CMOS detector technology can address gaps in commercially available X-ray detectors which limit their usefulness for existing synchrotron applications at energies greater than 50 keV; for example, phase contrast tomography and high-resolution imaging of nanoscale lattice distortions in bulk crystalline materials using Bragg coherent diffraction imaging. The technology will also facilitate the creation of novel synchrotron imaging applications for X-ray energies at or above 20 keV.

MTF and DQE enhancement using an apodized-aperture x-ray detector design.

PURPOSE: Acquisition of high-quality x-ray images using low patient exposures requires detectors with high detective quantum efficiency (DQE). We describe a novel apodized-aperture pixel (AAP) design that increases high-frequency modulation transfer function (MTF) and DQE values. The AAP design makes a separation of physical sensor elements from image pixels by using very small sensor elements (e.g., 0.010-0.025 mm) to synthesize desired larger image pixels (e.g., 0.1-0.2 mm). METHODS: A cascaded systems model of signal and noise propagation is developed to describe the benefits of the AAP approach in terms of the MTF, Wiener noise power spectrum (NPS), and DQE. The theoretical model was validated experimentally using a CMOS/CsI detector with 0.05 mm sensor elements to synthesize 0.20 mm image pixels and a clinical Se detector with 0.07 mm sensor elements to synthesize 0.28 mm pixels. A Monte Carlo study and x-ray images of a star-pattern and rat leg are used to visually compare AAP images. RESULTS: When used with a high-resolution converter layer and sensor elements one quarter the size of image pixels, the MTF is increased by 53% and the DQE by a factor of 2.3× at the image sampling cut-off frequency. Both simulated and demonstration images show improved detectability of high-frequency content and removal of aliasing artifacts. Evidence of Gibbs ringing is sometimes seen near high-contrast edges. CONCLUSIONS: It is shown that the AAP approach preserves the MTF of the small sensor elements and attenuates frequencies above the image sampling cut-off frequency. This has the double benefit of improving the MTF while reducing both signal and noise aliasing, resulting in an increase of the DQE at high spatial frequencies. For optimal implementation, the converter layer must have very high spatial resolution and the detector must have low readout noise.

Technical Note: Detective quantum efficiency simulation of a-Se imaging detectors using ARTEMIS.

PURPOSE: This work studies the detective quantum efficiency (DQE) of a-Se-based solid state x-ray detectors for medical imaging applications using ARTEMIS, a Monte Carlo simulation tool for modeling x-ray photon, electron and charged carrier transport in semiconductors with the presence of applied electric field. METHODS: ARTEMIS is used to model the signal formation process in a-Se. The simulation model includes x-ray photon and high-energy electron interactions, and detailed electron-hole pair transport with applied detector bias taking into account drift, diffusion, Coulomb interactions, recombination and trapping. For experimental validation, the DQE performance of prototype a-Se detectors is measured following IEC Testing Standard 62220-1-3. RESULTS: Comparison of simulated and experimental DQE results show reasonable agreement for RQA beam qualities. Experimental validation demonstrated within 5% percentage difference between simulation and experimental DQE results for spatial frequency above 0.25 cycles/mm using uniform applied electric field for RQA beam qualities (RQA5, RQA7 and RQA9). Results include two different prototype detectors with thicknesses of 240 µm and 1 mm. CONCLUSIONS: ARTEMIS can be used to model the DQE of a-Se detectors as a function of x-ray energy, detector thickness, and spatial frequency. The ARTEMIS model can be used to improve understanding of the physics of x-ray interactions in a-Se and in optimization studies for the development of novel medical imaging applications.

Theoretical and Monte Carlo optimization of a stacked three-layer flat-panel x-ray imager for applications in multi-spectral medical imaging.

We propose a new design of a stacked three-layer flat-panel x-ray detector for dual-energy (DE) imaging. Each layer consists of its own scintillator of individual thickness and an underlying thin-film-transistor-based flat-panel. Three images are obtained simultaneously in the detector during the same x-ray exposure, thereby eliminating any motion artifacts. The detector operation is two-fold: a conventional radiography image can be obtained by combining all three layers' images, while a DE subtraction image can be obtained from the front and back layers' images, where the middle layer acts as a mid-filter that helps achieve spectral separation. We proceed to optimize the detector parameters for two sample imaging tasks that could particularly benefit from this new detector by obtaining the best possible signal to noise ratio per root entrance exposure using well-established theoretical models adapted to fit our new design. These results are compared to a conventional DE temporal subtraction detector and a single-shot DE subtraction detector with a copper mid-filter, both of which underwent the same theoretical optimization. The findings are then validated using advanced Monte Carlo simulations for all optimized detector setups. Given the performance expected from initial results and the recent decrease in price for digital x-ray detectors, the simplicity of the three-layer stacked imager approach appears promising to usher in a new generation of multi-spectral digital x-ray diagnostics.

