Optimization of a flat-panel based real time dual-energy system for cardiac imaging

A simulation study was conducted to evaluate the effects of high-energy beam filtration, dual-gain operation and noise reduction on dual-energy images using a digital flat-panel detector. High-energy beam filtration increases image contrast through greater beam separation and tends to reduce total radiation exposure and dose per image pair. It is also possible to reduce dual-energy image noise by acquiring low and high-energy images at two different detector gains. In addition, dual-energy noise reduction algorithms can further reduce image noise. The cumulative effect of these techniques applied in series was investigated in this study. The contrast from a small thickness of calcium was simulated over a step phantom of tissue equivalent material with a CsI phosphor as the image detector. The dual-energy contrast-to-noise ratio was calculated using values of energy absorption and energy variance. A figure-of-merit (FOM) was calculated from dual-energy contrast-to-noise ratio (CNR) and patient effective dose estimated from values of entrance exposure. Filter atomic numbers in the range of 1-100 were considered with thicknesses ranging from 0-2500 mg/cm2. The simulation examined combinations of the above techniques which maximized the FOM. The application of a filter increased image contrast by as much as 45%. Near maximal increases were seen for filter atomic numbers in the range of 40-60 and 85-100 with masses above 750 mg/cm2. Increasing filter thickness beyond 1000 mg/cm2 increased tube loading without further significant contrast enhancement. No additional FOM improvements were seen with dual gain before or after the application of any noise reduction algorithm. Narrow beam experiments were carried out to verify predictions. The measured FOM increased by more than a factor of 3.5 for a silver filter thickness of 800 microm, equal energy weighting and application of a noise clipping algorithm. The main limitation of dynamic high-energy filtration is increased tube loading. The results of this study can be used to help develop an optimal dual-energy imaging system.     

Calibration model of a dual gain flat panel detector for 2D and 3D x-ray imaging

The continuing research and further development in flat panel detector technology have led to its integration into more and more medical x-ray systems for two-dimensional (2D) and three-dimensional (3D) imaging, such as fixed or mobile C arms. Besides the obvious advantages of flat panel detectors, like the slim design and the resulting optimum accessibility to the patient, their success is primarily a product of the image quality that can be achieved. The benefits in the physical and performance-related features as opposed to conventional image intensifier systems, (e.g., distortion-free reproduction of imaging information or almost linear signal response over a large dynamic range) can be fully exploited, however, only if the raw detector images are correctly calibrated and postprocessed. Previous procedures for processing raw data contain idealizations that, in the real world, lead to artifacts or losses in image quality. Thus, for example, temperature dependencies or changes in beam geometry, as can occur with mobile C arm systems, have not been taken into account up to this time. Additionally, adverse characteristics such as image lag or aging effects have to be compensated to attain the best possible image quality. In this article a procedure is presented that takes into account the important dependencies of the individual pixel sensitivity of flat panel detectors used in 2D or 3D imaging and simultaneously minimizes the work required for an extensive recalibration. It is suitable for conventional detectors with only one gain mode as well as for the detectors specially developed for 3D imaging with dual gain read-out technology.     

Evaluation of the imaging properties of an amorphous selenium-based flat panel detector for digital fluoroscopy

The imaging performance of an amorphous selenium (a-Se) flat-panel detector for digital fluoroscopy was experimentally evaluated using the spatial frequency dependent modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE). These parameters were investigated at beam qualities and exposures within the range typical of gastrointestinal fluoroscopic imaging (approximately 0.1 - 10 microR, 75 kV). The investigation does not take into consideration the detector cover, which in clinical use will lower the DQE measured here by its percent attenuation. The MTF was found to be less than the expected aperture response and the NPS was not white which together indicate presampling blurring. The cause of this blurring was attributed to charge trapping at the interface between two different layers of the a-Se. The effect on the DQE was also consistent with presampling blur, which reduces the aliasing in the NPS and thereby reduces the spatial frequency dependence of the DQE. (The DQE was independent of spatial frequency from 0.12 to 0.73 mm(-1) due to antialiasing of the NPS.) Moreover, the first zero of the measured MTF and the aperture response appeared at the same spatial frequency (6.66 mm(-1) for a pixel of 150 microm). Hence, the geometric fill factor (77%) was increased to an effective fill factor of 99 +/- 1%. A large scale ( approximately 32 pixels) correlation in the noise due to the configuration of the readout electronics caused increased noise power in the gate line NPS at low spatial frequency (< 0.1 mm(-1)). The DQE (f = 0) was exposure independent over a large range of exposures but became exposure dependent at low exposures due to the electronic noise.     

