Energy-resolved X-ray detectors: the future of diagnostic imaging

This paper presents recent progress in the field of X-ray detectors, which could play a role in medical imaging in the near future, with special attention to the new generation of complementary metal-oxide semiconductor (C-MOS) imagers, working in photon counting, that opened the way to the energy-resolved X-ray imaging. A brief description of the detectors used so far in medical imaging (photographic films, imaging plates, flat panel detectors), together with the most relevant imaging quality parameters, shows differences between, and advantages of these new C-MOS imagers. X-ray energy-resolved imaging is very attractive not only for the increase of contrast but even for the capability of detecting the nature and composition of the material or tissue to be investigated. Since the X-ray absorption coefficients of the different parts or organs of the patient (object) are strongly dependent on the X-ray photon energy, this multienergy ("colored") X-ray imaging could increase enormously the probing capabilities. While dual-energy imaging is now a reality in medical practice, multienergy is still in its early stage, but a promising research activity. Based on this new technique of color X-ray imaging, the entire scheme of source-object-detector could be revised in the future, optimizing spec- trum and detector to the nature and composition of the target to be investigated. In this view, a transition to a set of monoenergetic X-ray lines, suitably chosen in energy and intensity, could be envisaged, instead of the present continuous spectra.