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.

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.

The proposed a-IGZO APS x-ray imager with a pixel pitch<75 μm is capable to achieve a high spatial frequency (>6.67 lp/mm) and a low dose (<0.4 mGy) in next generation DBT systems.

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The recently introduced robotic x-ray systems provide the flexibility to acquire cone-beam computed tomography (CBCT) data using customized, application-specific source-detector trajectories. We exploit this capability to mitigate the effects of x-ray scatter and noise in CBCT imaging of weight-bearing foot and cervical spine (C-spine) using scan orbits with a tilted rotation axis. Methods: We used an advanced CBCT simulator implementing accurate models of x-ray scatter, primary attenuation, and noise to investigate the effects of the orbital tilt angle in upright foot and Cspine imaging. The system model was parameterized using a laboratory version of a three-dimensional (3D) robotic x-ray system (Multitom RAX, Siemens Healthineers). We considered a generalized tilted axis scan configuration, where the detector remained parallel to patient's long body axis during the acquisition, but the elevation of source and detector was changing. A modified Feldkamp-Davis-Kress (FDK) algorithm was developed for reconstruction in this configuration, which departs from the FDK assumption of a detector that is perpendicular to the scan plane. The simulated foot scans involved source-detector distance (SDD) of 1386 mm, orbital tilt angles ranging 10°to 40°, and 400 views at 1 mAs/view and 0.5°increment; the C-spine scans involved À25°to À45°tilt angles, SDD of 1090 mm, and 202 views at 1.3 mAs and 1°increment The imaging performance was assessed by projection-domain measurements of the scatter-to-primary ratio (SPR) and by reconstruction-domain measurements of contrast, noise and generalized contrast-to-noise ratio (gCNR, accounting for both image noise and background nonuniformity) of the metatarsals (foot imaging) and cervical vertebrae (spine imaging). The effects of scatter correction were also compared for horizontal and tilted scans using an ideal Monte Carlo (MC)-based scatter correction and a frame-byframe mean scatter correction. Results: The proposed modified FDK, involving projection resampling, mitigated streak artifacts caused by the misalignment between the filtering direction and the detector rows. For foot imaging (no grids), an optimized 20°tilted orbit reduced the maximum SPR from~1.5 in a horizontal scan to <0.5. The gCNR of the second metatarsal was enhanced twofold compared to a horizontal orbit. For the C-spine (with vertical grids), imaging with a tilted orbit avoided highly attenuating x-ray paths through the lower cervical vertebrae and shoulders. A À35°tilted orbit yielded improved image quality and visualization of the lower cervical spine: the SPR of lower cervical vertebrae was reduced from~10 (horizontal orbit) to <6 (tilted orbit), and the gCNR for C5-C7 increased by a factor of 2. Furthermore, tilted orbits showed potential benefits over horizontal orbits by enabling scatter correction with a simple frame-by-frame mean correction without substantial increase in noise-induced artifacts after the correction. Conclusions: Tilted scan trajectories, enabled by the emerging robotic x-ray system technolo...

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