The design and imaging characteristics of dynamic, solid-state, flat-panel x-ray image detectors for digital fluoroscopy and fluorography

Dynamic, flat-panel, solid-state, x-ray image detectors for use in digital fluoroscopy and fluorography emerged at the turn of the millennium. This new generation of dynamic detectors utilize a thin layer of x-ray absorptive material superimposed upon an electronic active matrix array fabricated in a film of hydrogenated amorphous silicon (a-Si:H). Dynamic solid-state detectors come in two basic designs, the indirect-conversion (x-ray scintillator based) and the direct-conversion (x-ray photoconductor based). This review explains the underlying principles and enabling technologies associated with these detector designs, and evaluates their physical imaging characteristics, comparing their performance against the long established x-ray image intensifier television (TV) system. Solid-state detectors afford a number of physical imaging benefits compared with the latter. These include zero geometrical distortion and vignetting, immunity from blooming at exposure highlights and negligible contrast loss (due to internal scatter). They also exhibit a wider dynamic range and maintain higher spatial resolution when imaging over larger fields of view. The detective quantum efficiency of indirect-conversion, dynamic, solid-state detectors is superior to that of both x-ray image intensifier TV systems and direct-conversion detectors. Dynamic solid-state detectors are playing a burgeoning role in fluoroscopy-guided diagnosis and intervention, leading to the displacement of x-ray image intensifier TV-based systems. Future trends in dynamic, solid-state, digital fluoroscopy detectors are also briefly considered. These include the growth in associated three-dimensional (3D) visualization techniques and potential improvements in dynamic detector design.