Larry E. Antonuk

Active pixel imagers incorporating pixelâ level amplifiers based on polycrystallineâ silicon thinâ 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.

A review of electronic portal imaging devices (EPIDs)

On-line electronic portal imaging devices are beginning to come into clinical service in support of radiotherapy. A variety of technologies are being explored to provide real-time or near real-time images of patient anatomy within x-ray fields during treatment on linear accelerators. The availability of these devices makes it feasible to verify treatment portals with much greater frequency and clarity than with film. This article reviews the physics of high-energy imaging and describes the operation principles of the electronic portal imaging devices that are under development or are beginning to be used clinically.

Empirical and theoretical investigation of the noise performance of indirect detection, active matrix flat‐panel imagers (AMFPIs) for diagnostic radiology

Noise properties of active matrix, flat-panel imagers under conditions relevant to diagnostic radiology are investigated. These studies focus on imagers based upon arrays with pixels incorporating a discrete photodiode coupled to a thin-film transistor, both fabricated from hydrogenated amorphous silicon. These optically sensitive arrays are operated with an overlying x-ray converter to allow indirect detection of incident x rays. External electronics, including gate driver circuits and preamplification circuits, are also required to operate the arrays. A theoretical model describing the signal and noise transfer properties of the imagers under conditions relevant to diagnostic radiography, fluoroscopy, and mammography is developed. This frequency-dependent model is based upon a cascaded systems analysis wherein the imager is conceptually divided into a series of stages having intrinsic gain and spreading properties. Predictions from the model are compared with x-ray sensitivity and noise measurements obtained from individual pixels from an imager with a pixel format of 1536 x 1920 pixels at a pixel pitch of 127 microns. The model is shown to be in excellent agreement with measurements obtained with diagnostic x rays using various phosphor screens. The model is used to explore the potential performance of existing and hypothetical imagers for application in radiography, fluoroscopy, and mammography as a function of exposure, additive noise, and fill factor. These theoretical predictions suggest that imagers of this general design incorporating a CsI: Tl intensifying screen can be optimized to provide detective quantum efficiency (DQE) superior to existing screen-film and storage phosphor systems for general radiography and mammography. For fluoroscopy, the model predicts that with further optimization of a-Si:H imagers, DQE performance approaching that of the best x-ray image intensifier systems may be possible. The results of this analysis suggest strategies for future improvements of this imaging technology.

Signal, noise power spectrum, and detective quantum efficiency of indirect-detection flat-panel imagers for diagnostic radiology

The performance of an indirect-detection, active matrix flat-panel imager (FPI) at diagnostic energies is reported in terms of measured and theoretical signal size, noise power spectrum (NPS), and detective quantum efficiency (DQE). Based upon a 1536 x 1920 pixel, 127 microns pitch array of a-Si:H thin-film transistors and photodiodes, the FPI was developed as a prototype for examination of the potential of flat-panel technology in diagnostic x-ray imaging. The signal size per unit exposure (x-ray sensitivity) was measured for the FPI incorporating five commercially available Gd2O2S:Tb converting screens at energies 70-120 kVp. One-dimensional and two-dimensional NPS and DQE were measured for the FPI incorporating three such converters and as a function of the incident exposure. The measurements support the hypothesis that FPIs have significant potential for application in diagnostic radiology. A cascaded systems model that has shown good agreement with measured individual pixel signal and noise properties is employed to describe the performance of various FPI designs and configurations under a variety of diagnostic imaging conditions. Theoretical x-ray sensitivity, NPS, and DQE are compared to empirical results, and good agreement is observed in each case. The model is used to describe the potential performance of FPIs incorporating a recently developed, enhanced array that is commercially available and has been proposed for testing and application in diagnostic radiography and fluoroscopy. Under conditions corresponding to chest radiography, the analysis suggests that such systems can potentially meet or even exceed the DQE performance of existing technology, such as screen-film and storage phosphor systems; however, under conditions corresponding to general fluoroscopy, the typical exposure per frame is such that the DQE is limited by the total system gain and additive electronic noise. The cascaded systems analysis provides a valuable means of identifying the limiting stages of the imaging system, a tool for system optimization, and a guide for developing strategies of FPI design for various imaging applications.

Demonstration of megavoltage and diagnostic x-ray imaging with hydrogenated amorphous silicon arrays.

