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J. Imaging
Volume 12
Issue 8
10.3390/jimaging12080337
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Article

Comparison of Subjective Image Quality of Mobile C-Arms Equipped with a-Si, CMOS or IGZO Flat-Panel Detectors for Intraoperative Fluoroscopy

by
Fenna Brunken
1,
Benno Bullert
1,
Robert Brauweiler
2,
Paul A. Grützner
1,
Sven Y. Vetter
1 and
Nils Beisemann
1,*
1
BG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany
2
Siemens Healthineers AG, Siemensstr. 3, 91301 Forchheim, Germany
*
Author to whom correspondence should be addressed.
J. Imaging 2026, 12(8), 337; https://doi.org/10.3390/jimaging12080337
Submission received: 3 June 2026 / Revised: 17 July 2026 / Accepted: 23 July 2026 / Published: 24 July 2026
(This article belongs to the Section Medical Imaging)
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Abstract

Different flat-panel detector technologies are available for intraoperative fluoroscopy. This study compared orthopedic and trauma surgeons’ preference and subjective image quality among mobile C-arm systems equipped with amorphous silicon (a-Si), complementary metal oxide semiconductor (CMOS) or indium gallium zinc oxide (IGZO) detectors. Fluoroscopic imaging was performed on four human specimens at four anatomic locations at pulse rates of 1/s and 10/s in low- and high-dose settings using three C-arm systems. Subjective image quality was rated by two observers on 5-point Likert scales. Pairwise forced-choice comparisons of images with identical acquisition parameters were analyzed using a Bradley–Terry model. Across all images, CMOS- and IGZO-based systems were preferred over the a-Si-based system in 91.8% and 90.4% of comparisons, respectively (ORs 9.53 and 11.20; both p < 0.001). No significant overall preference was observed between the IGZO- and CMOS-equipped systems. Subjective image quality ratings were significantly higher for CMOS- and IGZO-based systems compared with the a-Si-based system, particularly for overall image quality and perceived noise, while no consistent differences in image quality were found between CMOS- and IGZO-based systems. Overall, the CMOS- and IGZO-based systems evaluated in this study were preferred over the a-Si-based system and achieved superior subjective image quality ratings.
Keywords: C-arm; flat-panel detector; a-Si; CMOS; IGZO C-arm; flat-panel detector; a-Si; CMOS; IGZO

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MDPI and ACS Style

Brunken, F.; Bullert, B.; Brauweiler, R.; Grützner, P.A.; Vetter, S.Y.; Beisemann, N. Comparison of Subjective Image Quality of Mobile C-Arms Equipped with a-Si, CMOS or IGZO Flat-Panel Detectors for Intraoperative Fluoroscopy. J. Imaging 2026, 12, 337. https://doi.org/10.3390/jimaging12080337

AMA Style

Brunken F, Bullert B, Brauweiler R, Grützner PA, Vetter SY, Beisemann N. Comparison of Subjective Image Quality of Mobile C-Arms Equipped with a-Si, CMOS or IGZO Flat-Panel Detectors for Intraoperative Fluoroscopy. Journal of Imaging. 2026; 12(8):337. https://doi.org/10.3390/jimaging12080337

Chicago/Turabian Style

Brunken, Fenna, Benno Bullert, Robert Brauweiler, Paul A. Grützner, Sven Y. Vetter, and Nils Beisemann. 2026. "Comparison of Subjective Image Quality of Mobile C-Arms Equipped with a-Si, CMOS or IGZO Flat-Panel Detectors for Intraoperative Fluoroscopy" Journal of Imaging 12, no. 8: 337. https://doi.org/10.3390/jimaging12080337

APA Style

Brunken, F., Bullert, B., Brauweiler, R., Grützner, P. A., Vetter, S. Y., & Beisemann, N. (2026). Comparison of Subjective Image Quality of Mobile C-Arms Equipped with a-Si, CMOS or IGZO Flat-Panel Detectors for Intraoperative Fluoroscopy. Journal of Imaging, 12(8), 337. https://doi.org/10.3390/jimaging12080337

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