Performance assessment of active vs passive pixel x-ray angiography detector systems using a bias-corrected...

Electronic noise associated with passive pixel (PP) x-ray angiography flat panel detectors is known to compromise fluoroscopic image quality. An active pixel (AP) crystalline silicon x-ray detector with potential for reduced influence of electronic noise is commercially available. The purpose of this work was to compare the performance of the AP vs PP x-ray angiography detectors over a detector target dose (DTD) range relevant for invasive cardiology procedures.

A total of 16 passive pixel detector systems representing two models and two active pixel detector systems of a single model were tested. Iodine contrast (160 mg I ml^-1 ) disk-shaped test objects of diameter 0.5-4.0 mm were embedded in 30 × 30 cm² 25-cm-thick PMMA phantom. Detector target dose was 6, 18, and 120 nGy and 1204 test signal present and signal absent images were acquired. A channelized Hotelling observer statistical model (CHO) was used to estimate detectability index (d') of the detectors for the various test objects. The CHO included correction for bias from finite sampling and that due to temporally variable electronic noise.

Detectability index estimates demonstrated similar performance between the two models of PP detectors and relatively improved performance for the AP detectors for all DTD levels and test object diameters. For DTD = 120 nGy and the 4.0 mm test object, d' of the AP detectors was 13% and 20% greater than that of the PP detectors. For DTD = 6 nGy, d' of the AP detectors was 42% and 54% greater.

The AP x-ray angiography detector demonstrated superior performance throughout the DTD range tested and especially for DTD consistent with low-dose fluoroscopy. The improved performance of the AP detectors may facilitate reduced patient dose and/or improved image quality.