Performance of a high fill factor, indirect detection prototype flat-panel imager for mammography.

Empirical and theoretical investigations of the performance of a small-area, high-spatial-resolution, active matrix flat-panel imager, operated under mammographic conditions, is reported. The imager is based on an indirect detection array incorporating a continuous photodiode design, as opposed to the discrete photodiode design employed in conventional flat-panel imagers. Continuous photodiodes offer the prospect of higher fill factors, particularly for arrays with pixel pitches below approximately 100 microm. The array has a pixel-to-pixel pitch of 75 microm and a pixel format of 512 x 512, resulting in an active area of approximately 3.8 x 3.8 cm2. The array was coupled to two commercially available, structured CsI: Tl scintillators of approximately 150 microm thickness: one optimized for high light output (FOS-HL) and the other for high spatial resolution (FOS-HR), resulting in a pair of imager configurations. Measurements of sensitivity, modulation transfer function (MTF), noise power spectra (NPS), and detective quantum efficiency (DQE) were performed with a 26 kVp mammography beam at exposures ranging from approximately 0.5 to approximately 19 mR. MTF results from both CsI:Tl scintillators show that the array demonstrates good spatial resolution, indicating effective isolation between adjacent pixels. The effect of additive noise of the system on DQE was observed to be significantly higher for the FOS-HR scintillator compared to the FOS-HL scintillator due to lower sensitivity of the former. For the FOS-HL scintillator, DQE performance was generally high at high exposures, limited by the x-ray quantum efficiency, Swank factor and the MTF of the scintillators. For both scintillators, the DQE performance degrades at lower exposures due to the relatively large contribution of additive noise. Theoretical calculations based on a cascaded systems model were found to be in general agreement with the empirically determined NPS and DQE values. Finally, such calculations were used to predict potential DQE performance for hypothetical 50 microm pixel pitch imagers, employing similar continuous photodiode design and realistic inputs derived from the empirical measurements.