We assessed interventional radiologists’ task-based image quality preferences for two- and three-dimensional images obtained with a complementary metal–oxide semiconductor (CMOS) flat-panel detector versus a hydrogenated amorphous silicon (a-Si:H) flat-panel detector. CMOS and a-Si:H detectors were implemented on identical mobile C-arms to acquire radiographic, fluoroscopic, and cone-beam computed tomography (CBCT) images of cadavers undergoing simulated interventional procedures using low- and high-dose settings. Images from both systems were displayed side by side on calibrated, diagnostic-quality displays, and three interventional radiologists evaluated task performance relevant to each image and ranked their preferences based on visibility of pertinent anatomy and interventional devices. Overall, CMOS images were preferred in fluoroscopy (p = 0.002) and CBCT (p = 0.004), at low-dose settings (p = 0.001), and for tasks associated with high levels of spatial resolution [e.g., fine anatomical details (p = 0.006) and assessment of interventional devices (p = 0.015)]. No significant difference was found for fluoroscopic imaging tasks emphasizing temporal resolution (p = 0.072), for radiography tasks (p = 0.825), when using high-dose settings (p = 0.360), or tasks involving general anatomy (p = 0.174). The image quality preferences are consistent with reported technical advantages of CMOS regarding finer pixel size and reduced electronic noise.
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.