Best In Physics (Imaging): High-Resolution Cone-Beam Ct Of The Extremities And Cancellous Bone Architecture With A Cmos Detector

Purpose:Extremity cone-beam CT (CBCT) with an amorphous silicon (aSi) flat-panel detector (FPD) provides low-dose volumetric imaging with high spatial resolution. We investigate the performance of the newer complementary metal-oxide semiconductor (CMOS) detectors to enhance resolution of extremities CBCT to ∼0.1 mm, enabling morphological analysis of trabecular bone. Quantitative in-vivo imaging of bone microarchitecture could present an important advance for osteoporosis and osteoarthritis diagnosis and therapy assessment.Methods:Cascaded systems models of CMOS- and FPD-based extremities CBCT were implemented. Performance was compared for a range of pixel sizes (0.05–0.4 mm), focal spot sizes (0.3–0.6 FS), and x-ray techniques (0.05–0.8 mAs/projection) using detectability of high-, low-, and all-frequency tasks for a nonprewhitening observer. Test-bench implementation of CMOS-based extremity CBCT involved a Teledyne DALSA Xineos3030HR detector with 0.099 mm pixels and a compact rotating anode x-ray source with 0.3 FS (IMD RTM37). Metrics of bone morphology obtained using CMOS-based CBCT were compared in cadaveric specimens to FPD-based system using a Varian PaxScan4030 (0.194 mm pixels).Results:Finer pixel size and reduced electronic noise for CMOS (136 e compared to 2000 e for FPD) resulted in ∼1.9× increase in detectability for high-frequency tasks and ∼1.1× increase for all-frequency tasks. Incorporation of the new x-ray source with reduced focal spot size (0.3 FS vs. 0.5 FS used on current extremities CBCT) improved detectability for CMOS-based CBCT by ∼1.7× for high-frequency tasks. Compared to FPD CBCT, the CMOS detector yielded improved agreement with micro-CT in measurements of trabecular thickness (∼1.7× reduction in relative error), bone volume (∼1.5× reduction), and trabecular spacing (∼3.5× reduction).Conclusion:Imaging performance modelling and experimentation indicate substantial improvements for high-frequency imaging tasks through adoption of the CMOS detector and small FS x-ray source, motivating the use of these components in a new system for quantitative in-vivo imaging of trabecular bone.Financial Support: US NIH grant R01EB018896. Qian Cao is a Howard Hughes Medical Institute International Student Research Fellow.Disclosures: W Zbijewski, J Siewerdsen and A Sisniega receive research funding from Carestream Health.