S Rudin, CN Ionita, A Kuhls-Gilcrist, C Keleshis, W Wang,
DR Bednarek
(Supported by NIH grants R01 EB002873, NS43924, and EB00842501;
UB Fnd. IRDF and a Toshiba Med. Sys. Corp. equipment grant)
1. Arterial puncture vs. larger dissection of body cavity or skull
2. Use of catheter vs. scalpel, drills, clamps, etc.
3. X-ray image guidance vs. visual viewing
Advances in EIGIs Devices and Detectors*
• Devices
– Catheters and stents
– Clot busters
– Flow modifying asymmetric vascular stents (AVS) for aneurysms
• Stainless, balloon expandable, open cell, steel mesh flow modifier
• Stainless, baloon expandable, open cell, polyurethane film modifier
• Nitinol, self-expanding, open cell, polyurethane film flow modifier
• Nitinol, self-expanding, closed cell, PTFE porous film flow modifier
• High Resolution Detectors
– Micro-angiographic (MA) detector
– Micro-angiographic Fluoroscope (MAF)
– Solid State X-ray Image Intensifier (SSXII)
• New Imaging System Evaluation Concepts
– MTF only from noise response measurements
– Instrumentation Noise Equivalent Exposure and Quantum
Limited Performance
– GMTF and GDQE
*Rudin S, Bednarek DR, Hoffmann KR: Endovascular Image Guided Interventions (EIGI).
Vision 20/20 paper. Medical Physics 35(1): 301-309, Jan 2008.
Advances in EIGIs Devices and Detectors*
• Devices
– Catheters and stents
– Clot busters
– Flow modifying asymmetric vascular stents (AVS) for aneurysms
• Stainless, balloon expandable, open cell, steel mesh flow modifier
• Stainless, balloon expandable, open cell, polyurethane film modifier
• Nitinol, self-expanding, open cell, polyurethane film flow modifier
• Nitinol, self-expanding, closed cell, PTFE porous film flow modifier
• High Resolution Detectors
– Micro-angiographic (MA) detector
– Micro-angiographic Fluoroscope (MAF)
– Solid State X-ray Image Intensifier (SSXII)
• New Imaging System Evaluation Concepts
– MTF only from noise response measurements
– Instrumentation Noise Equivalent Exposure and Quantum
Limited Performance
– GMTF and GDQE
*Rudin S, Bednarek DR, Hoffmann KR: Endovascular Image Guided Interventions (EIGI).
Vision 20/20 paper. Medical Physics 35(1): 301-309, Jan 2008.

guiding catheter introducer
microcatheters flexible
Stenotic vessel with plaque.
Stents: drug eluting or bare; covered or not; material: stainless steel, nitinol, dissolvable(?) expand: balloon or self
Velocity (Cordis)
Tetra (Guidant)
Stent on balloon
Various lengths and diameters
1
2
3
4
1. Integra, nitinol selfexpanding (J and J)
2. Multilink, stainless steel, balloon expanding (Guidant)
3. Needle, 26 Ga
4. Wallstent, stainless steel, self-expanding
(Boston Scientific)
Neurojet
Clot Busting
ECOS
MicroLysUS
LaTis laser
G. M. Nesbit et al:
JVIR 2004; 15:S103–S110

Clot Removal
InTime Retriever and Ensnare
Neuronet
Merci Retriever
Advances in EIGIs Devices and Detectors*
• Devices
– Catheters and stents
– Clot busters
– Flow modifying asymmetric vascular stents (AVS) for aneurysms
• Stainless, balloon expandable, open cell, steel mesh flow modifier
• Stainless, balloon expandable, open cell, polyurethane film modifier
• Nitinol, self-expanding, open cell, PTFE porous film flow modifier
• Nitinol, self-expanding, closed cell, PTFE porous film flow modifier
• High Resolution Detectors
– Micro-angiographic (MA) detector
– Micro-angiographic Fluoroscope (MAF)
– Solid State X-ray Image Intensifier (SSXII)
• New Imaging System Evaluation Concepts
– MTF only from noise response measurements
– Instrumentation Noise Equivalent Exposure and Quantum
Limited Performance
– GMTF and GDQE
*Rudin S, Bednarek DR, Hoffmann KR: Endovascular Image Guided Interventions (EIGI).
Vision 20/20 paper. Medical Physics 35(1): 301-309, Jan 2008.
Perforators
(50-200
µ m)
Asymmetric Stent in 2-3 mm vessel
C. Ionita
C. Ionita, et al

