Flat-panel Imagers Research Articles

Flat Panel Computed Tomography Pooled Blood Volume and Infarct Prediction in Endovascular Stroke Treatment.

Background and Purpose- Patients with large-vessel stroke frequently need to be transferred to comprehensive stroke centers for endovascular treatment. An update of physiological perfusion parameters and stroke progression on arrival is desirable. We examined the reliability of preinterventional pooled blood volume (PBV)-maps acquired by flat-panel detector computed tomography (CT) in the interventional angiography suite. Methods- The volumes of preinterventional perfusion deficit in flat-panel detector CT-PBV source images were compared with final infarct volume on follow-up multislice-CT after endovascular treatment of 29 consecutive patients with occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA). Results- Endovascular treatment was successful in 26 patients (Thrombolysis in Cerebral Infarction, 2b-3). Overall, the median preinterventional PBV-deficit was 9×larger than median final infarct volume on multislice-CT (86.4 mL [10.3; 111.6] versus 9.6 mL [3.6; 36.8]). This was especially evident in the subgroup of successful recanalization (PBV-deficit: 87.5 mL [10.6; 115.1], final infarct: 8.7 mL [3.6; 29]). In futile recanalization, the final infarct tended to be underestimated (PBV-deficit: 86.4 mL [5.9; -] and final infarct: 116.4 mL [3.5; -]). Conclusions- Flat panel detector CT-PBV is not reliable in predicting the final infarct volume and should not be used in clinical decision making for endovascular treatment of acute cerebral artery occlusions.

Back-irradiated and dual-screen sandwich detector configurations for radiography.

Recent advances in thin film transistor array technology have enabled the possibility of "back-irradiated" (BI) indirect active-matrix flat-panel imagers (AMFPIs), in which x-rays first expose the scintillator through the optical sensor, and "dual-screen" AMFPIs, in which two scintillating screens are sandwiched around a bidirectional active matrix. We developed a theoretical treatment of such detectors. The theory is used to investigate possible imaging performance improvements over conventional "front-irradiation" (FI) AMFPIs, where the active matrix is opposite the x-ray entrance surface. Simple expressions for the modulation transfer function, normalized noise power spectrum, Swank factor ( ), Lubberts function , and spatial frequency-dependent detective quantum efficiency are derived and used to compute these quantities for a variety of FI, BI, and dual-screen detector configurations. is used as the figure of merit for optimizing and comparing the performance of the various configurations. Large performance improvements over FI single-screen systems are found possible with BI. Further improvements are found possible with dual-screen configurations. The ratio of the thicknesses of the two screens that optimizes DQE is generally asymmetric, with the thinner screen facing the incident flux. The optimum ratio depends on the x-ray attenuation length in the screen.

Development of a reconstruction methodology for the X-Ray spectrum of a medical LinAc positioning flat panel

This work analyzes the possibility of using the kV flat panel detector of a medical radiotherapy LinAc for consistency verification of X-ray beam generation in order to perform a quality assurance (QA) protocol. For directly measuring the energy spectrum of X-ray tubes is highly complicated due to the pile up effect produced by the high fluence of photons emitted, we have considered the possibility of using the flat panel detector covered with a PMMA wedge to obtain a gradient dose curve corresponding to specific working conditions of this LinAc X-ray tube. The relation between the gray level curve registered by the flat panel image and the primary X-ray spectrum emitted is defined by a first order Fredholm integral equation. Normally this function can be approximated by a response matrix, which can be obtained by means of Monte Carlo simulations. Obtaining the measured gray level curve and the response matrix, the primary X-ray spectrum can be unfolded via mathematical algorithms. With this approach, we propose a novel method that uses the kV flat panel detector available on LinAc for X-ray generator test. This spectrum reconstruction methodology reduces the inefficiencies and irregularity associated with using third-party QA detectors while allowing an automated procedure.

