Dual Energy Chest X-Ray For Improved Covid-19 Detection Using A Dual-Layer Flat-Panel Detector: Simulation And Phantom Studies

Chest radiography (CXR) plays an important role in triage, management, and monitoring of patients with COVID-19. However, conventional CXR has limited performance for detecting opacities resulting from COVID-19 infection, in large part due to overlapping bones. Dual energy (DE) imaging overcomes this limitation by decomposing the CXR into material-specific images, but conventional DE techniques like kV switching introduce motion artifacts. In this work, we use a dual-layer (DL) flat-panel detector to perform artifact-free single-exposure DE CXR for COVID-19 detection. A simulation study was performed to generate DE CXRs from CT volumes of 13 patients diagnosed with COVID-19, which were compared with simulated conventional CXR by two chest radiologists. A phantom study was also conducted using an anthropomorphic chest phantom with synthetic opacifications. Improved visualization of opacities was observed for DE CXRs in both studies, indicating that the proposed DL detector could be a powerful new tool for COVID-19 diagnosis and patient management during the COVID-19 pandemic.