The seventh workshop on Medical Applications of Spectroscopic X-ray Detectors was held at CERN from 15 to 18 April. This year’s workshop brought together more than 100 experts in medical imaging, radiology, physics and engineering. The workshop focused on the latest advancements in spectroscopic X-ray detectors and their applications in medical diagnostics and treatment. Such detectors, whose origins are found in detector R&D for high-energy physics, are now experiencing a breakthrough moment in medical practice.
Spectroscopic X-ray detectors represent a significant advancement in medical imaging. Unlike traditional X-ray detectors that measure only the intensity of X-rays, these advanced detectors can differentiate the energies of X-ray photons. This enables enhanced tissue differentiation, improved tumour detection and advanced material characterisation, which may lead in certain cases to functional imaging without the need for radioactive tracers.
The technology has its roots in the 1980s and 1990s when the high-energy-physics community centred around CERN developed a combination of segmented silicon sensors and very large-scale integration (VLSI) readout circuits to enable precision measurements at unprecedented event rates, leading to the development of hybrid pixel detectors (see p37). In the context of the Medipix Collaborations, CERN has coordinated research on spectroscopic X-ray detectors including the development of photon-counting detectors and new semiconductor materials that offer higher sensitivity and energy resolution. By the late 1990s, several groups had proofs of concept, and by 2008, pre-clinical spectral photon-counting computed-tomography (CT) systems were under investigation.
Spectroscopic X-ray detectors offer unparalleled diagnostic capabilities, enabling more detailed imaging and earlier and precise disease detection
In 2011, leading researchers in the field decided to bring together engineers, physicists and clinicians to help address the scientific, medical and engineering challenges associated with guiding the technology toward clinical adoption. In 2021, the FDA approval of Siemens Healthineers’ photon-counting CT scanner marked a significant milestone in the field of medical imaging, validating the clinical benefits of spectroscopic X-ray detectors. The mobile CT scanner, OmniTom Elite from NeuroLogica, approved in March 2022, also integrates photon counting detector (PCD) technology. The 3D colour X-ray scanner developed by MARS Bioimaging, in collaboration with CERN based on Medipix3 technology, has already shown significant promise in pre-clinical and clinical trials. Clinical trials of MARS scanners demonstrated its applications for detecting acute fractures, evaluation of fracture healing and assessment of osseous integration at the bone–metal interface for fracture fixations and joint replacements. With more than 300 million CT scans being performed annually around the world, the potential impact for spectroscopic X-ray imaging is enormous, but technical and medical challenges remain, and the need for this highly specialised workshop continues.
The scientific presentations in the 2024 workshop covered the integration of spectroscopic CT in clinical workflows, addressed technical challenges in photon counting detector technology and explored new semiconductor materials for X-ray detectors. The technical sessions on detector physics and technology discussed new methodologies for manufacturing high-purity cadmium–zinc–tellurium semiconductor crystals and techniques to enhance the quantum efficiency of current detectors. Sessions on clinical applications and imaging techniques included case studies demonstrating the benefits of multi-energy CT in cardiology and neurology, and advances in using spectroscopic detectors for enhanced contrast agent differentiation. The sessions on computational methods and data processing covered the implementation of AI algorithms to improve image reconstruction and analysis, and efficient storage and retrieval systems for large-scale spectral imaging datasets. The sessions on regulatory and safety aspects focused on the regulatory pathway for new spectroscopic X-ray detectors, ensuring patient and operator safety with high-energy X-ray systems.
Enhancing patient outcomes
The field of spectroscopic X-ray detectors is rapidly evolving. Continued research, collaboration and innovation to enhance medical diagnostics and treatment outcomes will be essential. Spectroscopic X-ray detectors offer unparalleled diagnostic capabilities, enabling more detailed imaging and earlier and precise disease detection, which improves patient outcomes. To stay competitive and meet the demand for precision medicine, medical institutions are increasingly adopting advanced imaging technologies. Continued collaboration among researchers, physicists and industry leaders will drive innovation, benefiting patients, healthcare providers and research institutions.