Flat panel imaging of occlusion site and collateral scores for emergent large vessel occlusion

IntroductionFlat panel imaging for emergent large vessel occlusion can be acquired prior to mechanical thrombectomy (MT). In this study, we examined patients undergoing MT with computed tomography angiography (CTA) to determine agreement on the site of occlusion and CTA collateral score (CS). MethodsFlat Panel CTA (FP-CTA) was acquired before MT. Time between CTA and FP-CTA acquisition, site of occlusion, and CS were reported. Significant CS change was defined as >2-point change, or any change to/from a malignant profile (CS = 0 to CS > 0, or vice versa). ResultsEleven patients (mean age, 60.8 years; NIHSS, 17; 55.0% female) were included; IV tPA was administered to 7. Intra-reader occlusion site, dichotomous CS, and continuous CS correlation between CTA and FP-CTA were 96.6%, 90.0%, and 86.6%, respectively. Inter-reader correlation for occlusion site was 93% for CTA and 100% for FP-CTA; dichotomous CS correlation was 87% for both CTA and FP-CTA; correlation of continuous CS was 77% for CTA and 87% for FP-CTA. ConclusionStandard CTA and FP-CTA have high intra and inter-reader correlation determining site of occlusion and CS in ELVO setting. This angiographic tool may have potential applications for both triage and patient selection.

Iterative optimization of relative stopping power by single detector based multi-projection proton radiography

In proton therapy, range uncertainties induced by the conversion from x-ray CT (xCT) Hounsfield units (HU) to relative stopping power (RSP) compromise the precision of dose delivery. To reduce range uncertainties induced by HU-converted RSPs, this study investigates optimizing the RSP of individual voxels in xCT iteratively based on multi-projection proton radiography (pRG) acquired using a single amorphous silicon flat panel imager. Time-resolved dose rate functions (DRF) were measured by the imager placed downstream of a test phantom consisting of tissue substitute materials. Water equivalent path lengths (WEPL) in the pRG were derived. By rotating the phantom, multiple pRG projections were acquired at angles from 0 to 358° with an increment of 2°. X-ray CT of the phantom was acquired and co-registered with the pRG acquisition coordinates. RSPs of individual xCT voxels were optimized iteratively by minimizing the difference between the measured WEPLs and the calculated WEPLs by ray tracing with HU-converted RSPs. Pixels in pRGs that exhibited severe proton range mixing were rejected for the optimization. Tikhonov regularization was applied under the assumption that HU-converted RSPs are inaccurate, but the inaccuracy is within a few percent. While ~50% of WEPL pixels were rejected due to severe range mixing in pRG, RSPs of >90% CT voxels could still be optimized if multiple pRG projections, e.g. ⩾12, around the phantom are utilized. For tissue substitute materials in a cylindrical phantom, percentage errors of RSPs were reduced from a range of −8% to +4% to be within ±2%. Further optimization, achieved by implementing a material-specific regularization parameter, reduced percent errors to be within ±0.5%. This study demonstrates the concept of optimizing RSPs of individual CT voxels with multi-projection pRGs acquired by a single flat panel imager, which could be further explored and implemented in proton therapy to reduce range uncertainties.

Scatter Correction for Industrial Cone-Beam Computed Tomography (CBCT) Using VSHARP, a fast GPU-Based Linear Boltzmann Transport Equation Solver

The use of cone-beam computed tomography (CBCT) to inspect objects containing aluminum, Inconel and other metals is a challenge due to high amounts of scattered radiation in the projection data. Following in the footsteps of VSHARP, our kernel-based two-dimensional (2D) software scatter correction algorithm that operates on x-ray projection data, we introduce three-dimensional (3D) VSHARP designed to offer improved accuracy and flexibility. The core of 3D VSHARP is fast finite element Linear Boltzmann Transport Equation (LBTE) solver that models photon transport within the object-of-interest and computes the scatter component of the projection data with Monte Carlo-like accuracy but greatly reduced computation times. 3D VSHARP utilizes an object model consisting of 3D material density maps based on a first pass reconstruction, and an imaging chain model describing the system geometry, the x-ray source components (polychromatic spectrum, beam filtration, and collimation hardware), and the x-ray detector components (flat-panel imager in this case). The 3D material density maps making up the object model may be further informed by Computer Aided Design (CAD) files. Validation against Monte Carlo (MC) simulations of overlapping metal blocks showed that 3D VSHARP- and MC-computed scatter fractions agreed to within 3% RMS. The 3D VSHARP execution time was less than 1 sec per projection using a single NVidia TitanXp GPU (NVidia Inc., Santa Clara CA) while the MC simulations took 1566 CPU-hours using two Intel-Silver-Xenon, 2.2 GHz, 10x core CPU (Intel Inc., Santa Clara CA), in a Dell 7920 workstation (Dell Inc., Austin TX). Experimental CBCT scans were taken of an aluminum motorcycle cylinder head and Inconel turbine blade at 450kVp. Results showed that high quality reconstructions and volume renderings were obtained which may open up the possibility of in-line CBCT applications.

