Active Pixel Lead Dental Imagery into the Digital Age

NASA Technology

hey’re in your cell phone and probably in your handheld , but they may have been in your dentist’s X-ray machine first: image sensors based on CMOS technology. And they got their start at NASA. T NASA has an interest in capturing all sorts of images, in the visible spectrum and beyond. One of the pursuits the Agency is most famous for is transmitting spectacular vistas of other worlds, distant galaxies, and our home planet. Aside from providing windows into the cosmos, these images have significant scientific value, as they can be analyzed, for example, to determine the composition and temperatures of the objects they depict. NASA spent much of the 1980s developing image sensors based on charge coupled device (CCD) technology, which had enabled the first digital . But in the early 1990s, under a new administrator, NASA adopted a “faster, better, cheaper” approach, and engineer Eric Fossum, who had recently joined the Agency’s Jet Propulsion Laboratory (JPL), had an idea that might achieve that goal for spaceborne imagers. CCD-based pixel arrays operate like a bucket brigade, with the light-generated charge from each pixel passing along the entire array of pixels The use of CMOS imagers in to the corner of the chip, where it is amplified and recorded. Fossum thought such imagers might be supplanted by CMOS—or complementary dental X-ray devices reduces metal oxide semiconductor—technology, which consists of microelectronic that have been integral to computer circuitry since the susceptibility to electrical noise and gives dentists images they 1960s. Being amplifiers in and of themselves, photosensitive CMOS pixels in an array could each amplify their own signals. The concept had can manipulate to make more been explored before and discarded, but technology had advanced considerably in the ensuing decades. accurate diagnoses.

34 Health and Medicine Spinoff 2017 In Fossum’s innovation, pixels also contained a mini- for Schick, which became a subsidiary of Sirona Dental CCD to transfer charges internally, as well as an amplifier Systems in 2006. that reduced readout noise compared to the earlier CMOS The company had already developed CCD-based image sensors. By using well-established CMOS manufac- digital imagers to replace traditional X-ray Image courtesy of Wikipedia user Filya1 CC-BY SA 3.0 turing processes to make an array of photodetectors, Fossum film. Their higher sensitivity allowed and his team were able to integrate almost all the other for a lower dose of radiation, and, with camera electronics, such as timing and control systems, no need to develop film, turnaround an analog-to-digital converter, and signal processors, onto was much quicker. The toxic chemicals a single chip. The “camera on a chip” was born, and it and handling precautions associated with would enable much smaller, more efficient imaging devices film development had also been eliminated, (Spinoff 1999, 2002, 2010; see also page 86). Mandelkern says. The term active pixel (APS) entered the popular But the company saw additional benefits to lexicon. “Active pixel means the pixel’s got an active transis- CMOS sensors and began working with Fossum tor in it, an amplifier,” says Fossum. and his team to realize them. “There was a lot of But the budding technology required a lot of back-and-forth between our designers and their development, and it was not immediately embraced. engineers” to work out the idiosyncrasies inherent in “Displacing an incumbent technology is always a big adapting the technology for X-ray use, Fossum says. During his challenge,” Fossum says. “The new technology must have After he and a few colleagues founded the com- time at NASA’s compelling advantages.” pany Photobit in 1995, with an exclusive license for the Jet Propulsion Laboratory, engineer Eric Fossum and his team technology from the California Institute of Technology Technology Transfer created the CMOS active pixel sensor, an (Caltech), which manages JPL, Schick in turn got an innovation that Schick Technologies licensed for In the interest of advancing and commercializing CMOS- exclusive sublicense from Photobit and began producing dental imagery when it was young. CMOS imagers have APS, JPL entered into several Technology Cooperation CMOS-based dental imagers. Later, when Fossum sold his since taken over the industry. Agreements (TCA) with industry partners during the early company, Schick obtained an exclusive license from Caltech 1990s. No funds were exchanged under these agreements, for the use of CMOS-APS technology for dental imagery. for devices the company wanted to power with batteries, but JPL and partners shared resources, expertise, and equip- It’s a license the company holds to this day and one that says Mandelkern. has paid off handsomely, for both Caltech and Sirona. ment, working together to advance and apply the new Since most of the camera electronics could be integrated camera-on-a-chip technology. Benefits onto the CMOS sensor chip, devices could be smaller, Major players, including Kodak and AT&T , which, in the case of intraoral X-ray sensors that go inside established such agreements with JPL and explored com- X-rays can’t be focused with lenses, so the array of the mouth, translated directly to patient comfort, he adds. mercial uses for CMOS-APS, but many of these early efforts pixels in a digital X-ray imager has to be the size of the And, he says, a CCD system was more susceptible to electri- stalled for lack of corporate follow-through. In the end, object being observed, says Mandelkern. That means a lot cal noise than a CMOS imager, where the signal is processed perhaps the most significant TCA began when David Schick of pixels. A CCD-based array has to transfer each pixel’s directly on the chip. “If you can keep everything on one of Schick Technologies, then a three-person outfit in Long charge from pixel to pixel through the array with virtually piece of silicon, you get higher signal integrity at lower Island City, New York, contacted Fossum in 1994. no losses and requires a relatively high voltage. The more power and lower cost.” “I was trying to tell him it was still an early technology. pixels, the greater the overall potential for loss. “If you lose CMOS imagers also give the radiologist the ability to I couldn’t make small pixels,” Fossum recalls. “He didn’t even a small fraction of the charge as it’s moving through get a low-resolution preview or check for exposure using care.” the array, you really have almost no charge output at the a quick readout from a few pixels using minimal energy, “As a dental device manufacturer, we were looking at end,” he says. “Our array was really pushing that parameter whereas a CCD-based imager would have to read out the next-generation technology specific to dental imagery, and with CCDs.” entire array, he says. specifically, radiology,” says Stan Mandelkern, vice presi- CMOS pixel arrays, able to convert each pixel’s charge to For a long time, CCD technology retained an advan- dent of engineering at the original New York headquarters a digital output, proved more efficient, which was important tage in panoramic imaging—say, of a full jaw—by using