Performance of a 41X41-cm2 amorphous silicon flat panel x-ray detector for radiographic imaging applications

We report the performance of a 41 X 41-cm2 amorphous silicon-based flat panel detector designed for radiographic imaging applications. The detector consists of an array of photodiodes and thin film transistor switches on a 0.2-mm pitch with an overlying thallium-doped cesium iodide scintillator. The performance of the detector was evaluated through measurement of the frequency-dependent detective quantum efficiency [DQE(f)]. Measurements of the characteristic curve and modulation transfer function (MTF) are also reported. All measurements were made in a radiographic imaging mode with a readout time of 125 ms. We evaluated a total of 15 detectors. One detector was characterized at a range of exposures and at three different electronic gain settings. Measurements of DQE(f) and MTF were also performed as a function of position on one detector. The measured DQE at an exposure of about 1 mR was 0.66 at zero spatial frequency and fell smoothly with frequency to a value of 0.24 at the Nyquist frequency, 2.5 cycles/mm. The DQE is independent of exposure for exposures in the upper 80% of each gain range, but is reduced somewhat at lower exposures because of the influence of additive system noise. The reduction can be controlled by adjusting the electronic gain. For a gain that allows a maximum exposure of 5 mR, the DQE at 0.056 mR was 0.64 at zero frequency and 0.19 at 2.5 cycles/mm. The standard deviation in DQE among measurements on different detectors was less than 0.02 at any frequency. The presampling MTF was 0.26 at 2.5 cycles/mm. The standard deviation in MTF among measurements on different detectors was less than 0.01 at any frequency. Both MTF and DQE were substantially independent of position on the detector.     

An improved method for flat-field correction of flat panel x-ray detector

In this Technical Note, the effects of different flat-field techniques are examined for a cesium iodide flat panel detector, which exhibited a slightly nonlinear exposure response. The results indicate that the variable flat-field correction method with the appropriate polynomial fit provides excellent correction throughout the entire exposure range. The averaged normalized variation factor, used to assess the nonuniformity of the flat-field correction, decreased from 30.76 for the fixed correction method to 4.13 for the variable flat-field correction method with a fourth-order polynomial fit for the 60 kVp spectrum, and from 16.42 to 3.97 for the 95 kVp spectrum.     

Investigation of a direct conversion flat panel imager for portal imaging.

Flat-panel based x-ray imaging is an emerging new technology that could be used to significantly improve the quality of on-line portal imagers. There are two types of flat panel imagers: direct and indirect conversion. Previous experimental work on flat panel detectors for portal imaging application used indirect-conversion imagers. In this paper, a direct-conversion amorphous-selenium flat panel imager is investigated for application in portal imaging. The imager has an active imaging area of 14 in. X 17 in., i.e., 3072 X 2560 pixels each with dimensions 139 microm X 139 microm. The spatial frequency dependent detective quantum efficiency of the imager has been measured for a 6 MV beam and found to be amongst the best area detectors investigated for on-line portal imaging. Effects of changing pixel size, as well as possible improvements to both the image quality and convenience of operation are discussed. Comparison with an indirect conversion flat panel imager is also included.     

Performance of a 41 x 41 cm2 amorphous silicon flat panel x-ray detector designed for angiographic and R&F imaging applications

We measured the physical imaging performance of a 41 x 41 cm2 amorphous silicon flat panel detector designed for angiographic and R&F imaging applications using methods from the emerging IEC standard for the measurement of detective quantum efficiency (DQE) in digital radiographic detectors. Measurements on 12 production detectors demonstrate consistent performance. The mean DQE at the detector center is about 0.77 at zero frequency and 0.27 at the Nyquist frequency (2.5 cycles/mm) when measured with a 7 mm of Al HVL spectrum at about 3.6 microGy. The mean MTF at the center of the detector for this spectrum is 0.24 at the Nyquist frequency. For radiographic operation all 2048 x 2048 detector elements are read out individually. For fluoroscopy, the detector operates in two 30 frame per second modes: either the center 1024 x 1024 detector elements are read out or the entire detector is read out with 2 x 2 pixel binning. A model was developed to predict differences in performance between the modes, and measurements demonstrate agreement with the model. Lag was measured using a quasi-equilibrium exposure method and was found to be 0.044 in the first frame and less than 0.007 after 1 s. We demonstrated that it is possible to use the lag data to correct for temporal correlation in images when measuring DQE with a fluoroscopic imaging technique. Measurements as a function of position on the detector demonstrate a high degree of uniformity. We also characterized dependences on spectrum, exposure level, and direction. Finally, we measured the DQE of a current state of the art image intensifier/CCD system using the same method as for the flat panel. We found the image intensifier system to have lower DQE than the flat panel at high exposure levels and approximately equivalent DQE at fluoroscopic levels.     

