{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T12:01:43Z","timestamp":1784894503899,"version":"3.55.0"},"reference-count":37,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>Different flat-panel detector technologies are available for intraoperative fluoroscopy. This study compared orthopedic and trauma surgeons\u2019 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\u2013Terry 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 &lt; 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.<\/jats:p>","DOI":"10.3390\/jimaging12080337","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T10:38:41Z","timestamp":1784889521000},"page":"337","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Subjective Image Quality of Mobile C-Arms Equipped with a-Si, CMOS or IGZO Flat-Panel Detectors for Intraoperative Fluoroscopy"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8113-3786","authenticated-orcid":false,"given":"Fenna","family":"Brunken","sequence":"first","affiliation":[{"name":"BG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benno","family":"Bullert","sequence":"additional","affiliation":[{"name":"BG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Brauweiler","sequence":"additional","affiliation":[{"name":"Siemens Healthineers AG, Siemensstr. 3, 91301 Forchheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0730-4782","authenticated-orcid":false,"given":"Paul A.","family":"Gr\u00fctzner","sequence":"additional","affiliation":[{"name":"BG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8024-9276","authenticated-orcid":false,"given":"Sven Y.","family":"Vetter","sequence":"additional","affiliation":[{"name":"BG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Beisemann","sequence":"additional","affiliation":[{"name":"BG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1007\/s00247-015-3456-z","article-title":"Comparison of Image Quality and Radiation Dose between an Image-Intensifier System and a Newer-Generation Flat-Panel Detector System\u2014Technical Phantom Measurements and Evaluation of Clinical Imaging in Children","volume":"46","author":"Weis","year":"2016","journal-title":"Pediatr. 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