Flat-panel imagers consisting of the first large area, self-scanning, pixelated, solid-state arrays made with hydrogenated amorphous silicon (a-Si:H) are under development by the authors for applications in diagnostic x-ray and megavoltage radiotherapy imaging. The arrays, designated by the acronym MASDA for multi-element amorphous silicon detector array, consist of a two-dimensional array of a-Si:H photodiodes and thin-film transistors and are used in conjunction with scintillating materials. Imagers utilizing MASDA arrays offer a variety of advantages over existing technologies. This article presents initial megavoltage and diagnostic-quality x-ray images taken with several such arrays including the first examples of anatomical-phantom images. The external readout electronics and imaging techniques required to obtain such images are outlined, the construction, operation, and advantages of the arrays briefly reviewed, and the future potential of this new technology discussed.

Electronic portal imaging devices: a review and historical perspective of contemporary technologies and research

A review of electronic portal imaging devices (EPIDs) used in external beam, megavoltage radiation therapy is presented. The review consists of a brief introduction to the definition, role and clinical significance of portal imaging, along with a discussion of radiotherapy film systems and the motivations for EPIDs. This is followed by a summary of the challenges and constraints inherent to portal imaging along with a concise, historical review of the technologies that have been explored and developed. The paper then examines, in greater depth, the two first-generation technologies that have found widespread clinical use starting from the late 1980s. This is followed by a broad overview of the physics, operation, properties and advantages of active matrix, flat-panel, megavoltage imagers, presently being commercially introduced to clinical environments or expected to be introduced in the future. Finally, a survey of contemporary research efforts focused on improving portal imaging performance by addressing various weaknesses in existing commercial systems is presented.

Strategies to improve the signal and noise performance of active matrix, flat-panel imagers for diagnostic x-ray applications.

A theoretical investigation of factors limiting the detective quantum efficiency (DQE) of active matrix flat-panel imagers (AMFPIs), and of methods to overcome these limitations, is reported. At the higher exposure levels associated with radiography, the present generation of AMFPIs is capable of exhibiting DQE performance equivalent, or superior, to that of existing film-screen and computed radiography systems. However, at exposure levels commonly encountered in fluoroscopy, AMFPIs exhibit significantly reduced DQE and this problem is accentuated at higher spatial frequencies. The problem applies both to AMFPIs that rely on indirect detection as well as direct detection of the incident radiation. This reduced performance derives from the relatively large magnitude of the square of the total additive noise compared to the system gain for existing AMFPIs. In order to circumvent these restrictions, a variety of strategies to decrease additive noise and enhance system gain are proposed. Additive noise could be reduced through improved preamplifier, pixel and array design, including the incorporation of compensation lines to sample external line noise. System gain could be enhanced through the use of continuous photodiodes, pixel amplifiers, or higher gain x-ray converters such as lead iodide. The feasibility of these and other strategies is discussed and potential improvements to DQE performance are quantified through a theoretical investigation of a variety of hypothetical 200 microm pitch designs. At low exposures, such improvements could greatly increase the magnitude of the low spatial frequency component of the DQE, rendering it practically independent of exposure while simultaneously reducing the falloff in DQE at higher spatial frequencies. Furthermore, such noise reduction and gain enhancement could lead to the development of AMFPIs with high DQE performance which are capable of providing both high resolution radiographic images, at approximately 100 microm pixel resolution, as well as variable resolution fluoroscopic images at 30 fps.

Relative dosimetry using active matrix flat-panel imager (AMFPI) technology

The first examination of the use of active matrix flat-panel arrays for dosimetry in radiotherapy is reported. Such arrays are under widespread development for diagnostic and radiotherapy imaging. In the current study, an array consisting of 512 x 512 pixels with a pixel pitch of 508 microm giving an area of 26 x 26 cm2 has been used. Each pixel consists of a light sensitive amorphous silicon (a-Si:H) photodiode coupled to an a-Si:H thin-film transistor. Data was obtained from the array using a dedicated electronics system allowing real-time data acquisition. In order to examine the potential of such arrays as quality assurance devices for radiotherapy beams, field profile data at photon energies of 6 and 15 MV were obtained as a function of field size and thickness of overlying absorbing material (solid water). Two detection configurations using the array were considered: a configuration (similar to the imaging configuration) in which an overlying phosphor screen is used to convert incident radiation to visible light photons which are detected by the photodiodes; and a configuration without the screen where radiation is directly sensed by the photodiodes. Compared to relative dosimetry data obtained with an ion chamber, data taken using the former configuration exhibited significant differences whereas data obtained using the latter configuration was generally found to be in close agreement. Basic signal properties, which are pertinent to dosimetry, have been investigated through measurements of individual pixel response for fluoroscopic and radiographic array operation. For signal levels acquired within the first 25% of pixel charge capacity, the degree of linear response with dose was found to be better than 99%. The independence of signal on dose rate was demonstrated by means of stability of pixel response over the range of dose rates allowed by the radiation source (80-400 MU/min). Finally, excellent long-term stability in pixel response, extending over a 2 month period, was observed.

