Imaging performance of CMOS and a-Si: H flat-panel detectors for C-arm fluoroscopy and cone-beam CT

Purpose: CMOS detectors are a potentially advantageous sensor technology for indirect-detection flat-panel detectors (FPDs), offering finer pixel pitch, faster frame rate, and lower electronic noise compared to a-Si:H sensors. This work presents a preliminary analysis of the 2D and 3D imaging performance of both detector technologies. Methods: Two mobile C-arms were equipped with CMOS (Xineos 3030HS) and a-Si:H (PaxScan 3030X) FPDs. Technical assessment includes measurement of spatial resolution (MTF), image noise (NPS), and detective quantum efficiency (DQE). Evaluation of CBCT performance considers soft tissue visibility including axial image MTF, NPS, and noise-equivalent quanta (NEQ). Results: The CMOS detector exhibited lower readout noise and slightly higher spatial resolution as expected. The a- Si:H detector showed about 10-15% higher DQE at low spatial frequencies while the CMOS detector showed greater resilience in DQE at higher spatial frequencies. In matched resolution CBCT, both detectors showed roughly equivalent performance. Conclusion: CMOS detectors benefit performance with respect to high-frequency tasks, but the current work did not demonstrate strong advantage with respect to low-contrast soft-tissue visualization, in part due to light losses in scintillator-semiconductor coupling. Additional advantages include improved frame rate (reduced CBCT scan time). Ongoing work includes further investigation of modified bandwidth filters to take better advantage of underlying noiseresolution properties.