Photonic upconversion in solution-processed Gd-based thin films for delayed quantum efficiency roll-off in a-Si flat panel image detectors

ABSTRACTAmorphous Si (a-Si) is used for fabrication of commercial low-cost flat panel image detectors for radiographic applications such as computed tomography (CT) imaging. a-Si photodiodes are known to exhibit a rapid decrease in quantum efficiency near 750nm. While crystalline Si does not suffer from such an early decline, the large-area and low-cost constraints of medical imagers make it challenging and costly to use crystalline Si for such devices. In this work, we report on the development of a sensitive layer for upconversion from 785 nm to green region of the spectrum, which nearly matches the peak quantum efficiency of a-Si detectors. Various host materials have been extensively studied in literature with rare earth ions such as Er3+(emission: green+red), Tm3+(emission: blue), Ho3+(emission: red+green) along with Yb3+ as a sensitizer for upconversion to the visible regime at high incident optical power (∼100 mW) for colloidal solutions. We carried out a thermal decomposition synthesis of NaYF4:Yb(18%),Er(2%),Gd(15%) at moderate temperature (∼320°C), resulting in a nearly pure hexagonal phase material. This is confirmed by powder X-ray diffraction (PXRD) of the unannealed sample with a lattice constant (∼5.17 Å). High-resolution transmission electron microscopy (HRTEM) measurements reveal the formation of nearly spherical nanoparticles. The observed plane ([100]) inferred from lattice fringes in TEM data with a visibly estimated interplanar distance (4.4±1.6 Å) is in reasonable agreement with standard data (∼5.17 Å) for comparable NaYF4-based materials. Excitation (785 nm) of the deposited thin films of Gd-doped unannealed material at relatively low incident power (∼0.4 mW) exhibits a PL response in green (539 nm) and red (665 nm) region of the spectrum. Gd-based upconversion material based thin films are thus a feasible photonic material for potential effective extension of high quantum efficiency range in a-Si for flat panel image detectors.

Detection of Pulmonary Embolism Based on Reduced Changes in Radiographic Lung Density During Cardiac Beating Using Dynamic Flat-panel Detector: An Animal-based Study

To assess the capacity of dynamic flat-panel detector imaging without the use of contrast media to detect pulmonary embolism (PE) based on temporal changes in radiographic lung density during cardiac beating. Sequential chest radiographs of six pigs were acquired using a dynamic flat-panel detector system. A porcine model of PE was developed, and temporal changes in pixel values in the imaged lungs were analyzed during a whole cardiac cycle. Mean differences in temporal changes in pixel values between affected and unaffected lobes were assessed using the paired t test. To facilitate visual evaluation, temporal changes in pixel values were depicted using a colorimetric scale and were compared to the findings of contrast-enhanced images. Affected lobes exhibited a mean reduction of 49.6% in temporal changes in pixel values compared to unaffected lobes within the same animals, and a mean reduction of 41.3% compared to that before vessel blockage in the same lobe. All unaffected lobes exhibited significantly-increased changes in pixel values after vessel blockage (p < 0.01). In all PE models, there were color-deficient areas with shapes and locations that matched well with the perfusion defects confirmed in the corresponding contrast-enhanced images. Dynamic chest radiography enables the detection of perfusion defects in the lobe unit based on temporal changes in image density, even without the use of contrast media. Quantification and visualization techniques provide a better understanding of the circulation-induced changes depicted in dynamic chest radiographs.