Pre-stent Post-stent
Obtain 3D model (vessel or aneurysm)
Create a mathematical grid
Solve the differential equations
(Navier-Stokes equations) at each grid point at each time point
Velocities
Untreated Stented
Untreated Stented
Streamlines
Untreated Stented
Wall Shear Stress
WSS
(dyne/cm )

Advances in EIGIs Devices and Detectors*
• Devices
– Catheters and stents
– Clot busters
– Flow modifying asymmetric vascular stents (AVS) for aneurysms
• Stainless, balloon expandable, open cell, steel mesh flow modifier
• Stainless, balloon expandable, open cell, polyurethane film modifier
• Nitinol, self-expanding, open cell, PTFE porous film flow modifier
• Nitinol, self-expanding, closed cell, PTFE porous film flow modifier
• High Resolution Detectors
– Micro-angiographic (MA) detector
– Micro-angiographic Fluoroscope (MAF)
– Solid State X-ray Image Intensifier (SSXII)
• New Imaging System Evaluation Concepts
– MTF only from noise response measurements
– Instrumentation Noise Equivalent Exposure and Quantum
Limited Performance
– GMTF and GDQE
*Rudin S, Bednarek DR, Hoffmann KR: Endovascular Image Guided Interventions (EIGI).
Vision 20/20 paper. Medical Physics 35(1): 301-309, Jan 2008.
Flow Modifying Asymmetric Vascular Stents
(AVS)
Balloon expandable
Stainless steel stent
Stainless steel mesh flow modifier
Open cell
C. Ionita, et al
Asymmetric Vascular Stents (AVS)
Balloon expandable
Stainless steel stent
Polyurethane film flow modifier
Open cell
Self expanding
Nitinol stents
PTFE film flow modifier
Open Cell
Closed Cell
Ionita CN, Chang C, Sinelnikov A, Bednarek DR, Rudin S: Angiographic analysis of aneurysms treated with a novel self-expanding asymmetric vascular stents (SAVS) (abstract). Medical Physics, June 2009, WE-C-304A-5.
Stent designs such as Enterprise and Wingspan

Advances in EIGIs Devices and Detectors*
• Devices
– Catheters and stents
– Clot busters
– Flow modifying asymmetric vascular stents (AVS) for aneurysms
• Stainless, balloon expandable, open cell, steel mesh flow modifier
• Stainless, balloon expandable, open cell, polyurethane film modifier
• Nitinol, self-expanding, open cell, PTFE porous film flow modifier
• Nitinol, self-expanding, closed cell, PTFE porous film flow modifier
• High Resolution Detectors
– Micro-angiographic (MA) detector
– Micro-angiographic Fluoroscope (MAF)
– Solid State X-ray Image Intensifier (SSXII)
• New Imaging System Evaluation Concepts
– MTF only from noise response measurements
– Instrumentation Noise Equivalent Exposure and Quantum
Limited Performance
– GMTF and GDQE
*Rudin S, Bednarek DR, Hoffmann KR: Endovascular Image Guided Interventions (EIGI).
Vision 20/20 paper. Medical Physics 35(1): 301-309, Jan 2008.
Region of Interest (ROI) Micro-angiography and
Fluoroscopy for Image-guided
Interventions (IGI)
Detector requirements:
Angiography, ROI-CT, and new device imaging:
• High resolution (> 4 Lp/mm)
Real-time fluoroscopy for image guidance:
• High sensitivity - low instrumentation noise (quantum noise limited)
• High speed (30 fps)
• No lag (high temporal resolution)
ROI imaging: reduce integral radiation dose
Detectors:
High Sensitivity Micro-Angiographic Fluoroscope, MAF
Solid State X-ray Image Intensifier, SSXII
• Micro-angiographic detector, MA (not fluoro capable )
• High Sensitivity Micro-angiographic Fluoroscope,
MAF (with light amplifier for gain)
• Solid State X-ray Image Intensifier, SSXII
(built-in EMCCD gain, fluoro capable)
CCD Camera
EMCCD Camera
CCD Camera
FOP
FOT
FOP
CsI
FOPs
Photocathode
FOP
FOP
FOT
Gen2 LA with
MCPs
CsI
FOP
CsI
FOP
FOT
MA detector (no gain) MAF detector SSXII detector
• Micro-angiographic detector, MA (not fluoro capable )
• High Sensitivity Micro-angiographic Fluoroscope,
MAF (with light amplifier for gain)
• Solid State X-ray Image Intensifier, SSXII
(built-in EMCCD gain, fluoro capable)
CCD Camera
EMCCD Camera
CCD Camera
FOP
FOT
FOP
CsI
FOPs
Photocathode
FOP
FOP
MA detector (no gain) MAF detector
FOT
Gen2 LA with
MCPs
CsI
FOP
CsI
FOT
FOP
SSXII detector

