Anastasios C. Konstantinidis

A non-free-space propagation x-ray phase contrast imaging method sensitive to phase effects in two directions simultaneously

We present an x-ray phase contrast imaging method based on coded apertures sensitive to phase effects in two directions simultaneously. To date, this is the only non-free-space propagation approach with this capability. Whereas the use of free-space propagation methods is limited to synchrotron radiation or microfocal x-ray sources, which impose severe limits in terms of practical applicability, coded-aperture based methods have been shown to provide synchrotronlike phase contrast enhancements with conventional x-ray sources. A two-directional sensitive method working with conventional sources could create a breakthrough in medical imaging, where two-directional sensitivity is often a mandatory requirement.

DynAMITe: a wafer scale sensor for biomedical applications

In many biomedical imaging applications Flat Panel Imagers (FPIs) are currently the most common option. However, FPIs possess several key drawbacks such as large pixels, high noise, low frame rates, and excessive image artefacts. Recently Active Pixel Sensors (APS) have gained popularity overcoming such issues and are now scalable up to wafer size by appropriate reticule stitching. Detectors for biomedical imaging applications require high spatial resolution, low noise and high dynamic range. These figures of merit are related to pixel size and as the pixel size is fixed at the time of the design, spatial resolution, noise and dynamic range cannot be further optimized. The authors report on a new rad-hard monolithic APS, named DynAMITe (Dynamic range Adjustable for Medical Imaging Technology), developed by the UK MI-3 Plus consortium. This large area detector (12.8 cm × 12.8 cm) is based on the use of two different diode geometries within the same pixel array with different size pixels (50 μm and 100 μm). Hence the resulting device can possess two inherently different resolutions each with different noise and saturation performance. The small and the large pixel cameras can be reset at different voltages, resulting in different depletion widths. The larger depletion width for the small pixels allows the initial generated photo-charge to be promptly collected, which ensures an intrinsically lower noise and higher spatial resolution. After these pixels reach near saturation, the larger pixels start collecting so offering a higher dynamic range whereas the higher noise floor is not important as at higher signal levels performance is governed by the Poisson noise of the incident radiation beam. The overall architecture and detailed characterization of DynAMITe will be presented in this paper.

Luminescence Emission Properties of

LYSO:Ce and LuYAP:Ce are single crystal non-hygroscopic scintillators of high density, high light yield and short decay time, which have been successfully used in small animal PET imagers. In the present study, the luminescence emission properties of (Lu0.9, Y0.1)2SiO5:Ce (LYSO:Ce) and (Lu0.7, Y0.3)AIO3:Ce (LuYAP:Ce) crystals were investigated for use in X-ray medical imaging. Both crystals had dimensions of 2 times 2 times 8 mm3, with all surfaces polished. Evaluation was performed by determining the X-ray luminescence efficiency (XLE) (emitted light energy flux over incident X-ray energy flux) and the detector optical gain (DOG) (emitted light photons per incident x-ray photon) in a wide range of X-ray energies employed in mammography (22-49 kVp) and in general X-ray imaging (50-140 kVp). Measurements were performed using an experimental set-up based on a photomultiplier coupled to an integration sphere. The emission spectrum under X-ray excitation was measured using an optical grating monochromator to determine the spectral compatibility to various optical photon detectors incorporated in medical imaging detectors. Optical characteristics such as transmission and absorption spectra were investigated in addition to the scintillation properties. The light emission performance of the two scintillation materials studied was found adequately high for X-ray imaging.

({\rm Lu},{\rm Y})_{2}{\rm SiO}_{5}

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.

:Ce (LYSO:Ce) and

Wafer-scale CMOS active pixel sensors (APSs) have been developed recently for x-ray imaging applications. The small pixel pitch and low noise are very promising properties for medical imaging applications such as digital breast tomosynthesis (DBT). In this work, we evaluated experimentally and through modeling the imaging properties of a 50 μm pixel pitch CMOS APS x-ray detector named DynAMITe (Dynamic Range Adjustable for Medical Imaging Technology). A modified cascaded system model was developed for CMOS APS x-ray detectors by taking into account the device nonlinear signal and noise properties. The imaging properties such as modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE) were extracted from both measurements and the nonlinear cascaded system analysis. The results show that the DynAMITe x-ray detector achieves a high spatial resolution of 10 mm(-1) and a DQE of around 0.5 at spatial frequencies  <1 mm(-1). In addition, the modeling results were used to calculate the image signal-to-noise ratio (SNRi) of microcalcifications at various mean glandular dose (MGD). For an average breast (5 cm thickness, 50% glandular fraction), 165 μm microcalcifications can be distinguished at a MGD of 27% lower than the clinical value (~1.3 mGy). To detect 100 μm microcalcifications, further optimizations of the CMOS APS x-ray detector, image aquisition geometry and image reconstruction techniques should be considered.

({\rm Lu},{\rm Y}){\rm AlO}_{3}

Digital detectors based on complementary metal-oxide-semiconductors (CMOS) active pixel sensor (APS) technology have been introduced recently in many scientific applications. This work is focused on the X-ray performance evaluation of a novel CMOS APS detector in low energy medical imaging applications using monochromatic synchrotron radiation (i.e., 17-35 keV), which also allows studying how the performance varies with energy. The CMOS sensor was coupled to a Thallium-activated structured cesium iodide (CsI:Tl) scintillator and the detectors X-ray performance evaluation was carried out in terms of sensitivity, presampling modulation transfer function (pMTF), normalized noise power spectrum (NNPS) and the resulting detective quantum efficiency (DQE). A Monte Carlo simulation was used to validate the experimentally measured low frequency DQE. Finally, the effect of iodines secondary generated K-fluorescence X-rays on pMTF and DQE results was evaluated. Good agreement (within 5%) was observed between the Monte Carlo and experimentally measured low frequency DQE results. A CMOS APS detector was characterized for the first time over a wide range of low energies covering the mammographic spectra. The detectors performance is limited mainly by the detectability of the scintillator. Finally, we show that the current data could be used to calculate the detectors pMTF, NNPS and DQE for any mammographic spectral shape within the investigated energies.

