Scanning-beam digital x-ray (SBDX) technology for interventional and diagnostic cardiac angiography

The scanning-beam digital x-ray (SBDX) system is designed for x-ray dose reduction in cardiac angiographic applications. Scatter reduction, efficient detection of primary x-rays, and an inverse beam geometry are the main components of the entrance dose reduction strategy. This paper reports the construction of an SBDX prototype, image reconstruction techniques, and measurements of spatial resolution and x-ray output. The x-ray source has a focal spot that is electronically scanned across a large-area transmission target. A multihole collimator beyond the target defines a series of x-ray beams directed at a distant small-area detector array. The prototype has a 23 cm X 23 cm target, 100 X 100 focal spot positions, and a 5 cm X 5 cm CdTe detector positioned 150 cm from the target. With this nonmechanical method of beam scanning, patient images with low detected scatter are generated at up to 30 frame/s. SBDX data acquisition is tomosynthetic. The prototype simultaneously reconstructs 16 planes spaced throughout the cardiac volume using shift-and-add backprojection. Image frames analogous to conventional projection images are generated with a multiplane compositing algorithm. Single-plane versus multiplane reconstruction of contrast-filled coronary arteries is demonstrated with images of the porcine heart. Phantom and porcine imaging studies show multiplane reconstruction is practicable under clinically realistic levels of patient attenuation and cardiac motion. The modulation transfer function for an in-plane slit at mechanical isocenter measured 0.41-0.56 at 1 cycle/mm, depending on the detector element to image pixel interpolation technique. Modeling indicates that desired gains in spatial resolution are achievable by halving the detector element width. The x-ray exposure rate 15 cm below isocenter, without table or patient in the beam, measured 11.5 R/min at 120 kVp, 24.3 kWp and 3.42 R/min at 70 kVp, 14.2 kWp.