A novel wafer-scale CMOS APS X-ray detector for breast cancer diagnosis using X-ray diffraction studies

The current study uses a novel large area (12.8 cm × 13.1 cm) complementary metal-oxide-semiconductor (CMOS) active pixel sensor (APS) X-ray detector, named Dynamic range Adjustable for Medical Imaging Technology (DynAMITe), for breast cancer diagnosis. The detector consists of two geometrically superimposed grids: a) 2560 × 2624 fine-pitch grid of pixels (50 µm pitch), named Sub-Pixels (SP camera), for low intrinsic noise and high spatial resolution and b) 1280 × 1312 large-pitch grid of pixels (100 µm pitch), named Pixels (P camera), for high dynamic range. X-ray performance characterization measurements show that the detective quantum efficiency (DQE) of the SP camera is in the range 0.7-0.75 at low spatial frequencies using a tungsten (W) anode X-ray source at 28 kV. Hence, the detector is suitable for mammography. Furthermore, we used the SP camera to combine mammograms with angle dispersive X-ray diffraction (ADXRD) measurements in order to apply the X-ray biopsy concept in one examination. The results show that ADXRD technique indicates the presence of cancer in suspicious areas on the mammogram. Hence, it could be used to determine the region affected by cancer and assist in planning surgery. This study is the proof of concept that mammography and ADXRD can be combined in one examination.