Technical assessment of 2D and 3D imaging performance of an IGZO-based flat-panel X-ray detector

Background Indirect detection flat-panel detectors (FPDs) consisting of hydrogenated amorphous silicon (a-Si:H) thin-film transistors (TFTs) are a prevalent technology for digital x-ray imaging. However, their performance is challenged in applications requiring low exposure levels, high spatial resolution, and high frame rate. Emerging FPD designs using metal oxide TFTs may offer potential performance improvements compared to FPDs based on a-Si:H TFTs. Purpose This work investigates the imaging performance of a new indium gallium zinc oxide (IGZO) TFT-based detector in 2D fluoroscopy and 3D cone-beam CT (CBCT). Methods The new FPD consists of a sensor array combining IGZO TFTs with a-Si:H photodiodes and a 0.7-mm thick CsI:Tl scintillator. The FPD was implemented on an x-ray imaging bench with system geometry emulating intraoperative CBCT. A conventional FPD with a-Si:H TFTs and a 0.6-mm thick CsI:Tl scintillator was similarly implemented as a basis of comparison. 2D imaging performance was characterized in terms of electronic noise, sensitivity, linearity, lag, spatial resolution (modulation transfer function, MTF), image noise (noise-power spectrum, NPS), and detective quantum efficiency (DQE) with entrance air kerma (EAK) ranging from 0.3 to 1.2 mu Gy. 3D imaging performance was evaluated in terms of the 3D MTF and noise-equivalent quanta (NEQ), soft-tissue contrast-to-noise ratio (CNR), and image quality evident in anthropomorphic phantoms for a range of anatomical sites and dose, with weighted air kerma, Kw${K_w}$, ranging from 0.8 to 4.9 mGy. Results The 2D imaging performance of the IGZO-based FPD exhibited up to similar to 1.7x lower electronic noise than the a-Si:H FPD at matched pixel pitch. Furthermore, the IGZO FPD exhibited similar to 27% increase in mid-frequency DQE (1 mm(-1)) at matched pixel size and dose (EAK approximate to 1.0 mu Gy) and similar to 11% increase after adjusting for differences in scintillator thickness. 2D spatial resolution was limited by the scintillator for each FPD. The IGZO-based FPD demonstrated improved 3D NEQ at all spatial frequencies in both head (>= 25% increase for all dose levels) and body (>= 10% increase for Kw${K_w}$ <= 2 mGy) imaging scenarios. These characteristics translated to improved low-contrast visualization in anthropomorphic phantoms, demonstrating >= 10% improvement in CNR and extension of the low-dose range for which the detector is input-quantum limited. Conclusion The IGZO-based FPD demonstrated improvements in electronic noise, image lag, and NEQ that translated to measurable improvements in 2D and 3D imaging performance compared to a conventional FPD based on a-Si:H TFTs. The improvements are most beneficial for 2D or 3D imaging scenarios involving low-dose and/or high-frame rate.