Zero-Dimensional Cs2TeI6 Perovskite: Solution-Processed Thick Films with High X-ray Sensitivity

We demonstrate a potential candidate, the 0D “all-inorganic” perovskite material Cs2TeI6, as a sensitive all-inorganic X-ray photoconductor for the development of the new generation of direct photon-to-current conversion flat-panel X-ray imagers. Cs2TeI6 consists of high atomic number elements, has high electrical resistance, and exhibits high air and moisture stability, making it suitable as a sensitive X-ray photoconductor. In addition, we identify that Cs2TeI6 film can be prepared under a low-temperature process using electrostatic-assisted spray technique under atmospheric conditions and achieved resistivity of 4.2 × 1010 Ω·cm. The resulting air- and water-stable Cs2TeI6 device exhibits a strong photoresponse to X-ray radiation. An electron drift length on the order of 200 μm is estimated under an applied electrical field strength of 400 V·cm–1. A high sensitivity for Cs2TeI6 thick film device is realized, with the value of 192 nC·R–1cm–2 under 40 kVp X-rays at an electrical field of 250 V·cm–1, which...

Enhanced Detectivity and Suppressed Dark Current of Perovskite-InGaZnO Phototransistor via a PCBM Interlayer.

Hybrid phototransistors based on InGaZnO (IGZO) metal oxide thin-film transistors (TFT) and a photoabsorbing capping layer such as perovskite (MAPbI3) are a promising low-cost device for developing advanced X-ray and UV flat-panel imagers. However, it is found that the introduction of MAPbI3 inevitably damages the IGZO channel layer during fabrication, leading to deteriorated TFT characteristics such as off-current rising and threshold voltage shift. Here, we report an effective approach for improving the performance of the perovskite-IGZO phototransistor by inserting a [6,6]-phenyl C61-butyric acid methyl ester (PCBM) or PCBM:PMMA interlayer between the patterned MAPbI3 and IGZO. The interlayer effectively prevents the IGZO from damage by the perovskite fabrication process, while allowing efficient charge transfer for photosensing. In this configuration, we have achieved a high-detectivity (1.35 × 1012 Jones) perovskite-IGZO phototransistor with suppressed off-state drain current (∼10 pA) in the dark. This work points out the importance of interface engineering for realizing higher performance and reliable heterogeneous phototransistors.

Theoretical investigation of the count rate capabilities of in-pixel amplifiers for photon counting arrays based on polycrystalline silicon TFTs.

Photon counting arrays (PCAs), capable of measuring the spectral information of individual x-ray photons and recording that information digitally, provide a number of advantages compared to conventional, energy-integrating active matrix flat-panel imagers - such as reducing the undesirable effects of electronic readout noise and Swank noise. While contemporary PCAs are based on crystalline silicon, our group has been examining the use of polycrystalline silicon (poly-Si, a semiconductor material better-suited for the manufacture of large-area devices) for such arrays. In this study, a theoretical investigation of the front-end amplifiers of array pixels incorporating photon counting circuits is described - building upon circuit simulation techniques developed in a previous study. Results for amplifier circuit designs corresponding to prototype PCAs currently under development, as well as for hypothetical circuit designs identified in the study, are reported. In the simulations, performance metrics (such as signal gain, linearity of signal response, and energy resolution) as well as various measures of count rate are determined. The simulations employed various input energy distributions (i.e., a 72kVp spectrum as well as monoenergetic x rays) in order to determine circuit performance. To make the results representative of the properties of poly-Si, the simulations incorporated transistor characteristics that were empirically obtained from test devices. Optimal operating conditions for the circuits were determined by applying criteria to the performance metrics and identifying which conditions minimized settling time. Once the optimal operating conditions were identified, trains of input pulses simulating x-ray flux were used to determine two measures of count rate corresponding to dead time losses of 10% and 30% (referred to as CR10 and CR30 , respectively). The best-performing prototype amplifier design (implemented at a pixel pitch of 1mm) exhibited CR10 and CR30 values (expressed in counts per second per pixel) of 8.4 and 21.6kcps/pixel, respectively. A hypothetical amplifier design was derived by modifying transistor, resistor, and capacitor elements of the prototype amplifier designs. This hypothetical design (implemented at a pitch of 1mm) exhibited CR10 and CR30 values of 154 and 381kcps/pixel, respectively. When implemented at a pitch of 0.25mm, the performance of that design increased to 210 and 491kcps/pixel, respectively (corresponding to counts per second per unit area of 3.4 and 7.9Mcps/mm2 ). The simulation methodology described in this paper represents a useful tool for identifying promising designs for the amplifier component of photon counting arrays, as well as evaluating the analog signal and noise performance of those designs. The results obtained from the current study support the hypothesis that large-area, photon counting arrays based on poly-Si transistors can provide clinically useful count rates. Encouraged by these early results, further development of the methodology to assist in the identification and evaluation of even more promising designs, along with development and empirical characterization of prototype designs, is planned.