Effect of burst and recombination models for Monte Carlo transport of interacting carriers in a-Se x-ray detectors on Swank noise.

PURPOSE: The authors describe the modification to a previously developed Monte Carlo model of semiconductor direct x-ray detector required for studying the effect of burst and recombination algorithms on detector performance. This work provides insight into the effect of different charge generation models for a-Se detectors on Swank noise and recombination fraction. METHODS: The proposed burst and recombination models are implemented in the Monte Carlo simulation package, ARTEMIS, developed by Fang et al. ["Spatiotemporal Monte Carlo transport methods in x-ray semiconductor detectors: Application to pulse-height spectroscopy in a-Se," Med. Phys. 39(1), 308-319 (2012)]. The burst model generates a cloud of electron-hole pairs based on electron velocity, energy deposition, and material parameters distributed within a spherical uniform volume (SUV) or on a spherical surface area (SSA). A simple first-hit (FH) and a more detailed but computationally expensive nearest-neighbor (NN) recombination algorithms are also described and compared. RESULTS: Simulated recombination fractions for a single electron-hole pair show good agreement with Onsager model for a wide range of electric field, thermalization distance, and temperature. The recombination fraction and Swank noise exhibit a dependence on the burst model for generation of many electron-hole pairs from a single x ray. The Swank noise decreased for the SSA compared to the SUV model at 4 V/µm, while the recombination fraction decreased for SSA compared to the SUV model at 30 V/µm. The NN and FH recombination results were comparable. CONCLUSIONS: Results obtained with the ARTEMIS Monte Carlo transport model incorporating drift and diffusion are validated with the Onsager model for a single electron-hole pair as a function of electric field, thermalization distance, and temperature. For x-ray interactions, the authors demonstrate that the choice of burst model can affect the simulation results for the generation of many electron-hole pairs. The SSA model is more sensitive to the effect of electric field compared to the SUV model and that the NN and FH recombination algorithms did not significantly affect simulation results.

Enhanced detection efficiency of direct conversion X-ray detector using polyimide as hole-blocking layer.

In this article we demonstrate the performance of a direct conversion amorphous selenium (a-Se) X-ray detector using biphenyldisnhydride/1,4 phenylenediamine (BPDA/PPD) polyimide (PI) as a hole-blocking layer. The use of a PI layer with a-Se allows detector operation at high electric fields (≥10 V/µm) while maintaining low dark current, without deterioration of transient performance. The hole mobility of the PI/a-Se device is measured by the time-of-flight method at different electric fields to investigate the effect of the PI layer on detector performance. It was found that hole mobility as high as 0.75 cm(2)/Vs is achievable by increasing the electric field in the PI/a-Se device structure. Avalanche multiplication is also shown to be achievable when using PI as a blocking layer. Increasing the electric field within a-Se reduces the X-ray ionization energy, increases hole mobility, and improves the dynamic range and sensitivity of the detector.

Evaluating noise reduction techniques while considering anatomical noise in dual-energy contrast-enhanced mammography.

PURPOSE: The authors describe modifications to previously developed cascaded systems analysis to include the anatomical noise in evaluation of dual-energy noise reduction techniques. Previous models have ignored the anatomical noise in theoretical analysis of noise reduction techniques. The inclusion of anatomical noise leads to more accurate estimation of potential noise reduction improvements and optimization. METHODS: The model is applied to dual-energy contrast-enhanced mammography. The effect of linear noise reduction filters on the anatomical noise is taken into account using cascaded systems analysis. The noise model is included in the ideal observer detectability for performance evaluation of the noise reduction techniques. RESULTS: Dual-energy image noise with and without including the effect of anatomical noise in noise reduction technique analysis is reported. The theoretical model is compared with clinical images from a previous dual-energy contrast enhanced mammography clinical study and good agreement is observed. The results suggest that the inclusion of anatomical noise in the evaluation and comparison of noise reduction techniques is highly warranted for more accurate analysis. CONCLUSIONS: This work establishes a useful extension to dual-energy cascaded systems analysis for maximizing image quality using noise reduction techniques. The extension includes the effect of linear image filtering, such as that used for noise reduction, on anatomical noise. The results suggest that the inclusion of anatomical noise in the evaluation of noise reduction techniques can lead to more accurate optimization, noise, and performance estimations.

Spatiotemporal Monte Carlo transport methods in x-ray semiconductor detectors: application to pulse-height spectroscopy in a-Se.

