Libyan Academy for Postgraduate

Academy

Faculty of Engineering

Department of Medical Engineering

Biomedical sensors

CMOS

transducer for biomedical applications

MEE604
By:
Mohammed Naji Altaitali
10518
Introduction:

Biomedical sensors are special electronic devices that can transduce biomedical signals
into easily measurable electric signals. Biomedical sensors are the key component in
various medical diagnostic instruments and equipment. Research on biomedical sensing
technology is mainly focused on how to improve the understanding of biology
processes and technology for medical diagnosis and treatment. Numerous discoveries
and inventions in biomedical, physical, chemical, and electronic materials have quickly
gained importance in applications for biomedical sensors, such as microstructure and
integrated cell molecular detection sensors, drug analysis and screening sensors, and
micronano implantable probes. Biomedical sensors have been widely applied in
medical image analysis and diagnostics, portable and clinical diagnostics, and
laboratory analytical applications. In this chapter, we mainly introduce five different
biomedical sensors/sensing technologies for various applications including wearable
devices, biochips, biosensors, implantable sensors, and neural sensing and interfacing.

Basic concept of sensor:

Sensor or transducer is a device which can respond to a measured object and transform
it into signals which can be detected. A sensor is usually composed of a sensitive
component which directly responds to a measured object, a conversion component and
related electronic circuits. Along with the development of modern electronic
technology, micro-electronic technology and communication technology, which
represent some various useful signals, electrical signals are most convenient for
processing, transporting, displaying, and recording.

Sensors often provide information about the physical, chemical or biological state of a
system. Measurement is defined as an operation that aims to obtain the measured value
of the quantity. Therefore, sensors are defined as devices that can transform non-
electrical signals into electrical signals. Sensors often provide information about the
physical, chemical or biological state of a system. Measurement is defined as operations
that aim to obtain the measured value of the quantity. Therefore, sensor detection
technology is one that uses sensors to transform measured quantities into physical
quantities which are easy for communication and processing, and then goes on with
transformation, communication, displaying, recording and analysising.
Biomedical sensors are special electronic devices which can transfer various non-
electrical quantities in biomedical fields into easily detectable electrical quantities. For
this reason, they are incorporated into health care analysis. They expand the sensing
function of the human sensing organ while the key parts consist of various diagnostic
medical analysis instruments and equipment. Biomedical sensing technology is the key
to collecting human physiological and pathological information and is also an important
disciplinary branch.

Classification of Biomedical Sensors:

Biomedical sensors can be classified in the following categories according to their

detection quantities. Classified by working principle, sensors include physical sensors,
chemical sensors, and biological sensors.

Physical sensors: It refers to the sensor made according to physical nature and effect.
This kind of sensors is mostly represented by sensors such as metal resistance strain
sensors, semiconductor piezo resistive sensors, piezoelectric sensors, photoelectric
sensors, etc.

Chemical sensors: It refers to the sensor made according to chemical nature and effect.
This kind of sensors usually uses ion-selective sensitive film to transform non-
electricity such as a chemical component, content, density, etc. to related electric
quantity, such as various ion sensitive electrodes, ion sensitive tubes, humidity sensors
and, etc.

Biological sensors or biosensors: It refers to the sensor using biological active material
as a molecule recognition system. This kind of sensors usually uses enzyme to catalyze
some biochemical reaction or exams the type and content of large molecule organic
substances through some specific combination. It is a newly developed sensor in the
second half of the century, and examples include enzyme sensors, microorganism
sensors, immunity sensors, tissue sensors, DNA sensors and, etc.

Classified by detection type, there are displacement sensors, flow sensors, temperature
sensors, speed sensors, pressure sensors, etc. As for pressure sensors, there are metal
strain foil pressure sensors, semiconductor pressure sensors, capacity pressure sensors
and other sensors that can detect pressure. As for temperature sensors, it includes
thermal resistance sensors, thermocouple sensors, PN junction temperature sensors and
other sensors that can detect temperature.

