This paper presents a CMOS image sensor (CIS) with pinned-photodiode 5T active pixels which use an in-pixel buried channel source follower (BSF) with an optimized row selector (RS). According to our previous work [1][2], using in-pixel BSFs with optimized RS can achieve significant pixel dark random noise reduction, i.e. 50% reduction, specially for random telegraph signal (RTS) noise, and an increase of the pixel output swing and dynamic range. With significant dark random noise reduction, in order to evaluate the performance for perspective space or medical imaging application, this proposed pixel structure using 0.18μm CMOS image sensor process is also further characterized under X-ray radiation. The results show that although X-ray radiation induced additional acceptor-like interface traps will increase dark random noise, the BSF pixels are able to constrain the dark random noise increase after X-ray radiation.