Reducing Radiation Dose for High-resolution Flat-panel CT Imaging of Superior Semicircular Canal Dehiscence

High-resolution flat panel computed tomography (FPCT) is useful for the evaluation of temporal bone pathologies. While radiation exposure remains a concern, efforts have been devoted to reduce dose, while maintaining image quality. We hypothesize that removing the antiscatter grid (ASG) results in decreased radiation exposure, while maintaining diagnostic image quality for the evaluation of superior semicircular canal dehiscence (SSCD). Ten patients with clinical suspicion for SSCD participated in this prospective study. Two sequential collimated 20-second FPCT acquisitions were performed (first: grid in; second: grid removed) in all patients. Secondary reconstructions were created by manually generating the volume of interest to include the middle ear using a voxel size of 0.1 mm and 512 × 512 matrix. Radiation dose parameters (air kerma (Ka,r) in mGy and dose area product (DAP) in μGym) were recorded. Three reviewers analyzed images for the ability to diagnose SSCD, to identify the stapes crurae, and to determine if an ASG was present. The average Ka,r and DAP for the grid-in acquisitions were 246.7 mGy (SD 47.9) and 2838.0 μGym (SD 862.8), versus 160.2 mGy (SD 33.2) and 2026.3 μGym (SD 644.8) for the grid-out acquisitions, respectively (p<0.001 for both Ka,r and DAP). Radiation exposure was reduced by approximately 30% solely by removing the ASG. All reviewers correctly identified all patients with SSCD (confirmed at surgery), with mean AUC of 0.99 (κ = 0.90). Removing the antiscatter grid during FPCT imaging of the temporal bones is a simple and effective way to reduce radiation exposure while maintaining diagnostic image quality for the evaluation of SSCD.

All-inorganic perovskite nanocrystal scintillators.

The rising demand for radiation detection materials in many applications has led to extensive research on scintillators1-3. The ability of a scintillator to absorb high-energy (kiloelectronvolt-scale) X-ray photons and convert the absorbed energy into low-energy visible photons is critical for applications in radiation exposure monitoring, security inspection, X-ray astronomy and medical radiography4,5. However, conventional scintillators are generally synthesized by crystallization at a high temperature and their radioluminescence is difficult to tune across the visible spectrum. Here we describe experimental investigations of a series of all-inorganic perovskite nanocrystals comprising caesium and lead atoms and their response to X-ray irradiation. These nanocrystal scintillators exhibit strong X-ray absorption and intense radioluminescence at visible wavelengths. Unlike bulk inorganic scintillators, these perovskite nanomaterials are solution-processable at a relatively low temperature and can generate X-ray-induced emissions that are easily tunable across the visible spectrum by tailoring the anionic component of colloidal precursors during their synthesis. These features allow the fabrication of flexible and highly sensitive X-ray detectors with a detection limit of 13 nanograys per second, which is about 400 times lower than typical medical imaging doses. We show that these colour-tunable perovskite nanocrystal scintillators can provide a convenient visualization tool for X-ray radiography, as the associated image can be directly recorded by standard digital cameras. We also demonstrate their direct integration with commercial flat-panel imagers and their utility in examining electronic circuit boards under low-dose X-ray illumination.

