Current large area x-ray detectors for digital breast tomosynthesis (DBT) are based on the amorphous silicon (a-Si:H) passive pixel sensor (PPS) technology. However, PPS detectors suffer from a limited resolution and high electronic noise. In this dissertation, we propose high resolution large area active pixel sensor (APS) x-ray detectors based on the complementary metal-oxide-semiconductor (CMOS) and amorphous In-Sn-Zn-O (a-ITZO) thin-film transistor (TFT) technologies to improve the imager resolution and noise properties. We evaluated the two-dimensional (2D) x-ray imaging performance as measured by the modulation transfer function (MTF), noise power spectrum (NPS) and detective quantum efficiency (DQE) for both 75 µm (Dexela 2923 MAM) and 50 µm pixel pitch (DynAMITe) CMOS APS x-ray detectors. Excellent imaging performance (DQE in the range of 0.7 – 0.3) has been achieved over the entire spatial frequency range (0 – 6.7 mm-1) at low air kerma below 10 µGy using the 75 µm pixel pitch Dexela 2923 MAM detector. The 50 μm pixel pitch DyAMITe detector has further extended the spatial resolution of the detector to 10 mm-1 with a low electronic noise of 150 e-. Also, a 2D cascaded system analysis model has been developed to describe the signal and noise transfer for the CMOS APS x-ray imaging systems. We also implemented three-dimensional (3D) cascaded system analysis to simulated the 3D MTF, NPS and DQE characteristics using DBT radiation conditions and acquisition geometries. The 3D cascaded system analysis for the DynAMITe detector was integrated with an object task function, a medical imaging display model, and the human eye contrast sensitivity function to calculate the detectability index and area under the ROC curve (AUC). It has been demonstrated that the display pixel pitch and zoom factor should be optimized to improve the AUC for detecting high contrast objects such as microcalcifications. Also, detector electronic noise of smaller than 300 e- and a high display maximum luminance (>1000 cd/cm2) are desirable to distinguish microcalcifications of 150 µm or smaller in size. For low contrast object detection, a medical imaging display with a minimum of 12 bits gray levels is needed to realize accurate luminance levels. A wide projection angle range (≥ ±30°) combined with the image gray level magnification could improve the detectability for low contrast objects especially when the anatomical background noise is high. CMOS APS x-ray detectors demonstrate both a high pixel resolution and low electronic noise, but are challenging to be fabricated in a large detector size greater than the wafer scale. Alternatively, current-mode APS (C-APS) based on a-ITZO TFTs was proposed for DBT due to the high gain, low noise, and capability to realize a large detector area. Specifically, we fabricated a-ITZO TFTs and achieved a high field-effect mobility of >30 cm2/Vs. We have also evaluated the electrical performance of a 50 µm pixel pitch a-ITZO TFT C-APS combined with an a-Si:H p+-i-n+ photodiode using SPICE simulation. The proposed C-APS circuit demonstrates a high charge gain of 885 with data line loadings considered. A pixel circuit layout and fabrication process have also been suggested. Finally, noise analysis has been applied to the a-ITZO TFT C-APS. A low electronic noise of around 239 e- has been established.The research presented in this thesis indicates that APS x-ray detectors based on both CMOS and a-ITZO TFT technologies are promising for next generation DBT systems.
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High Resolution Active Pixel Sensor X-Ray Detectors for Digital Breast Tomosynthesis