Tomographic quality evaluation of flexible X-ray scintillating imaging skins

OBJECTIVE: Detecting abnormal tissue is minimally invasive surgery is challenging due to the lack of direct palpation for the surgeon, with visualisation often being limited to white light endoscope images of the tissue surface, providing no information about inner structures. Imaging skins are being explored as a novel method of surgical image guidance: they are flexible and stretchable scintillating films that can act as indirect x-ray detectors when placed directly on the organ surface. Approach. Tomographic imaging of a custom quality evaluation phantom was performed using the imaging skin system. Image quality metrics, including spatial resolution, contrast, and uniformity, were obtained and compared to a conventional flat-panel micro-CT system. Main results. The imaging skin scan achieved a spatial resolution of 3.11 lp/mm at 10% contrast. While these results were worse than that of the micro-CT system, the imaging skin system still met the requirements for clinical CT, demonstrating its clinical suitability. Significance. The feasibility of 3D x-ray imaging using imaging skins directly placed onto the imaged object has been demonstrated, achieving high resolution, comparable to clinical CT. Future work will involve artefact corrections and more advanced reconstruction techniques for the intended application of imaging skins for real-time surgical guidance.