In vivo dynamic acromiohumeral distance in shoulders with rotator cuff tears

BackgroundThere are no previous studies on the acromiohumeral distance in shoulders with large-to-massive full-thickness rotator cuff tears. In this study, the acromiohumeral distance in rotator cuff tear and healthy shoulders was measured using 3D-to-2D model-to-image registration techniques. MethodsThe dynamic glenohumeral kinematics during scapular plane abduction and axial rotation were analyzed in 11 rotator cuff tear patients and 10 healthy control subjects. Periodic radiographic images of scapular plane abduction and axial rotation were taken using a flat-panel radiograph image detector. Movements of the shoulder joint were assessed using radiographic images and computed tomography-derived digitally reconstructed radiographs. The acromiohumeral distance was defined as the shortest 3D distance between the acromion and the proximal humerus. FindingsFor scapular plane abduction, the rotator cuff tear group had significantly smaller acromiohumeral distance than the control group at 15°, 30°, 45°, 60°, 75°, 135°, and 150° of humeral abduction (P < 0.05 at each measured angle). For axial rotation in the adducted position, the rotator cuff tear group had significantly smaller acromiohumeral distance than the control group at each point between −20° and 40° of glenohumeral external rotation (P < 0.05 at each measured angle). InterpretationThe minimum measured acromiohumeral distance was 0.9 mm in the rotator cuff tear shoulders and 2.1 mm in the healthy shoulders at 90° of scapular plane abduction. The findings are of clinical relevance because quantitative evaluation of the dynamic acromiohumeral distances in rotator cuff tear and healthy shoulders might provide important insight into subacromial impingement.

The Practice of Chest Radiography Using Different Digital Imaging Systems: Dose and Image Quality

Introduction: The study was undertaken to evaluate the practice of chest radiography using different digital imaging systems and its influence on dose and image quality. Materials and Methods: The study was carried out in two hospitals from March 2016 to June 2016. Sixty ambulatory patients aged 21 to 60 years who were able to cooperate without difficulty and weighed between 60 to 80 kg were selected randomly. The active matrix flat panel imagers technology was employed in the direct radiography (DR) system for Hospital A, whilst Hospital B used the single read out computed radiography (CR) system. The dose area product (DAP) meter was utilized in measuring the entrance surface air kerma. The chest radiographs were evaluated by two radiologists. Results: The mean entrance surface doses (ESDs) for posteroanterior chest in Hospital A (0.098 mGy) was lower than that obtained in Hospital B (0.161 mGy). However, the ESDs at both centres were lower than the recommended value by the International Atomic Energy Agency (IAEA; 0.3 mGy). The quality of the images for chest radiography in both hospitals was adequate to make a diagnosis with ESDs and effective doses lower than those recommended by IAEA and United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Conclusion: The study serves to highlight the practice of chest radiography with two different systems and its influence on image quality and dose. It can be concluded that there were significant differences in image quality and radiation dose for chest radiography practice using CR and DR.

Acuros CTS: A fast, linear Boltzmann transport equation solver for computed tomography scatter - Part II: System modeling, scatter correction, and optimization.

