Complementary metal-oxide-semiconductors (CMOS) flat panel detectors (FPD) have steadily gained acceptance into medical imaging applications1-15. Selecting the proper detector technology for the imaging task requires optimization to balance the cost and the image quality. To facilitate this, fundamental detector performance of CMOS and a-Si panels were evaluated using the following quantitative imaging metrics: X-ray sensitivity, Noise Equivalent Dose (NED,) Noise Power Spectrum (NPS), Modulation Transfer Function (MTF), and Detective Quantum Efficiency (DQE). Imaging task measurements involved high-contrast and low-contrast resolution assessment. Varex FPDs evaluated for this study included: CMOS 3131 (150 μm pixel), a-Si 3030X (194 μm pixel), a-Si XRpad2 3025 (100 μm) and CMOS 2020 (100 μm pixel). Performance comparisons were organized by pixel size: large pixels, 150 μm CMOS and 194 μm a-Si, and small pixels, 100 μm in a-Si and CMOS technology. The results showed high dose DQE of the a-Si 3030X was about 10% higher than the CMOS 3131 between 0 - 1.8 cycles/mm, while beyond 1.8 cycles/mm, the CMOS performed better. The 3030X low dose DQE was higher than the 3131 between 0-1.3 cycles/mm, while the CMOS performance was higher beyond 1.3 cycles/mm. The high dose DQE of 100 μm a-Si was higher than the 100 μm CMOS for all frequencies. However, the low dose DQE of 100 μm CMOS was higher beyond 0.6 cycles/mm, while the 100 μm a-Si pixel had higher DQE only between 0 – 0.6 cycles/mm. Large pixel image quality (IQ) assessment favored a-Si pixel with 7% higher Contrast-to-Noise-Ratio (CNR) results for both high and low contrast-detail at 500 nGy. Small pixel CNR favored CMOS with ~38% better high contrast-detail and 12% greater low contrast-detail at ~500 nGy. Through these measurements that combine imaging metrics and image quality, we demonstrated a practical method for selecting the appropriate detector technology based on the requirements of the imaging applications.
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