The High-Sensitivity Microangiographic Fluoroscopic
(MAF) Detector
Power Supply for the LII
CCD
Camera
FOT
LII
High sensitivity for fluoroscopic applications
• Direct fiber-optic coupling (no lenses): Fiber-optic plate (FOP) windows, Fiber-optic taper (FOT)
• LII (LA) with MCPs for variable high system gain
High resolution (~ 35 µm pixel in equal-area-framing)
Ionita CN, Keleshis C, Jain A, Bednarek DR, Rudin S: Testing of the high-resolution ROI micro-angio fluoroscope (MAF) detector using a modified NEMA XR-21 phantom (abstract). Medical Physics, June 2009, MO-FF-A4-3 .
Jain A, Bednarek DR, Rudin S: Performance evaluation of a custom-made anti-scatter grid used for the high-resolution Micro-
Angiographic Fluoroscope (MAF) (abstract). Medical Physics, June 2009, WE-C-304A-3 .
Line-Pair Phantom
MAF and FPD Detectors High Resolution ROI Detector Implementation
Wang W, Keleshis C, Kuhls-Gilcrist A,
Ionita CN, Jain A, Bednarek DR, Rudin
S: New High-Resolution-Detector
Changer for a Clinical Fluoroscopic C-
Arm Unit (abstract). Medical Physics,
June 2009, SU-FF-I-171
Retracted Deployed

Roadmaps of AVS treated-Aneurysms
MAF XII
• Micro-angiographic detector, MA (not fluoro capable )
• High Sensitivity Micro-angiographic Fluoroscope,
MAF (with light amplifier for gain)
• Solid State X-ray Image Intensifier, SSXII
(built-in EMCCD gain, fluoro capable)
CCD Camera
EMCCD Camera
CCD Camera
FOP
FOT
FOP
CsI
FOPs
Photocathode
FOP
FOP
MA detector (no gain) MAF detector
FOT
Gen2 LA with
MCPs
CsI
FOP
CsI
FOT
FOP
SSXII detector
22 V
15 V
Gain
Gain
=
=
(
1 .
019
)
400
(
1 .
006
)
400
≈
2000 x
≈
10 x

