X-ray region of interest imaging system for rapid-sequence angiography and fluoroscopy: The micro-angiographic fluoroscope

Neuro-endovascular interventional diagnosis and treatment require high resolution x-ray imaging guidance of fluoroscopy and angiography. Our group has developed a small field of view, 5 frames per second, high-resolution micro-angiographic imager. This imager has demonstrated substantial high-resolution advantages for angiography over the conventional image intensifier. The work of this dissertation is to build a new micro-angiographic fluoroscope (MAF) to expand the capabilities of the micro-angiographic imager to include fluoroscopic imaging over a small field of view.The components of the MAF are all commercially available including CsI (T1) scintillator, fiber-optic taper, light image intensifier (LII), mirror, lens, and CCD camera. The critical component is the microchannel plate based LII with very high spatial resolution. The LII has a large range of gain that can be controlled easily by a 5V to 9V DC voltage. This property enables the MAF to be used for angiography with a low gain of the LII, and for fluoroscopy with a high gain of the LII.This design was justified by the quantum accounting diagram calculation. The preliminary experimental results from the test model MAF demonstrated the feasibility of this design. The improved prototype MAF model demonstrates high-resolution imaging for both fluoroscopy and angiography. The performance descriptors of the prototype MAF such as MTF, NPS, and DQE, were measured in both angiographic mode and fluoroscopic mode. For angiographic mode, at spatial frequencies of 4 and 10 lp/mm, the MTF for the MAF was 14% and 1.5% respectively, the DQE for the MAF was 12% and 1.2% respectively, while the DQE (0) was about 60%. For fluoroscopic mode, at spatial frequency of 4 lp/mm, the MTF for the MAF was 11%, and the DQE for the MAF was 9.5%. The image lag for the MAF in fluoroscopic mode at a rate of 30 fps was measured to be minimal. The allowable maximum entrance exposure rate was found to be related with the maximum LII phosphor screen luminance due to the maximum current limitations of the LII. Real-time dark field and flat field correction and roadmapping at a rate of 30 fps in fluoroscopic mode were realized and applied in small animal interventional studies.The current work is the first stage in the development of a new level of high resolution image guidance for neuro-interventional procedures that has the potential to greatly advance the accuracy and effectiveness of minimally invasive catheter-based interventional procedures.