Empirical investigation of the signal performance of a high-resolution, indirect detection, active matrix flat-panel imager (AMFPI) for fluoroscopic and radiographic operation

Signal properties of the first large-area, high resolution, active matrix, flat-panel imager are reported. The imager is based on an array of 1536 x 1920 pixels with a pixel-to-pixel pitch of 127 microns. Each pixel consists of a discrete amorphous silicon n-i-p photodiode coupled to an amorphous silicon thin-film transistor. The imager detects incident x rays indirectly by means of an intensifying screen placed over the array. External acquisition electronics send control signals to the array and process analog imaging signals from the pixels. Considerations for operation of the imager in both fluoroscopic and radiographic modes are detailed and empirical signal performance data are presented with an emphasis on exploring similarities and differences between the two modes. Measurements which characterize the performance of the imager were performed as a function of operational parameters in the absence or presence of illumination from a light-emitting diode or x rays. These measurements include characterization of the drift and magnitude of the pixel dark signal, the size of the pixel switching transient, the temporal behavior of pixel sampling and the implied maximum frame rate, the dependence of relative pixel efficiency and pixel response on photodiode reverse bias voltage and operational mode, the degree of linearity of pixel response, and the trapping and release of charge from metastable states in the photodiodes. In addition, X-ray sensitivity as a function of energy for a variety of phosphor screens for both fluoroscopic and radiographic operation is reported. Example images of a line-pair pattern and an anthropomorphic phantom in each mode are presented along with a radiographic image of a human hand. General and specific improvements in imager design are described and anticipated developments are discussed. This represents the first systematic investigation of the operation and properties in both radiographic and fluoroscopic modes of an imager incorporating such an array.

Initial performance evaluation of an indirect-detection, active matrix flat-panel imager (AMFPI) prototype for megavoltage imaging

PURPOSE The development of the first prototype active matrix flat-panel imager (AMFPI) capable of radiographic and fluoroscopic megavoltage operation is reported. The signal and noise performance of individual pixels is empirically quantified. Results of an observer-dependent study of imaging performance, using a contrast-detail phantom, are detailed and radiographic patient images are shown. Finally, a theoretical investigation of the zero-frequency detective quantum efficiency (DQE) performance of such imagers, using a cascaded systems formalism, is presented. METHODS AND MATERIALS The imager is based on a 508-microm pitch, 26 x 26 cm2 array which detects radiation indirectly via an overlying copper plate + phosphor screen converter. RESULTS Due to its excellent optical coupling, the imager exhibits sensitivity superior to that of video-based systems. With an approximately 133 mg/cm2 Gd2O2S:Tb screen the system is x-ray quantum-noise-limited down to approximately 0.3 cGy, conservatively, and extensions of this behavior to even lower doses by means of reduced additive electronic noise is predicted. The observer-dependent study indicates performance superior to that of conventional radiotherapy film while the patient images demonstrate good image quality at 1 to 4 MU. The theoretical studies suggest that, with a 133 mg/cm2 Gd2O2S:Tb screen, the system would provide DQE performance equivalent to that of video-based systems and that almost a factor of two improvement in DQE is achievable through the incorporation of a 400 mg/cm2 screen. CONCLUSION The reported prototype imager is the first megavoltage AMFPI having performance characteristics consistent with practical clinical operation. The superior contrast-detail sensitivity of the imager allows the capture of high-quality 6- and 15-MV images at minimal dose. Moreover, significant performance improvements, including extension of the operational range up to full portal doses, appear feasible. Such capabilities could be of considerable practical benefit in patient localization and verification.