Stephen Rudin PhD, Presenter: Research Grant, Toshiba Corporation

Amit Jain PhD, Abstract Co-Author: Grant, Toshiba Corporation

Ciprian Ionita PhD, Abstract Co-Author: Grant, Toshiba Corporation

Daniel Bednarek PhD, Abstract Co-Author: Research Grant, Toshiba Corporation

Adnan Siddiqui MD, PhD, Abstract Co-Author: Grant, Toshiba Corporation

Elad Levy MD, Abstract Co-Author: Grant, Toshiba Corporation Research Grant, Boston Scientific Corporation Investigator, Boston Scientific Corporation Speaker, Boston Scientific Corporation Research support, Boston Scientific Corporation Research support, Covidien AG Consultant, Covidien AG Instructor, Covidien AG Research support, Johnson & Johnson Scientific Advisory Board, Johnson & Johnson Consultant, Johnson & Johnson Owner, Intratech Medical Ltd Owner, AccessClosure, Inc Consultant, TheraSyn Sensors Inc Instructor, Abbott Laboratories

Leroy Nelson Hopkins MD, Abstract Co-Author: Grant, Toshiba Corporation

Advances in the development of the MAF, which has a DQE far superior to standard dynamic flat-panel detectors (FPD) or x-ray image intensifiers (XII), and its use in neuro-endovascular aneurysm coiling will be described.

In the MAF, light from an x-ray absorbing phosphor is amplified with a light image intensifier and transferred to a CCD sensor via a fiberoptic taper resulting in 1024x1024 images with 35 micron pixels and over 10 cycles/mm resolution, recorded at up to 30 fps. The MAF is mounted onto the C-arm of a clinical angiographic unit by a changer that allows it to be moved in front of the XII or FPD during a patient interventional procedure when high-resolution image guidance over the region of interest is required. Advantages in performance and physical size reduction made possible by replacing the fiber-optic-CCD camera combination with a large CMOS sensor will be described.

The MAF-CCD (compared to an FPD) has a DQE of 0.22 (0.05) at 2.5 cycles/mm and of 0.08 (0) at 6 cycles/mm. With the MAF-CMOS, there is further DQE improvement to 0.42 and 0.3 at 2.5 and 6 cycles/mm, respectively. The MAF’s smaller FOV results in over a 10X reduction in effective dose compared to the FPD so that increased localized exposure can be used to reduce quantum mottle and improve contrast resolution; existing x-ray tube technology has been shown to be able to provide a small focal spot with sufficient output for high spatial and contrast resolution. The MAF has had a demonstrated positive impact on clinical aneurysm-treatment procedures in initial tests; interventional decisions regarding stent deployment, coil filling and micro-catheter placement have been made with greater confidence than could be achievable with lower-resolution standard XII images.

Both physical and clinical evidence substantiates the basic concept that a small field of view detector such as the MAF, far superior in image quality to standard x-ray flat panels or XIIs, can improve image-guided interventions at reduced patient effective dose. Advances in the MAF design demonstrate marked improvement in DQE especially for high spatial frequencies.

The small field of view MAF detector, with far superior spatial resolution than standard dynamic x-ray detectors, can have substantial impact on improving diagnoses and image-guided interventions.

Rudin, S, Jain, A, Ionita, C, Bednarek, D, Siddiqui, A, Levy, E, Hopkins, L, Advances in the Micro-Angiographic Fluoroscope (MAF).  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12024775.html