Development of active matrix imagers fabricated on plastic substrates has become increasingly possible due to widespread efforts to develop the means to create inexpensive, very large area, flexible displays. In addition to benefits associated with cost, robustness, and weight, such novel x-ray imaging devices could provide significant performance improvements by virtue of substrates offering a thinner profile, lower density, and lower atomic number composition, as well as the ability to mechanically conform to non-planar geometries. One potential candidate for advantageous utilization of plastic substrates is that of a high resolution, indirect detection active matrix imager operated at mammographic x-ray energies. Such an imager, configured in an arc and operated in a back illumination geometry, could offer enhanced modulation transfer function and detective quantum efficiency by virtue of reduced optical spread in the scintillator relative to the optical sensor as well as reduction (or elimination) of oblique angles of incidence of primary x-rays. Motivated by such prospects, it is of interest to quantify the degree of performance improvement to be expected from such novel devices. In this paper, we describe a methodology under development by our collaboration to quantitatively examine the performance of indirect detection active matrix imagers incorporating plastic substrates. This methodology is based on the cascaded systems formalism with input provided by, among other things, Monte Carlo simulation of radiation and optical transport in the detector. Finally, illustrative examples of the use of this methodology are presented - although key input parameters are, as yet, insufficiently precise to allow the simulations to accurately depict the complete physical situation.
Megavoltage cone-beam computed tomography (CBCT) using active matrix flat-panel imagers (AMFPIs) is a promising
candidate for providing image guidance in radiation therapy. Unfortunately, the practical clinical implementation of this
technique is limited by the relatively low detective quantum efficiency (DQE) of conventional megavoltage AMFPIs.
This limitation is due to the modest thickness of the phosphor screen employed to convert incident x-rays to optical
photons and the trade-off that exists between phosphor thickness and spatial resolution. Recently, our group has begun
pursuing the development of thick crystalline segmented scintillating detectors as x-ray converters for AMFPIs so as to
circumvent this limitation. In order to examine the potential of such detectors for providing soft-tissue visualization by
means of CBCT at megavoltage energies, a Monte Carlo-based method was used to simulate the acquisition of
projection images of a contrast phantom. These images were used to perform CT reconstructions by means of a
Feldkamp-based algorithm. In this study, various detector configurations involving CsI and BGO scintillators at
thicknesses of 10 mm and 40 mm were evaluated. In addition, since the simulations only considered energy deposition,
and did not include optical phenomena, both segmented and non-segmented (continuous) detector configurations were
evaluated. For the segmented CsI detectors, septal wall materials with densities lower, equivalent and higher than that of
the scintillator were considered. Performance was quantified in terms of the contrast-to-noise ratio obtained for lowcontrast,
soft-tissue-equivalent objects (i.e., liver, brain, and breast) embedded in the phantom. The results obtained
from these early studies suggest that such segmented converters can provide visualization of soft-tissue contrast in
tomographic images at clinically practical doses. It is anticipated that the realization of optimized segmented detector
designs will lead to clinically useful megavoltage AMFPIs exhibiting impressive performance.
The numerous merits of x-ray imagers based on active matrix, flat-panel array technology have led to their introduction in a wide variety of x-ray imaging applications. However, under certain conditions, the performance of direct and indirect detection AMFPIs is significantly limited by the relatively modest ratio of singal to noise provided by conventional systems. While substantial reduction in the additive noise of such systems is difficult, significant enhancement of signal can be achieved through the incorporation of an amplification circuit in each pixel. In addition, innovative photodiode structures can be incorporated into indirect detection designs to enhance optical signal collection efficiency. In this paper, an investigation of these strategies, involving the design, fabrication and performance evaluation of a variety of novel, small area, indirect detection arrays, is described. Each prototype array incorporates innovative features, such as continuous photodiodes and single-stage and dual-stage in-pixel amplifiers, that are designed to provide insight into promising avenues for achieving significant singal-to-noise enhancement. This information will assist in the realization of a next generation of highly-optimized AMFPI pixel architectures whose DQE performance will be limited only by x-ray noise and x-ray converter properties under a very wide range of conditions. In this paper, the design and operation of the present prototype arrays are described and initial performance results are reported. In addition, the benefits of significant improvements to the signal-to-noise properties of AMFPIs are illustrated through cascaded systems calculations of the DQE performance of hypothetical systems.
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