SSXII Current State-of-the-Art
Acquisition Parameters: 70kVp; 160mA; 45ms; 2” PMMA; 0.3mm Focal Spot; Identical Geometry
Kuhls-Gilcrist A, Bednarek DR, Rudin S: Component analysis of a new solid state x-ray image intensifier (SSXII) using photon transfer. SPIE vol. 7258, 2009. In: Proc. from Med. Imaging 2009: Physics of Med. Imaging, Orlando, FL, # 7258-42, 725817:1-10.
Kuhls AT, Yadava G, Rudin S: Progress in electron-multiplying CCD (EMCCD) based, high-resolution, high-sensitivity x-ray detector for fluoroscopy and radiography. SPIE 6510-47, 2007. In: Proc. Med. Imag. 2007: Phys. of Med. Imag., San Diego, CA.
Kuhls-Gilcrist AT, Yadava GK, Patel V, Bednarek DR, Rudin S: The Solid-State X-Ray Image Intensifier (SSXII): An
EMCCD-Based X-Ray Detector. SPIE 6913-19, 2008. In: Proc. Med. Imag. 2008: Phys. of Med. Imag., San Diego, CA.
100 µm Au
50 µm Pt
100 µm I
AVS w, polyU
Patch marked
(Extended FOV)
Rudin S, Yadava G, Josan G, Kuhls A, Rangwala H, Wu Y, Ionita C, Bednarek DR: New light-amplifier-based detector designs for high spatial resolution and high sensitivity CBCT mammography. SPIE vol. 6142, pp. 6142R1-11, 2006. In: Proc. Med. Imag. 2006: Phys. of Med. Imag., San Diego, CA, paper #63.

Control, Acquisition, Processing, and Image Display System
(CAPIDS)
Wang W, Keleshis C, Kuhls-Gilcrist A, Bednarek DR,
Hoffmann KR, Rudin S: Control, Acquisition, Processing, and
Image Display System (CAPIDS) for the Solid-State X-Ray
Image Intensifier (SSXII) (abstract). Medical Physics, June
2009, SU-FF-I-170.
Control, Acquisition, Processing, and Image Display System
(CAPIDS)
Control, Acquisition, Processing, and Image Display System
(CAPIDS)
Control, Acquisition, Processing, and Image Display System
(CAPIDS)

Advances in EIGIs Devices and Detectors*
• Devices
– Catheters and stents
– Clot busters
– Flow modifying asymmetric vascular stents (AVS) for aneurysms
• Stainless, balloon expandable, open cell, steel mesh flow modifier
• Stainless, balloon expandable, open cell, polyurethane film modifier
• Nitinol, self-expanding, open cell, PTFE porous film flow modifier
• Nitinol, self-expanding, closed cell, PTFE porous film flow modifier
• High Resolution Detectors
– Micro-angiographic (MA) detector
– Micro-angiographic Fluoroscope (MAF)
– Solid State X-ray Image Intensifier (SSXII)
• New Imaging System Evaluation Concepts
– MTF only from noise response measurements
– Instrumentation Noise Equivalent Exposure and Quantum
Limited Performance
– GMTF and GDQE
*Rudin S, Bednarek DR, Hoffmann KR: Endovascular Image Guided Interventions (EIGI).
Vision 20/20 paper. Medical Physics 35(1): 301-309, Jan 2008.
Slit Width
Errors in
Conventional Slit Method
(Simulation)
Jain A, Patel V, Kuhls-Gilcrist A, Bednarek DR, Hoffmann KR, Rudin S:
Effect of point spread function, x-ray quantum noise, and additive instrumentation noise on the accuracy of the angulated slit method for determination of pre-sampled detector MTF. (abstract).
Medical Physics, June 2009, SU-FF-I-108.
3 % Added Noise
Slit Angle
Advances in EIGIs Devices and Detectors*
• Devices
– Catheters and stents
– Clot busters
– Flow modifying asymmetric vascular stents (AVS) for aneurysms
• Stainless, balloon expandable, open cell, steel mesh flow modifier
• Stainless, balloon expandable, open cell, polyurethane film modifier
• Nitinol, self-expanding, open cell, PTFE porous film flow modifier
• Nitinol, self-expanding, closed cell, PTFE porous film flow modifier
• High Resolution Detectors
– Micro-angiographic (MA) detector
– Micro-angiographic Fluoroscope (MAF)
– Solid State X-ray Image Intensifier (SSXII)
• New Imaging System Evaluation Concepts
– MTF only from noise response measurements
– Instrumentation Noise Equivalent Exposure and Quantum
Limited Performance
– GMTF and GDQE
*Rudin S, Bednarek DR, Hoffmann KR: Endovascular Image Guided Interventions (EIGI).
Vision 20/20 paper. Medical Physics 35(1): 301-309, Jan 2008.
Advances in EIGIs Devices and Detectors*
• Devices
– Catheters and stents
– Clot busters
– Flow modifying asymmetric vascular stents (AVS) for aneurysms
• Stainless, balloon expandable, open cell, steel mesh flow modifier
• Stainless, balloon expandable, open cell, polyurethane film modifier
• Nitinol, self-expanding, open cell, PTFE porous film flow modifier
• Nitinol, self-expanding, closed cell, PTFE porous film flow modifier
• High Resolution Detectors
– Micro-angiographic (MA) detector
– Micro-angiographic Fluoroscope (MAF)
– Solid State X-ray Image Intensifier (SSXII)
• New Imaging System Evaluation Concepts
– MTF only from noise response measurements
– Instrumentation Noise Equivalent Exposure and Quantum
Limited Performance
– GMTF and GDQE
*Rudin S, Bednarek DR, Hoffmann KR: Endovascular Image Guided Interventions (EIGI).
Vision 20/20 paper. Medical Physics 35(1): 301-309, Jan 2008.