To correct for scatter in kV cone-beam CT (CBCT) projection data on a clinical system using a new tool, Acuros® CTS, that estimates scatter images rapidly and accurately by deterministically solving the linear Boltzmann transport equation. Phantom and patient CBCT scans were acquired on TrueBeam® radiotherapy machines. A first-pass reconstruction was used to create water and bone density maps of the imaged object, which was updated to include a more accurate representation of the patient couch. The imaging system model accounted for the TrueBeam x-ray source (polychromatic spectrum, beam filtration, bowtie filter, and collimation hardware) and x-ray detection system (antiscatter grid, flat-panel imager). Acuros CTS then used the system and object models to estimate the scatter component of each projection image, which was subtracted from the measured projections. The corrected projections were then reconstructed to produce the final result. We examined the tradeoff between run time and accuracy using a Pareto optimization of key parameters, including the voxel size of the down-sampled object model, the number of pixels in the down-sampled detector, and the number of scatter images (angular down-sampling). All computations and reconstructions were performed on a research workstation containing two graphics processing units (GPUs). In addition, we established a method for selecting a subset of projections for which scatter images were calculated. The projections were selected to minimize interpolation errors in the remaining projections. Image quality improvement was assessed by measuring the accuracy of the reconstructed phantom and patient images. The Pareto optimization yielded a set of parameters with an average run time of 26 seconds for scatter correction while maintaining high accuracy of scatter estimation. This was achieved in part by means of optimizing the projection angles that were processed, thus favoring the use of more angles in the lateral (i.e., horizontal) direction and fewer angles in the AP direction. In a 40 cm solid water phantom reconstruction, nonuniformities were decreased from 217 HU without scatter correction to 51 HU with conventional (kernel-based) scatter correction to 17 HU with Acuros CTS-based scatter correction. In clinical pelvis scans, nonuniformities in the bladder were reduced from 85 HU with conventional scatter correction to 14 HU with Acuros CTS. Acuros CTS is a promising new tool for fast and accurate scatter correction for CBCT imaging. By carefully modeling the imaging chain and optimizing several parameters, we achieved high correction accuracies with computation times compatible with the clinical workflow. The improvement in image quality enables better soft-tissue visualization and potentially enables applications such as adaptive radiotherapy.

Commissioning of a dedicated commercial Co-60 total body irradiation unit.

We describe the commissioning of the first dedicated commercial total body irradiation (TBI) unit in clinical operation. The Best Theratronics GammaBeam 500 is a Co‐60 teletherapy unit with extended field size and imaging capabilities. Radiation safety, mechanical and imaging systems, and radiation output are characterized. Beam data collection, calibration, and external dosimetric validation are described. All radiation safety and mechanical tests satisfied relevant requirements and measured dose distributions meet recommendations of American Association of Physicists in Medicine (AAPM) Report #17. At a typical treatment distance, the dose rate in free space per unit source activity using the thick flattening filter is 1.53 × 10−3 cGy*min−1*Ci−1. With a 14,000 Ci source, the resulting dose rate at the midplane of a typical patient is approximately 17 and 30 cGy/min using the thick and thin flattening filters, respectively, using the maximum source to couch distance. The maximum useful field size, defined by the 90% isodose line, at this location is 225 × 78 cm with field flatness within 5% over the central 178 × 73 cm. Measured output agreed with external validation within 0.5%. End‐to‐end testing was performed in a modified Rando phantom. In‐house MATLAB software was developed to calculate patient‐specific dose distributions using DOSXYZnrc, and fabricate custom 3D‐printed forms for creating patient‐specific lung blocks. End‐to‐end OSLD and diode measurements both with and without lung blocks agreed with Monte Carlo calculated doses to within 5% and in‐phantom film measurements validated dose distribution uniformity. Custom lung block transmission measurements agree well with design criteria and provide clinically favorable dose distributions within the lungs. Block placement is easily facilitated using the flat panel imaging system with an exposure time of 0.01 min. In conclusion, a novel dedicated TBI unit has been commissioned and clinically implemented. Its mechanical, dosimetric, and imaging capabilities are suitable to provide state‐of‐the‐art TBI for patients as large as 220 cm in height and 78 cm in width.

New Unexpected Use of Display Devices: Display Virtually Seeing on “Accidentally Happening Events of Construction Steel Directly Falling on Human-Head” Can be Sensed by Oneself?

Someone passed by a street in the vicinity of a highlight building broken down might have caught in an unexpected big accident on site, to have caused him seriously injured. However, in rare cases, it is possible for any human to avoid big accident by taking an action of avoiding accident, perceiving the serious fear status. Responding to such status, we tried to apply an experiment of simulation using a normal-sized, flat-panel high-definition image display. Incorporating virtual reality with high definition display, as well as generating big noise of iron angle poles crashed, letting a subject to see it with feeling of fear, instantaneously we measured subject’s reaction against the crushing scenes as well as big noise. Responding to the noise heard as well as big iron poles crashing seen, a resulting only 6% of subjects acknowledged valid response safely. Avoiding crisis of reaction in the subject’s behavior was taken from the virtual reality of experiment as some results. Seeing the fake big accidental scene on high definition image display was striking to the function of the subject’s brain sensor. This display system alarms on time the dangerous accident encountered to the subject for avoiding ultimate damages by viewing scenes if the display might be of high definition version.

