New cone-beam computed tomographic (CBCT) mammography system designs are presented where the detectors provide high spatial resolution, high sensitivity, low noise, wide dynamic range, negligible lag and high frame rates similar to features required for high performance fluoroscopy detectors. The x-ray detectors consist of a phosphor coupled by a fiber-optic taper to either a high gain image light amplifier (LA) then CCD camera or to an electron multiplying CCD. When a square-array of such detectors is used, a field-of-view (FOV) to 20 × 20 cm can be obtained where the images have pixel-resolution of 100 µm or better. To achieve practical CBCT mammography scan-times, 30 fps may be acquired with quantum limited (noise free) performance below 0.2 µR detector exposure per frame. Because of the flexible voltage controlled gain of the LA's and EMCCDs, large detector dynamic range is also achievable. Features of such detector systems with arrays of either generation 2 (Gen 2) or 3 (Gen 3) LAs optically coupled to CCD cameras or arrays of EMCCDs coupled directly are compared. Quantum accounting analysis is done for a variety of such designs where either the lowest number of information carriers off the LA photo-cathode or electrons released in the EMCCDs per x-ray absorbed in the phosphor are large enough to imply no quantum sink for the design. These new LA-or EMCCD-based systems could lead to vastly improved CBCT mammography, ROI-CT, or fluoroscopy performance compared to systems using flat panels.
A new high-resolution, high-sensitivity, low-noise x-ray detector based on EMCCDs has been developed. The EMCCD detector module consists of a 1kx1k, 8μm pixel EMCCD camera coupled to a CsI(Tl) scintillating phosphor via a fiber optic taper (FOT). Multiple modules can be used to provide the desired field-of-view (FOV). The detector is capable of acquisitions over 30fps. The EMCCD's variable gain of up to 2000x for the pixel signal enables high sensitivity for fluoroscopic applications. With a 3:1 FOT, the detector can operate with a 144μm effective pixel size, comparable to current flat-panel detectors. Higher resolutions of 96 and 48μm pixel size can also be achieved with various binning modes. The detector MTFs and DQEs were calculated using a linear-systems analysis. The zero frequency DQE was calculated to be 59% at 74 kVp. The DQE for the 144μm pixel size was shown to exhibit quantum-noise limited behavior down to ~0.1μR using a conservative 30x gain. At this low exposure, gains above 30x showed limited improvements in DQE suggesting such increased gains may not be necessary. For operation down to 48μm pixel sizes, the detector instrumentation noise equivalent exposure (INEE), defined as the exposure where the instrumentation noise equals the quantum-noise, was <0.1μR for a 20x gain. This new technology may provide improvements over current flat-panel detectors for applications such as fluoroscopy and angiography requiring high frame rates, resolution, dynamic range and sensitivity while maintaining essentially no lag and very low INEE. Initial images from a prototype detector are also presented.
A new microangiographic system (MA) integrated into a c-arm gantry has been developed allowing precise placement of a MA at the exact same angle as the standard x-ray image intensifier (II) with unchanged source and object position. The MA can also be arbitrarily moved about the object and easily moved into the field of view (FOV) in front of the lower resolution II when higher resolution angiographic sequences are needed. The benefits of this new system are illustrated in a neurovascular study, where a rabbit is injected with contrast media for varying oblique angles. Digital subtraction angiographic (DSA) images were obtained and compared using both the MA and II detectors for the same projection view. Vessels imaged with the MA appear sharper with smaller vessels visualized. Visualization of ~100 μm vessels was possible with the MA whereas not with the II. Further, the MA could better resolve vessel overlap. Contrast to noise ratios (CNR) were calculated for vessels of varying sizes for the MA versus the II and were found to be similar for large vessels, approximately double for medium vessels, and infinitely better for the smallest vessels. In addition, a 3D reconstruction of selected vessel segments was performed, using multiple (three) projections at oblique angles, for each detector. This new MA/II integrated system should lead to improved diagnosis and image guidance of neurovascular interventions by enabling initial guidance with the low resolution large FOV II combined with use of the high resolution MA during critical parts of diagnostic and interventional procedures.