PURPOSE: The authors describe a detailed Monte Carlo (MC) method for the coupled transport of ionizing particles and charge carriers in amorphous selenium (a-Se) semiconductor x-ray detectors, and model the effect of statistical variations on the detected signal. METHODS: A detailed transport code was developed for modeling the signal formation process in semiconductor x-ray detectors. The charge transport routines include three-dimensional spatial and temporal models of electron-hole pair transport taking into account recombination and trapping. Many electron-hole pairs are created simultaneously in bursts from energy deposition events. Carrier transport processes include drift due to external field and Coulombic interactions, and diffusion due to Brownian motion. RESULTS: Pulse-height spectra (PHS) have been simulated with different transport conditions for a range of monoenergetic incident x-ray energies and mammography radiation beam qualities. Two methods for calculating Swank factors from simulated PHS are shown, one using the entire PHS distribution, and the other using the photopeak. The latter ignores contributions from Compton scattering and K-fluorescence. Comparisons differ by approximately 2% between experimental measurements and simulations. CONCLUSIONS: The a-Se x-ray detector PHS responses simulated in this work include three-dimensional spatial and temporal transport of electron-hole pairs. These PHS were used to calculate the Swank factor and compare it with experimental measurements. The Swank factor was shown to be a function of x-ray energy and applied electric field. Trapping and recombination models are all shown to affect the Swank factor.

Amorphous and polycrystalline photoconductors for direct conversion flat panel x-ray image sensors.

In the last ten to fifteen years there has been much research in using amorphous and polycrystalline semiconductors as x-ray photoconductors in various x-ray image sensor applications, most notably in flat panel x-ray imagers (FPXIs). We first outline the essential requirements for an ideal large area photoconductor for use in a FPXI, and discuss how some of the current amorphous and polycrystalline semiconductors fulfill these requirements. At present, only stabilized amorphous selenium (doped and alloyed a-Se) has been commercialized, and FPXIs based on a-Se are particularly suitable for mammography, operating at the ideal limit of high detective quantum efficiency (DQE). Further, these FPXIs can also be used in real-time, and have already been used in such applications as tomosynthesis. We discuss some of the important attributes of amorphous and polycrystalline x-ray photoconductors such as their large area deposition ability, charge collection efficiency, x-ray sensitivity, DQE, modulation transfer function (MTF) and the importance of the dark current. We show the importance of charge trapping in limiting not only the sensitivity but also the resolution of these detectors. Limitations on the maximum acceptable dark current and the corresponding charge collection efficiency jointly impose a practical constraint that many photoconductors fail to satisfy. We discuss the case of a-Se in which the dark current was brought down by three orders of magnitude by the use of special blocking layers to satisfy the dark current constraint. There are also a number of polycrystalline photoconductors, HgI(2) and PbO being good examples, that show potential for commercialization in the same way that multilayer stabilized a-Se x-ray photoconductors were developed for commercial applications. We highlight the unique nature of avalanche multiplication in a-Se and how it has led to the development of the commercial HARP video-tube. An all solid state version of the HARP has been recently demonstrated with excellent avalanche gains; the latter is expected to lead to a number of novel imaging device applications that would be quantum noise limited. While passive pixel sensors use one TFT (thin film transistor) as a switch at the pixel, active pixel sensors (APSs) have two or more transistors and provide gain at the pixel level. The advantages of APS based x-ray imagers are also discussed with examples.

Design and feasibility of active matrix flat panel detector using avalanche amorphous selenium for protein crystallography.

Protein crystallography is the most important technique for resolving the three-dimensional atomic structure of protein by measuring the intensity of its x-ray diffraction pattern. This work proposes a large area flat panel detector for protein crystallography based on direct conversion x-ray detection technique using avalanche amorphous selenium (a-Se) as the high gain photoconductor, and active matrix readout using amorphous silicon (a-Si:H) thin film transistors. The detector employs avalanche multiplication phenomenon of a-Se to make the detector sensitive to each incident x ray. The advantages of the proposed detector over the existing imaging plate and charge coupled device detectors are large area, high dynamic range coupled to single x-ray detection capability, fast readout, high spatial resolution, and inexpensive manufacturing process. The optimal detector design parameters (such as detector size, pixel size, and thickness of a-Se layer), and operating parameters (such as electric field across the a-Se layer) are determined based on the requirements for protein crystallography application. The performance of the detector is evaluated in terms of readout time (<1 s), dynamic range (approximately 10(5)), and sensitivity (approximately 1 x-ray photon), thus validating the detector's efficacy for protein crystallography.