Optimization of image process parameters through factorial experiments using a flat panel detector

In the optimization process of lumbar spine examinations, factorial experiments were performed addressing the question of whether the effective dose can be reduced and the image quality maintained by adjusting the image processing parameters. A 2k-factorial design was used which is a systematic and effective method of investigating the influence of many parameters on a result variable. Radiographic images of a Contrast Detail phantom were exposed using the default settings of the process parameters for lumbar spine examinations. The image was processed using different settings of the process parameters. The parameters studied were ROI density, gamma, detail contrast enhancement (DCE), noise compensation, unsharp masking and unsharp masking kernel (UMK). The images were computer analysed and an image quality figure (IQF) was calculated and used as a measurement of the image quality. The parameters with the largest influence on image quality were noise compensation, unsharp masking, unsharp masking kernel and detail contrast enhancement. There was an interaction between unsharp masking and kernel indicating that increasing the unsharp masking improved the image quality when combined with a large kernel size. Combined with a small kernel size however the unsharp masking had a deteriorating effect. Performing a factorial experiment gave an overview of how the image quality was influenced by image processing. By adjusting the level of noise compensation, unsharp masking and kernel, the IQF was improved to a 30% lower effective dose.     

Evaluation of a flat panel digital radiographic system for low-dose portable imaging of neonates

The purpose of this study was to evaluate the clinical utility of an investigational flat-panel digital radiography system for low-dose portable neonatal imaging. Thirty image-pairs from neonatal intensive care unit patients were acquired with a commercial Computed Radiography system (Agfa, ADC 70), and with the investigational system (Varian, Paxscan 2520) at one-quarter of the exposure. The images were evaluated for conspicuity and localization of the endings of ancillary catheters and tubes in two observer performance experiments with three pediatric radiologists and three neonatologists serving as observers. The results indicated no statistically significant difference in diagnostic quality between the images from the investigational system and from CR. Given the investigational system's superior resolution and noise characteristics, observer results suggest that the high detective quantum efficiency of flat-panel digital radiography systems can be utilized to decrease the radiation dose/exposure to neonatal patients, although post-processing of the images remains to be optimized. The rapid availability of flat-panel images in portable imaging was found to be an added advantage for timely clinical decision-making.     

Evaluation of the quality of CT-like images obtained using a commercial flat panel detector system

Purpose

The development of flat panel detector technology has resulted in renewed interest in the possibility of generating CT-like images from rotational angiographic acquisitions. At least two commercial products now use cone beam reconstruction software in conjunction with flat panel detectors to produce such images. The purpose of the work presented here is to report on image quality obtained from one such system in objective and subjective terms and to compare it with the quality of images obtained from a modern multi-detector CT scanner.

Method

The Image quality was assessed using a CATPHAN 500 model and an AAPM CT Performance Phantom model. Image noise, CT number accuracy, CT number consistency, Low Contrast Resolution, surface dose and Modulation Transfer Function were assessed for the flat panel detector and compared with results obtained from a 4 slice CT scanner.

Results

As expected image quality obtained from the CT scanner was much better than from the flat panel detector. Low contrast resolution was much worse and the surface dose was higher for the flat panel detector than the CT scanner. There was an inaccuracy in CT number determination and the noise was greater by a factor of two or three. Limiting resolution was better on images from the CT scanner.

Conclusion

The poor low contrast resolution from flat panel detector was expected given the expected resolution of ±10 Hounsfield Units. These systems should not be considered as diagnostic CT scanners. However, the remaining performance figures indicate that the CT-like images obtained from this type of equipment are of sufficient quality for at least some clinical applications, such as detection of brain haemorrhages in the vascular suite.     