This is also the method that classifies sensors according to the human sense organ that
each sensor can replace, such as vision sensors, including various optical sensors and
other sensors that can replace the visual function; hearing sensors, including sound
pick-up, piezoelectric sensors, capacity sensors and other sensors that can replace the
hearing function; olfaction sensors, including various gas sensors and other sensors that
can replace the smelling function (Harsányi, 2000). This kind of classification is good
for the development of simulation sensors. In many situations, these classification
methods are used together. For example, The strain gauge pressure sensor, conductance
cardiac sounds sensor, monitoring techniques. The trend is to develop new non-
invasive or slightly invasive detecting methods and use one sensor once to detect
multiple physiological parameters. For example, use the photoelectric method to detect
the pulse as well as other information such as the heart rate, blood pressure, oxygen
saturation; use electromagnetic coupling or optical coupling to detect intracranial
pressure, and pressure in the mouth. Non-contact and long-distance detection also lead
current development trends.

Biochemical parameter detection usually uses blood and body fluid as a sample to
conduct the measurement. Therefore, most of the methods are invasive and cannot
measure the changes in the parameters over a long-time and in real-time. At present,
non-invasive and slightly invasive biochemical parameter detecting methods have
received great attention. For example, researchers have detected phenacetin in the saliva
and compared it with the results of blood plasma tests; researchers extract lixivium by
exerting a small amount of negative pressure on the skin and then use ion field effect
transistor sensors to detect blood sugar; dielectric spectroscopy (DS) has been applied
to monitor changes in the glucose level by combining electromagnetic and optical
sensors (Talary et al., 2007).
What is a CMOS sensor ?

CMOS sensors are a type of image sensor that captures light and converts it into an
electrical signal. CMOS sensors are mainly used in smartphones, digital cameras, video
cameras, and other electronic devices.

CMOS stands for complementary metal-oxide semiconductor, which is a type of

integrated circuit, and are a type of image sensor that is most commonly used in digital
cameras .

CMOS sensors are made up of an array of pixels, which measure the intensity of light
in the scene and convert it into electrical signals. These electrical signals are then
processed by the camera's analog-to-digital converter to give us a digital image.

These sensors are also used in other types of imaging devices, such as scanners and
webcams.

The diverse nature of this CMOS image sensor:

CMOS sensors are a type of image sensor that is used in a wide range of applications.
As they convert light into electrical signals and can also detect the amount of light,
CMOS sensors come in very handy for a lot of different applications in almost any
technological industry .

CMOS sensors are the most commonly used type of sensor in digital cameras but are
also used in a wide range of other applications, such as telescopic technologies and even
optical character recognition. The versatile ability of this little chip to interact with light
allows it to give room for imaginative use, data recognition and analyses. This is why
we keep experiencing many innovations in terms of the possible applications of CMOS
and image sensors at a growing rate still .

The CMOS technology-based market is expected to dominate during the forecast period
due to its various advantageous features that it possesses over the CCD (charged
coupled device) image sensors. High resolutions, Small size, higher frame rates, low
power consumption, greater sensitivity, faster frame rate, low noise, and lower
manufacturing cost are a few of the critical advantages of CMOS over CCD.
CMOS sensors as opposed to CCD sensors:

Compared to CMOS, CCD cells require more power for light gathering. As a result,
they are less efficient but also allow for an improvement in image noise and sensitivity.
CMOS (complementary metal-oxide semiconductor) are low-power, yet less sensitive
to light than CCD (charge-coupled device) cells. CMOS require the use of the charge
which is created by the conversion of light into an electric current. However, they are
much less efficient in gathering light. CCD cells are more sensitive and because they
require a higher amount of power, they are not as efficient in gathering light. As a result,
CMOS provide less noise and require less sensitivity than CCD cells.