:Ce (LuYAP:Ce) Single Crystal Scintillators Under Medical Imaging Conditions

The SYRMEP (SYnchrotron Radiation for MEdical Physics) beamline at Elettra is performing the first mammography study on human patients using free-space propagation phase contrast imaging. The stricter spatial resolution requirements of this method currently force the use of conventional films or specialized computed radiography (CR) systems. This also prevents the implementation of three-dimensional (3D) approaches. This paper explores the use of an X-ray detector based on complementary metal-oxide-semiconductor (CMOS) active pixel sensor (APS) technology as a possible alternative, for acquisitions both in planar and tomosynthesis geometry. Results indicate higher quality of the images acquired with the synchrotron set-up in both geometries. This improvement can be partly ascribed to the use of parallel, collimated and monochromatic synchrotron radiation (resulting in scatter rejection, no penumbra-induced blurring and optimized X-ray energy), and partly to phase contrast effects. Even though the pixel size of the used detector is still too large - and thus suboptimal - for free-space propagation phase contrast imaging, a degree of phase-induced edge enhancement can clearly be observed in the images.

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

Breast tomosynthesis is a promising technology for breast imaging Although existing tomosynthesis systems using detector technology developed for FFDM and uniform acquisition parameters have demonstrated the potential to improve the effectiveness of breast screening, the full potential of tomosynthesis is yet to be realised The effectiveness of tomosynthesis depends on multiple factors, including acquisition geometry, number of projections, reconstruction software and X-ray detector performance In this study, the authors investigated the use of a specially designed 29 cm x 23 cm CMOS flat panel X-ray detector with a novel Active Pixel Sensor with high spatial resolution, high speed read-out, low noise, negligible image lag and a unique ability to reconfigure imaging parameters such as resolution and gain during an acquisition Advanced tomosynthesis acquisition methods were used with the new detector including non-uniform spacing of projection views This combination of optimised X-ray detector and optimised acquisition methods provides enhanced imaging performance.

50 μm pixel pitch wafer-scale CMOS active pixel sensor x-ray detector for digital breast tomosynthesis

X-ray diffraction studies are used to identify specific materials. Several laboratory-based x-ray diffraction studies were made for breast cancer diagnosis. Ideally a large area, low noise, linear and wide dynamic range digital x-ray detector is required to perform x-ray diffraction measurements. Recently, digital detectors based on Complementary Metal-Oxide- Semiconductor (CMOS) Active Pixel Sensor (APS) technology have been used in x-ray diffraction studies. Two APS detectors, namely Vanilla and Large Area Sensor (LAS), were developed by the Multidimensional Integrated Intelligent Imaging (MI-3) consortium to cover a range of scientific applications including x-ray diffraction. The MI-3 Plus consortium developed a novel large area APS, named as Dynamically Adjustable Medical Imaging Technology (DynAMITe), to combine the key characteristics of Vanilla and LAS with a number of extra features. The active area (12.8 × 13.1 cm2) of DynaMITe offers the ability of angle dispersive x-ray diffraction (ADXRD). The current study demonstrates the feasibility of using DynaMITe for breast cancer diagnosis by identifying six breast-equivalent plastics. Further work will be done to optimize the system in order to perform ADXRD for identification of suspicious areas of breast tissue following a conventional mammogram taken with the same sensor.

X-ray Performance Evaluation of the Dexela CMOS APS X-ray Detector Using Monochromatic Synchrotron Radiation in the Mammographic Energy Range

High-resolution, low-noise x-ray detectors based on the complementary metal-oxide-semiconductor (CMOS) active pixel sensor (APS) technology have been developed and proposed for digital breast tomosynthesis (DBT). In this study, we evaluated the three-dimensional (3D) imaging performance of a 50 µm pixel pitch CMOS APS x-ray detector named DynAMITe (Dynamic Range Adjustable for Medical Imaging Technology). The two-dimensional (2D) angle-dependent modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE) were experimentally characterized and modeled using the cascaded system analysis at oblique incident angles up to 30°. The cascaded system model was extended to the 3D spatial frequency space in combination with the filtered back-projection (FBP) reconstruction method to calculate the 3D and in-plane MTF, NNPS and DQE parameters. The results demonstrate that the beam obliquity blurs the 2D MTF and DQE in the high spatial frequency range. However, this effect can be eliminated after FBP image reconstruction. In addition, impacts of the image acquisition geometry and detector parameters were evaluated using the 3D cascaded system analysis for DBT. The result shows that a wider projection angle range (e.g.  ±30°) improves the low spatial frequency (below 5 mm-1) performance of the CMOS APS detector. In addition, to maintain a high spatial resolution for DBT, a focal spot size of smaller than 0.3 mm should be used. Theoretical analysis suggests that a pixelated scintillator in combination with the 50 µm pixel pitch CMOS APS detector could further improve the 3D image resolution. Finally, the 3D imaging performance of the CMOS APS and an indirect amorphous silicon (a-Si:H) thin-film transistor (TFT) passive pixel sensor (PPS) detector was simulated and compared.