• GOAL: Provide a Simple and Accurate Presampled MTF
Measurement Technique for Digital Radiography Systems
• Use only the Detector Noise Response
• Inherently 2-D
Line Spread Function
Output NPS:
NPS ( u , v )
=
[
∆ x
∆ y
~
A
S
−
1 + ∆ x
∆ yg
4
]
Φ
4
+
NPS
ADD
∆ x ,
∆ y
T
SYS
A
S
NPS
ADD
(((( ))))
(((( )))) u , v
(((( )))) g
Φ
4
4
==== pixel width
==== system gain (DN per absorbed x ray)
==== presampled MTF
==== frequency
==== additive
dependent electronic
Swank noise factor
==== electron to
==== output signal
digital number conversion factor
Kuhls-Gilcrist A, Jain A, Bednarek DR, Rudin S: A method for measuring the MTF of digital radiography systems using noise response (abstract). Medical Physics, June 2009, WE-C-304A-7.
Output NPS:
NPS ( u , v )
=
[
∆ x
∆ y
~
A
S
−
1 + ∆ x
∆ yg
4
]
Φ
4
+
NPS
ADD
Primary Quantum +
Poisson Excess Noise
Secondary
Quantum Noise
Additive Noise
Output NPS:
NPS ( u , v )
=
[
∆ x
∆ y
~
A
S
−
1 + ∆ x
∆ yg
4
]
Φ
4
+
NPS
ADD
Primary Quantum +
Poisson Excess Noise
Secondary
Quantum Noise
Presampled MTF is
Inherently in the Noise
Response!
Additive Noise

• Acquire 30 Flat-Field Images at Several mAs
Values [IEC Guidelines; Standardized Spectrum
(RQA)]
• Measure NPS ( u , v )
• 1000 x 1000, 32 µ m Pixels
• 150 µ m CsI Phosphor
• “True” MTF Known Exactly
• Acquire 30 Flat-Field Images at Several mAs
Values [IEC Guidelines; Standardized Spectrum
(RQA)]
• Measure NPS ( u , v )
• Plot NPS ( u , v ) versus Signal and Fit with 2 nd
Poly.
Order
• Acquire 30 Flat-Field Images at Several mAs
Values [IEC Guidelines; Standardized Spectrum
(RQA)]
• Measure NPS ( u , v )
• Plot NPS ( u , v ) versus Signal and Fit with 2 nd
Poly.
2
F
A h
1
( f
− h
3
)
2
• Fit Quantum NPS (Slope Data)
S 4
Order
Presampled MTF