CMOS achieves the same resolution of an image regardless of the size of the sensor or
pixel size. This is because it does not need to rely on how many pixels it has but rather
its individual pixels are large enough to capture all of the required information from a
single point in an image. On the other hand, CCDs use separate tiles which are smaller
than the pixels on an iPhone, usually meaning they require more light to capture all of
the information required.

How do CMOS sensors work?

CMOS sensors are the most common type of image sensor in modern digital cameras.
CMOS stands for Complimentary Metal-Oxide Semiconductor, which is a technology
that was developed by NASA to take pictures of space. CMOS sensors are made up of
an array of light-sensitive diodes, which convert light into electricity and then store it
as a signal that can be read by a computer. These signals can be used to create an image
or video and they can also be used to measure the amount of light in a scene. CMOS
cells of this design are closely surrounded by transistors and work to amplify the charge
on the electrons gathered by the cells. The CMOS cells themselves are made from a
semi-conducting silicon, which is then built into a chip's circuitry to allow for a quick
and effective transition of information. After the CMOS sensor gathered the data, it
transfers it to a digital-to-analog converter at one of the corners which converts
individual pixels made up of cells with different electron charges into colors of various
shades.
Applications of CMOS in Medical Imaging and Life Sciences :

Imaging sensors are used for a wide variety of life sciences applications, including but
not limited to:

Medical and Dental Radiology:

Radiology requires high-resolution image capture. To detect finer details for accurate
diagnostics of medical anomalies at earlier stages, CMOS sensors are leveraged to
significantly reduce treatment costs, improve patient recovery, as well as increase the
probability of early illness detection and intervention.

Ophthalmology:

Vision sensors are rapidly integrated into ophthalmology applications, using the latest
techniques and therapies in the prevention and specialized treatment of conditions such
as cataract, retinal detachment, and glaucoma, to name a few. Important requirements
for imaging components in ophthalmology include, but are not limited to, consistency,
sensitivity, reproducibility, a long service life, and superior image quality to accurately
diagnose and treat eye conditions.

Radiotherapy and Fluorescence Applications:

Low light imaging is required to detect metastatic cancer cells to determine the
likelihood of them spreading throughout the body. State-of-the-art CMOS sensor
technology makes it possible to “see” or measure tumor cell potential by detecting
different signaling mechanisms related to metastasis with the help of fluorescence. In
terms of treatment, fluorescence microscopy lights up tumor cells that have acquired
high metastatic potential during chemotherapy and keeps the cells that are sensitive to
chemotherapy or that have low potential dark and unlit.

CMOS technology for digital dental imaging:

The dental industry is continually changing, with more and more dentists adopting the
latest digital x-ray technology into their practices. The driving advantages of digital x-
ray systems versus film-based systems include the following: increased work flow,
high-quality x-ray images for improved diagnosis and reduced radiation exposure for
patients. Digital systems are based primarily on two sensor technologies: CMOS
(complementary metal oxide semiconductor) and CCD (charge-coupled device). This
article focuses on the key features and benefits of CMOS technology used in the dental
field.

Digital x-ray systems are used for three imaging modalities for dental diagnosis:
intraoral, panoramic and cone beam computed tomography (CBCT). Intraoral systems,
used for taking horizontal and vertical bitewings, provide dentists with detailed images
for enhanced diagnosis. Panoramic systems, which scan a patient’s entire mouth, often
use time delay integration (TDI) technology. CBCT equipment takes slices of images,
which are then reconstructed to form a three-dimensional image of a patient’s entire
jaw and mouth. These imaging systems use scintillators, which convert x-rays into
visible light, and solid-state sensors, such as a CMOS device, which detect the
scintillator’s emission.

A CMOS device converts light into a digital signal using photosensitive pixels and on-
chip circuitry. CMOS technology has a limited photosensitive area and higher noise
compared with a CCD, but the noise level has been improving. CMOS has several
useful characteristics: It requires low power to operate, has high-speed readout, is
capable of on-chip integration of electronic circuitry and produces digital signals
without external converters.

