Imaging skins: stretchable Gd2O2S:Tb X-ray detectors for image-guided surgery

PURPOSE: With the growing demands for diverse X-ray imaging applications, there is a need for the development of flexible X-ray detectors to enable conformity to curved surfaces, improving spatial resolution, reducing X-ray exposure, and extending the potential of X-ray imaging to fields such as minimally invasive surgery, which would not be achievable using conventional rigid flat-panel detectors. METHODS: In this paper, we fabricate imaging skins-flexible and stretchable Gd2O2S:Tb-elastomer scintillator films-and integrate them into an indirect X-ray imaging system. We characterise X-ray imaging performance and mechanical properties of the imaging skins, investigating the impact of varying film fabrication parameters such as thickness and concentration. RESULTS: The results demonstrate the clinical suitability of the imaging skin system, achieving 1.05 to 2.18 lp/mm at 10% contrast despite the low X-ray energy used, which is comparable to clinical CT. Additionally, the high stretchability (255%) from the elastomer component was maintained in imaging skins with up to 50% Gd2O2S:Tb loading. CONCLUSION: This work provides a basis for the integration of imaging skins in clinical settings, where they have the potential to be used for real-time intraoperative image guidance. Future work will investigate dynamic and tomographic imaging methods, determine effective deployment strategies of the imaging skins onto organ surfaces, and investigate the effects of imaging skin deformation on image quality.