Performance characteristics of a dual-energy detector for digital scan projection radiography

An energy discriminating x-ray detector has been developed for dual-energy, scan projection digital radiography. The detector is comprised of a pair of x-ray intensifying screen/linear photodiode arrays, aligned one behind the other. Energy discrimination is achieved by employing a low atomic number phosphor in the front screen and a high atomic number phosphor in the back screen. The x-ray response, modulation transfer function, and defective quantum efficiency of the detector are reported along with the experimental methodology utilized for the measurements. Also presented is an analysis which indicates that in a typical patient's lung field, the detector can resolve the projected density (g/cm2) of a 3-mm-thick, 1-cm2 area of bone to better than 1.5%.     

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.     

The long-term stability of amorphous silicon flat panel imaging devices for dosimetry purposes

This study was carried out to determine the stability of the response of amorphous silicon (a-Si)-flat panel imagers for dosimetry applications. Measurements of the imager's response under reference conditions were performed on a regular basis for four detectors of the same manufacturer. We found that the ambient temperature influenced the dark-field, while the gain of the imager signal was unaffected. Therefore, temperature fluctuations were corrected for by applying a "dynamic" darkfield correction. This correction method also removed the influence of a small, irreversible increase of the dark-field current, which was equal to 0.5% of the dynamic range of the imager per year and was probably caused by mild radiation damage to the a-Si array. By applying a dynamic dark-field correction, excellent stability of the response over the entire panel of all imagers of 0.5% (1 SD) was obtained over an observation period up to 23 months. However, two imagers had to be replaced after several months. For one imager, an image segment stopped functioning, while the image quality of the other imager degraded significantly. We conclude that the tested a-Si EPIDs have a very stable response and are therefore well suited for dosimetry. We recommend, however, applying quality assurance tests dedicated to both imaging and dosimetry.     

Evaluation of detector dynamic range in the x-ray exposure domain in mammography: a comparison between film-screen and flat panel detector systems

Digital detectors in mammography have wide dynamic range in addition to the benefit of decoupled acquisition and display. How wide the dynamic range is and how it compares to film-screen systems in the clinical x-ray exposure domain are unclear. In this work, we compare the effective dynamic ranges of film-screen and flat panel mammography systems, along with the dynamic ranges of their component image receptors in the clinical x-ray exposure domain. An ACR mammography phantom was imaged using variable mAs (exposure) values for both systems. The dynamic range of the contrast-limited film-screen system was defined as that ratio of mAs (exposure) values for a 26 kVp Mo/Mo (HVL=0.34 mm Al) beam that yielded passing phantom scores. The same approach was done for the noise-limited digital system. Data from three independent observers delineated a useful phantom background optical density range of 1.27 to 2.63, which corresponded to a dynamic range of 2.3 +/- 0.53. The digital system had a dynamic range of 9.9 +/- 1.8, which was wider than the film-screen system (p<0.02). The dynamic range of the film-screen system was limited by the dynamic range of the film. The digital detector, on the other hand, had an estimated dynamic range of 42, which was wider than the dynamic range of the digital system in its entirety by a factor of 4. The generator/tube combination was the limiting factor in determining the digital system's dynamic range.     

A real time PCR assay for the detection and quantification of orf virus

A real time quantitative PCR assay based on TaqMan technology was developed for orf virus (ORFV) DNA quantification in clinical samples, infected cells and organotypic cultures. This method was based on the amplification of a 70 bp fragment from the ORFV B2L gene (orthologue of the Vaccinia virus Copenhagen F13L gene) that encodes the major envelope protein. Both intra- and inter-assay variability were well within +/-0.25 log(10) S.D. showing the high efficiency and reproducibility of the assay. The TaqMan PCR was subsequently used to determine the titre of several batches of the ORFV strain NZ-2, with it being possible to quantify virus solutions in the range of 1 x 10(1) to 1 x 10(6) TCID(50)/ml. A good correlation between the titre determined by the TaqMan PCR and by conventional endpoint dilution was found. The PCR assay is reproducible and can be used for a rapid quantification of ORFV in vitro and ex vivo, being readily achievable within 1h.     

Full breast digital mammography with an amorphous silicon-based flat panel detector: physical characteristics of a clinical prototype

The physical characteristics of a clinical prototype amorphous silicon-based flat panel imager for full-breast digital mammography have been investigated. The imager employs a thin thallium doped CsI scintillator on an amorphous silicon matrix of detector elements with a pixel pitch of 100 microm. Objective criteria such as modulation transfer function (MTF), noise power spectrum, detective quantum efficiency (DQE), and noise equivalent quanta were employed for this evaluation. The presampling MTF was found to be 0.73, 0.42, and 0.28 at 2, 4, and 5 cycles/mm, respectively. The measured DQE of the current prototype utilizing a 28 kVp, Mo-Mo spectrum beam hardened with 4.5 cm Lucite is approximately 55% at close to zero spatial frequency at an exposure of 32.8 mR, and decreases to approximately 40% at a low exposure of 1.3 mR. Detector element nonuniformity and electronic gain variations were not significant after appropriate calibration and software corrections. The response of the imager was linear and did not exhibit signal saturation under tested exposure conditions.     