Purpose: Present the design for the new SSXII high‐resolution fluoroscope capable of overcoming lag, noise, and resolution limitations of current flat‐panel devices (FPDs). Method and Materials: The SSXII consists of an array of modules each featuring an electron multiplying (EM) CCD which views a structured phosphor through a fiber‐optic taper (FOT). The EMCCD operates like a standard frame‐transfer CCD; however, an additional row of multiplication elements enables on‐chip signal gains up to 2000X to overcome subsequent instrumentation‐noise degradation. The SSXII therefore has quantum‐limited performance at both fluoroscopic exposures with moderate gain, and radiographic exposures with low gain. The SSXII array design, through pixel binning and module selection, will enable rapid sequence and fluoroscopic imaging for either the full field‐of‐view (FOV) or high‐resolution regions‐of‐interest (ROIs). Results: A SSXII module was assembled with direct fiber‐optic coupling of the 350 micron thick CsI(Tl) phosphor and the EMCCD (Texas Instruments TC285SPD chip with 1004×1002 pixels). Operation at fluoroscopic and angiographic exposure levels was verified experimentally for gains of ∼80X and 1X, respectively, demonstrating sequences of a moving stent with no lag and bar‐pattern resolution up to 20 1p/mm with a 1:1 FOT. An array of four modules each with 6:1 FOTs will have an effective pixel size of 48 microns covering a FOV of 10×10 cm, sufficient for region‐of‐interest and neurovascular imaging. Larger arrays may be constructed to satisfy both cardiac imaging and general fluoroscopic applications. Module alignment, digital stitching, and distortion correction issues are being addressed. Conclusion: When assembled in an array of sufficient size, the new SSXII can be used in the same applications as current FPD's with advantages of high frame rates with no lag, high resolution due to the smaller pixels possible, and low‐effective‐noise, quantum‐limited fluoroscopic performance due to the on‐chip gain. (Support: UB Foundation, NIH grants R01‐EB002873, R01‐NS43924).
Purpose: For modern high‐sensitivity digital imaging detectors operating at fluoroscopic exposure rates, the additive instrumentation readout noise may prevent desirable optimal quantum‐limited performance. A formalism and experimental validation of the representation of instrumentation noise in terms of the equivalent x‐ray entrance exposure to the detector is presented as a more practical noise measure than the equipment‐invasive measurement of electrons per pixel. Method and Materials: The instrumentation noise in terms of exposure equivalent is added in quadrature to the quantum noise to give the total measurable noise. Experimental validation was done using two different CCD‐based detectors: a high‐sensitivity microangiographic fluoroscope (MAF) and a less sensitive microangiographic detector (MA). Both detectors have a CsI(Tl) phosphor coupled to a fiber‐optic taper followed by a CCD camera (the MAF additionally has a variable‐gain light amplifier between the taper and the CCD). To determine the INEE for both detectors, a least‐squares regression technique was used to fit the measured data to the theoretical equation relating the signal‐to‐noise ratio squared SNR2 to the detector entrance exposure. Results: The SNR2 versus exposure plot deviates from linear behavior at lower exposures as expected, and closely follows the modeled equation used to derive the INEE. The measured INEE for the high‐sensitivity MAF was 0.034 μR and that for the MA was 10.8 μR. Conclusion: A formal treatment of the instrumentation noise in terms of the detector entrance exposure was developed and validated by using two different CCD based systems of different sensitivity. This study demonstrates that the INEE is a practical way to gauge the range of quantum‐limited performance for clinical x‐ray imaging detectors, with the implication that detector performance at exposures below the INEE will be instrumentation‐noise limited rather than quantum‐noise limited. (Partial support from NIH Grants R01EB002873, R01NS43924, and Toshiba Medical Systems Corporation).
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