Averaged
Deviation = 0.3%
ER Averaged
Deviation > 30%
Advances in EIGIs Devices and Detectors*
• Devices
– Catheters and stents
– Clot busters
– Flow modifying asymmetric vascular stents (AVS) for aneurysms
• Stainless, balloon expandable, open cell, steel mesh flow modifier
• Stainless, balloon expandable, open cell, polyurethane film modifier
• Nitinol, self-expanding, open cell, PTFE porous film flow modifier
• Nitinol, self-expanding, closed cell, PTFE porous film flow modifier
• High Resolution Detectors
– Micro-angiographic (MA) detector
– Micro-angiographic Fluoroscope (MAF)
– Solid State X-ray Image Intensifier (SSXII)
• New Imaging System Evaluation Concepts
– MTF only from noise response measurements
– Instrumentation Noise Equivalent Exposure and Quantum
Limited Performance
– GMTF and GDQE
*Rudin S, Bednarek DR, Hoffmann KR: Endovascular Image Guided Interventions (EIGI).
Vision 20/20 paper. Medical Physics 35(1): 301-309, Jan 2008.
N exp
2 = k ( E + INEE )
IF E>INEE, then quantum noise limited.
IF E<INEE, then instrumentation noise limited.
*Kuhls-Gilcrist A, Bednarek DR, Rudin S: The Instrumentation Noise Equivalent Exposure (INEE): Including conversion, secondary quantum, structure and electronic noise (abstract). Medical Physics, June 2009,
WE-C-304A-8 .

INEE = 2.0 µR
Quantum
Noise
Limited
Instrumentation
Noise Limited
Quantum Noise
Limited
Instrumentation
Noise Limited
Advances in EIGIs Devices and Detectors*
• Devices
– Catheters and stents
– Clot busters
– Flow modifying asymmetric vascular stents (AVS) for aneurysms
• Stainless, balloon expandable, open cell, steel mesh flow modifier
• Stainless, balloon expandable, open cell, polyurethane film modifier
• Nitinol, self-expanding, open cell, PTFE porous film flow modifier
• Nitinol, self-expanding, closed cell, PTFE porous film flow modifier
• High Resolution Detectors
– Micro-angiographic (MA) detector
– Micro-angiographic Fluoroscope (MAF)
– Solid State X-ray Image Intensifier (SSXII)
• New Imaging System Evaluation Concepts
– MTF only from noise response measurements
– Instrumentation Noise Equivalent Exposure and Quantum
Limited Performance
– GMTF and GDQE
*Rudin S, Bednarek DR, Hoffmann KR: Endovascular Image Guided Interventions (EIGI).
Vision 20/20 paper. Medical Physics 35(1): 301-309, Jan 2008.

Factors affecting GMTF and GDQE for given object plane: detector scattering object focal spot
Image mag, m
MAF Detector,
D
Phantom: Scattering fraction,
Patient
Table
X-ray tube
Focal spot,
F
Generalized System Evaluation Metrics
Generalized Modulation Transfer Function (GMTF)
GMTF ( f ,
ρ
, m )
=
( 1
− ρ
) MTF
F
( m
− m
1 f )
+ ρ
MTF
S f
( m
) MTF
D f
( m
)
Generalized Noise Power Spectrum (GNPS)
GNNPS ( f , X , m )
=
NPS
D
( m 2 d 2 f m
,
( X )
X )
=
NNPS
D m 2 f
( m
, X )
Generalized Noise Equivalent Quanta (GNEQ)
GNEQ ( f ,
ρ
, X , m )
=
GMTF 2 (
GNNPS ( f f ,
ρ
, m )
,
ρ
, X , m )
Generalized Detective Quantum Efficiency (GDQE)
GDQE ( f ,
ρ
, X , m )
=
GNEQ ( f ,
ρ
, X m
2 Φ in
( X , m )
, m )
The generalized parameters are defined with reference to the object plane
Kyprianou I, Rudin S, Bednarek DR, Hoffmann KR: Generalizing the MTF and DQE to include x-ray scatter and focal spot unsharpness: Application to a new micro-angiographic system for clinical use. Medical Physics, 32(2): 613-626, 2005.
GMTFs
Impact of varying the x-ray tube focal-spot size and air gaps
0.3 mm focal-spot
DQE/GDQE
0.6 mm focal-spot
Yadava et al., AAPM 2005, Medical Physics 32 (6), 2080 (2005)

1. Appreciate the progress being made in improved EIGI devices and in particular flow modifiers such as the asymmetric vascular stent (AVS) for aneurysm treatment.
2. Understand the operation of new highresolution micro-angiographic systems including the MAF and SSXII.
3. Understand new objective image detector evaluations including INEE, GMTF, GDQE, and determination of MTF from noise response measurements alone.