Spinoff 2017 Health and Medicine 35 If you look at what we’re able to do Basing its dental X-ray devices on CMOS image sensors has allowed today, there’s a level of sophistication made Schick and parent company Sirona to possible that translates directly to better make the devices smaller and more energy-efficient, which is important for diagnosis and treatment for the patient.” battery-operated technology.

— Stan Mandelkern, Schick

For the patient, advanced digital dental imaging means lower exposure to potentially harmful X-rays, and it gives dentists images they can manipulate to make more accurate diagnoses, as well as communicate problems to the patient visually, Mandelkern says. “If you look at what we’re able to do today, there’s a level of sophistication made possible that translates directly to better diagnosis and treatment for the patient.” The company’s latest development in CMOS is three- dimensional imaging that’s being pioneered at Sirona’s German location, he says. “We continue to use CMOS as An X-ray by one of Sirona’s CMOS-based digital X-ray devices the starting point for our imaging products.” shows a tooth implant. Through Schick Technologies, which it acquired in 2006, the company holds an exclusive license for Although Sirona still holds an exclusive license to use use of the NASA-invented technology for dental imagery. CMOS-APS technology for dental imaging, “other com- panies can sublicense to be able to use the technology,” a technique called time delay integration to create a single Mandelkern says. “Today, a lot of companies that compete image from multiple frames, Mandelkern says. With the with us sublicense the technology from us.” advent of fast frame-readout CMOS imagers, though, that Mandelkern says this success was anything but predict- integration can now be carried out by software in post- able in the early days of the fledgling company’s NASA processing, he says. partnership. “In 1997, looking at this technology at all was In recent years, as CMOS sensors have been adopted very risky and required a higher level of technical aware- across the imaging industry, intense research and develop- ness than other companies in our industry were able to ment have led to rapid improvements in their size, speed, compete with us on,” he says. “That’s what our company memory, and quality. Cell phone cameras in particular has always stressed—innovation and keeping an eye on have driven the advancement and cheap mass-production what’s happening in technology and how we can leverage of CMOS-APS sensors. that in our product line.” “We were able to take advantage of that and leverage Fossum credits JPL’s cooperative agreements with com- that for our product line as well,” Mandelkern says. “We’re panies like Schick for turning his experimental technology benefiting from the same processes and improvements the into successful products. “That program was critical for rest of the electronics world has benefited from.” getting Schick going and for getting us going.” v

36 Health and Medicine Spinoff 2017 Schick’s dental imagers have benefited not only from the initial enhanced capabilities of NASA- invented CMOS image sensors but also from the rapid improvements and lower costs that have come with the technology’s explosion across the digital imaging industry.

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