Theoretical optimization of a split septaless xenon ionization detector for dual-energy chest radiography

It is proposed that digital scanned projection radiography of the chest be performed by using an energy-sensitive septaless xenon ionization detector (SXID) to obtain dual-energy images. The proposed detector is composed of a front region, sensitive to low-energy x rays, and a rear region, sensitive to high-energy x rays, separated by a suitable filter layer. We have developed a simple, precise theoretical formulation for dual-energy optimization, and applied it to the split SXID. We describe the variation of optimum detector performance with source kilovoltage and filtration (material and thickness), and hence heat loading, under conditions of constant exposure and constant dose. We estimate dose as the average absorbed dose to an equivalent water layer of suitable thickness, assuming slab geometry, so that the calculation is as simple as that for exposure.     

Development and validation of a real time PCR-based bioassay for quantification of neutralizing antibodies against human interferon-beta

There are two commonly employed types of bioassays for the detection of neutralizing antibodies (NAbs) against interferon-beta (IFNbeta): the cytopatic effect assay (CPE), and the MxA (myxovirus resistance protein A) protein assay (MPA). This article describes a bioassay based on the real time PCR measurement of mRNA that results from the induction, in cultured human cells, of the MxA gene by IFNbeta. Serum samples from 104 patients with multiple sclerosis (MS) treated with IFNbeta were tested for NAbs using our real time PCR bioassay. NAbs also were measured in the same specimens by the MPA assay and CPE assay. The calibration range of the real time PCR bioassay is 0.125-30 LU/mL. The range of the intra- and inter-assay variations (coefficients of variation in log(10)) were 4.05% (range 0.88%-7.90%) and 4.42% (range 0.31%-9.15%), respectively. Samples of the three commercial preparations of IFNbeta-1a and -1b were measured showing dose-response curves parallel to that of the NIH reference IFNbeta (mean SD at the midpoint of the dose-response curve=5%). In addition, the assay was robust with respect to number of cells plated (i.e., increasing cell densities from 12x10(3)/well to 384x10(3)/well resulted in 3.03% variability in MxA expression normalized with glyceraldehyde-3 phosphate dehydrogenase). NAbs titers measured were closely comparable to those obtained by the MPA [r(spearman)=0.899; 89% of observed agreements; K=0.779] and the CPE [r(spearman)=0.7899); 86%; K=0.729] assays. Despite the obvious disadvantage of cost, when carried out according to quality assurance guidelines for molecular diagnostics the new MxA gene-expression assay (MGA) has significant advantages over the other methods for testing NAbs: it has excellent reliability and reproducibility, and utilizes equipment and methodologies already accessible in many clinical laboratories.     

Development of high quantum efficiency flat panel detectors for portal imaging: intrinsic spatial resolution

Recently developed flat panel detectors have been proven to have a much better image quality than conventional electronic portal imaging devices (EPIDs). They are, however, not yet the ideal systems for portal imaging application due to the low x-ray absorption, i.e., low quantum efficiency (QE), which is typically on the order of 2-4% as compared to the theoretical limit of 100%. The QE of current flat panel systems can be improved by significantly increasing the thickness of the energy conversion layer (i.e., amorphous selenium or phosphor screen). This, however, will be at the expense of a decrease in spatial resolution mainly due to x-ray scatter in the conversion layer (and also the spread of optical photons in the case of phosphor screen). In this paper, we investigate theoretically the intrinsic spatial resolution of a high QE flat panel detector with a new energy conversion layer that is much denser and thicker than that of current flat panel systems. The modulation transfer function (MTF) of the system is calculated based on a theoretical model using a novel approach, which uses an analytical expression for absorbed dose. It is found that if appropriate materials are used for the conversion layer, then the intrinsic MTF of the high QE flat panel is better than that of current EPIDs, and in addition they have a high QE (e.g., approximately 60%). Some general rules for the design of the conversion layer to achieve both high QE and high resolution as well as high DQE are also discussed.