Always Instrumentation Noise Limited
Instrumentation Noise Limited @ 2 µR
NPS
Measured
(((( u , v , E
))))
====
S
Structure
(((( ))))
E 2 ++++ a 2 pixel
η
T 2
SYS u , 1
++++
ε g
CsI g
CsI
++++
K
ADC
T 2
Pixel u , E
++++
S
ADD u ,
NPS
Measured
====
NPS
Strcture
++++
NPS
Primary
++++
NPS
Excess
++++
NPS
Secondary
++++
NPS
Electronic
NPS
Structure
NPS
Primary
(((( u , v , E
(((( u , v , E
))))
)))) ====
====
S
Structure
(((( ))))
E 2 a
2 pixel
NPS
Excess
(((( u , v , E
)))) ==== a
2 pixel
NPS
Secondary
(((( u , v , E
)))) ==== a 2 pixel
η
η
η
2
T
2
SYS
(((( ))))
E
2
T
2
SYS u ,
K
ADC
T 2
CCD
ε g
CsI g
CsI
(((( ))))
E
E
NPS
Electronic
(((( u , v , E
)))) ====
S
ADD
NPS
Measured
(((( u , v , E
)))) (((( ))))
E
2 ++++
B
(((( ))))
E
++++
C
(((( ))))
Detector Comparison*
Detector System INEE
MA
MAF, SSXII
XII
FPD**
20.4 µR
<0.1 µR
<0.2 µR
2.75 µR
Pixel (µm)
43
35-48
120-300+
~300
Lag (frames)
None
None
None
5+
Frame Rate (fps)
4
30
30
30
*Kuhls-Gilcrist A, Jain A, Bednarek DR, Rudin S: Instrumentation Noise Equivalent Exposure (INEE): an investigation of spatial frequency effects (abstract). Medical Physics 2008, SU-DD-A4-6 .
*Szczykutowicz, T, Kuhls-Gilcrist A, Bednarek DR, Rudin S: Instrumentation noise equivalent exposure
(INEE) for routine quality assurance: INEE measurements on a clinical flat panel detector (abstract).
Medical Physics 2008, MO-E-332-7 .
**Roos et al., “Multiple gain ranging readout method to extend the dynamic range of amorphous silicon flat panel imagers”, Physics of Medical Imaging, Proc SPIE 5368, 139-149 (2004).

Dual Detector ROI Cone Beam CT
1. Chityala R, Hoffmann KR, Rudin S, Bednarek DR: Region-of-interest (ROI) Computed Tomography: Combining dual resolution
XRII images (abstract). Medical Physics, 32(6): 2056, June 2005, MO-D-I-611-4. (AAPM05)
2. Patel V, Ionita CN, Keleshis C, Sherman J, Hoffmann KR, Bednarek DR, Rudin S: First implementation of high-resolution dualdetector Region-of-Interest Cone-Beam Computed Tomography (ROI-CBCT) for a rotating C-arm gantry system (abstract).
Medical Physics, TH-C-332-2. (AAPM08)
3. Patel V, Hoffmann KR, Bednarek DR, Rudin S: Automatic registration technique for rotating-gantry dual-detector Region
-of-Interest Cone-Beam Computed Tomography (ROI-CBCT) (abstract). Medical Physics, TH-D-332-4 (AAPM08)
Dual Detector ROI CBCT
Ionita CN, Patel V, Keleshis C,
Hoffmann KR, Bednarek DR, Rudin S:
Update on the development of a new dual detector (Micro-Angiographic
Fluoroscope/Flat Panel) C-arm mounted system for endovascular image guided interventions (EIGI) (abstract). Medical
Physics 2008, MO-D-332-7.
High Resolution ROI Detector Implementation
Retracted Deployed
MAF projection of stent deployed in rabbit carotid artery near constriction.

FPD-CBCT Dual Detector ROI-CBCT
First in –vivo
3D ROI-CBCT of a Stent
Schematics of the AVS-treated aneurysms
Asymmetric Vascular Stent
(AVS)
Aneurysm treated with AVS
Side View Transverse View