Theoretical considerations predicted the feasibility of K-edge x-ray computed tomography (CT) imaging using energy discriminating detectors with more than two energy bins. This technique enables material-specific imaging in CT, which in combination with high-Z element based contrast agents, opens up possibilities for new medical applications. In this paper, we present a CT system with energy detection capabilities, which was used to demonstrate the feasibility of quantitative K-edge CT imaging experimentally. A phantom was imaged containing PMMA, calcium-hydroxyapatite, water and two contrast agents based on iodine and gadolinium, respectively. Separate images of the attenuation by photoelectric absorption and Compton scattering were reconstructed from energy-resolved projection data using maximum-likelihood basis-component decomposition. The data analysis further enabled the display of images of the individual contrast agents and their concentrations, separated from the anatomical background. Measured concentrations of iodine and gadolinium were in good agreement with the actual concentrations. Prior to the tomographic measurements, the detector response functions for monochromatic illumination using synchrotron radiation were determined in the energy range 25 keV-60 keV. These data were used to calibrate the detector and derive a phenomenological model for the detector response and the energy bin sensitivities.

For medical imaging applications, such as cardiac imaging, dual-source computed tomography (CT) improves the temporal resolution by the simultaneous use of two cone beams, which acquire twice as many projections as single-source CT does within the same time interval. Besides this advantage, a drawback of such a system is additional x-ray scatter originating from the extra (cross-illuminating) cone beam. In this work, a comparison with single-source CT images is performed under same-dose conditions for two different thorax phantoms, and for different cone beam angles corresponding to a coverage of 20, 40, 80, and 160 mm on the rotation axis (z coverage). As a general result, the HU-magnitude of scatter-induced streak and cupping artifacts scale almost proportional to the illuminated volume. In dual-source CT, cross scatter induces a further factor of almost 2 in the scaling of artifacts in comparison to single-source CT. For all examined systems, the scatter-induced noise reduces the contrast-to-noise ratio (CNR). In the case of an ideal scatter correction, the CNR is reduced even more, but contrast and CNR can be restored by an additional x-ray dose. With a 32-slice single-source CT (z overage of 20 mm) taken as a reference, a corresponding dual-source CT requires 7% more dose to maintain the same CNR. A CT system with a z coverage of 40, 80, and 160 mm requires 8%, 23%, and 54% more dose in a single-source configuration, respectively, and 20%, 47%, and 102% more dose in a dual-source configuration, respectively. In conclusion, a dual-source CT is comparable to a single-source CT with twice the z coverage concerning image degradation by scatter.

Imaging detectors for medical X-ray and computed tomography (CT) applications have undergone many improvements and technology changes over time. But most (dynamic) detectors sold in this field still rely on indirect conversion, using scintillators and photodiodes to convert the X-ray quanta ultimately into electrical signals. Direct conversion detectors promise very high spatial resolution and high signal-to-noise ratios. Some direct conversion materials may allow for counting or even energy resolving detection of the X-ray quanta. Based on this, for example spectrally resolving CT systems are becoming an interesting option for the next decade. This contribution highlights the requirements of advanced medical X-ray and CT imaging and reviews examples of status and progress in the field. The emphasis is on the direct conversion sensors for pixelated detectors, but considerations on read-out concepts and on associated challenges such as interconnects will also be presented. Finally, the most burning issues, such as count rate limitations and polarization effects, will be discussed from an application point of view.

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