Toward Scintillator High-Gain Avalanche Rushing Photoconductor Active Matrix Flat Panel Imager (SHARP-AMFPI): Initial fabrication and characterization.

We present the first prototype Scintillator High-Gain Avalanche Rushing Photoconductor Active Matrix Flat Panel Imager (SHARP-AMFPI). This detector includes a layer of avalanche amorphous Selenium (a-Se) (HARP) as the photoconductor in an indirect detector to amplify the signal and reduce the effects of electronic noise to obtain quantum noise-limited images for low-dose applications. It is the first time avalanche a-Se has been used in a solid-state imaging device and poses as a possible solution to eliminate the effects of electronic noise, which is crucial for low-dose imaging performance of AMFPI. We successfully deposited a solid-state HARP structure onto a 24 × 30 cm2 array of thin-film transistors (TFT array) with a pixel pitch of 85 μm. The HARP layer consists of 16 μm of a-Se with a hole-blocking and electron-blocking layer to prevent charge injection from the high-voltage bias and pixel electrodes, respectively. An electric field (ESe ) up to 105 V μm-1 was applied across the a-Se layer without breakdown. A 150 μm thick-structured CsI:Tl scintillator was used to form SHARP-AMFPI. The x-ray imaging performance is characterized using a 30 kVp Mo/Mo beam. We evaluate the spatial resolution, noise power, and detective quantum efficiency at zero frequency of the system with and without avalanche gain. The results are analyzed using cascaded linear system model (CLSM). An avalanche gain of 76 ± 5 was measured at ESe = 105 V μm-1 . We demonstrate that avalanche gain can amplify the signal to overcome electronic noise. As avalanche gain is increased, image quality improves for a constant (0.76 mR) exposure until electronic noise is overcome. Our system is currently limited by poor optical transparency of our high-voltage electrode and long integrating time which results in dark current noise. These two effects cause high-spatial frequency noise to dominate imaging performance. We demonstrate the feasibility of a solid-state HARP x-ray imager and have fabricated the largest active area HARP sensor to date. Procedures to reduce secondary quantum and dark noise are outlined. Future work will improve optical coupling and charge transport which will allow for frequency DQE and temporal metrics to be obtained.

A comparative study of scintillator combining methods for flat-panel X-ray image sensors

An X-ray transmission imaging based on scintillation detection method is the most widely used radiation technique particularly in the medical and industrial areas. As the name suggests, scintillation detection uses a scintillator as an intermediate material to convert incoming radiation into visible-light particles. Among different types of scintillators, CsI(Tl) in a columnar configuration is the most popular type used for applications that require an energy less than 150 keV due to its capability in obtaining a high spatial resolution with a reduced light spreading effect. In this study, different methods in combining a scintillator with a light-receiving unit are investigated and their relationships are given in terms of the image quality. Three different methods of combining a scintillator with a light-receiving unit are selected to investigate their performance in X-ray imaging: upward or downward oriented needles structure of CsI(Tl), coating layer deposition around CsI(Tl), and insertion of FOP. A charge-coupled device was chosen to serve as the light-receiving unit for the proposed system. From the result, the difference of needle directions in CsI(Tl) had no significant effects in the X-ray image. In contrast, deposition of the coating material around CsI(Tl) showed 17.3% reduction in the DQE. Insertion of the FOP increased the spatial resolution by 38%, however, it decreased the light yield in the acquired image by 56%. In order to have the maximum scintillation performance in X-ray imaging, not only the reflection material but also the bonding method must be considered when combining the scintillator with the light-receiving unit. In addition, the use of FOP should be carefully decided based on the purpose of X-ray imaging, e.g., image sharpness or SNR.