Cone beam computed tomography:

CBCT, also known as cone beam volumetric tomography (CBVT) or cone beam
volumetric imaging (CBVI), generates 3-D images of the teeth and head using x-rays
and computer software. It was introduced in Europe and Asia in the late 1990s, followed
by its introduction in North America in 2001.

“The adoption is huge,” said Dr. Dale A. Miles, a diplomate of the American Board of
Oral and Maxillofacial Radiology. Miles, who also analyzes cone beam computed
tomography data from dentists across the nation, said, “The early adopters [were] the
orthodontists and oral and maxillofacial surgeons. But periodontists and endodontists
are jumping right in there big time, especially because of the smaller field-of-view
machines that have come out”.
Dental specialists and surgeons use the data from CBCT for placement of dental
implants, third-molar (wisdom teeth) extractions, TMJ (temporomandibular joint)
evaluations, orthodontic treatment planning, surgical planning and others.1 Each type
of dentist requires a different CBCT field of view.

According to Miles, periodontists need a small field of view (6 x 6 or 8 x 8 cm) for

implant placement. Endodontists need the same field of view for implant surgery on
failed endo teeth and a smaller one (4 x 4 cm) for root canal therapy. For surgeons, an
8 x 8-cm field of view is sufficient for extractions, but a larger one is needed for trauma
cases and orthognathic surgery. Orthodontists require the largest field of view to
measure angles and lengths of anatomical landmarks for treatment planning.

Figure 1. In cone beam computed tomography, a cone-shaped x-ray beam irradiates

a patient’s jaw. The transmitted x-rays are detected by a sensor such as a CMOS flat
panel sensor from Hamamatsu. The data is sent to a computer and reconstructed into
3-D images by software.

Miles believes that CBCT will become the standard of care for presurgical implant
assessment and third-molar extraction. It is suited for such imaging needs because of
its accurate depictions of implant sites, its nondistorted 1:1 horizontal/vertical aspect
display, and its ability to generate 2-D and 3-D color images that aid the surgeon by
showing the precise location of the inferior alveolar nerve and other relevant structures.

To generate 3-D images, a CBCT machine captures x-ray images of a patient’s head,
which computer software then reconstructs into a 3-D image within a few minutes. In
a CBCT machine, an x-ray source and a sensor are placed 180° apart on a rotating arm,
and the patient is placed in the middle (Figure 1). CBCT uses a cone-shaped x-ray beam
to acquire a volume of data at each frame, generating a complete 3-D image (Figure 2)
in one rotation or less. It requires a much lower dose of radiation than medical computed
tomography (CT), a benefit to patients.

Figure 2. Three-dimensional images created from a cone beam data set show teeth
(left) and soft tissue outline (right). The patient was imaged using Planmeca Oy’s
ProMax3D CBVT machine (Helsinki, Finland). Images were created in CyberMed
International software called OnDemand3D (Seoul, South Korea). Courtesy of Dr.
Dale A. Miles.

The sensors used in CBCT machines are amorphous silicon (α-Si) flat panels, CMOS
flat panels or image intensifiers coupled to a CCD. CMOS flat panel sensors have
advantages and disadvantages compared with α-Si flat panels. One advantage is smaller
pixel size, resulting in higher resolution (Figure 3). Also, unlike α-Si flat panels, CMOS
flat panels do not suffer from image lag, a residual charge left behind in the sensor that
degrades overall image quality. It is especially troublesome in CT applications because
there is no time to correct for it by reading the same exposure repeatedly until all the
signal is read out and summed and the pixels completely reset.
A disadvantage of CMOS flat panel sensors is the size of the active detection area. It is
difficult to produce a single CMOS chip in a large size, unlike α-Si flat panels. A
common technique to overcome this issue is tiling multiple CMOS chips to form a
larger mosaic.

Figure 3. This is a general comparison of pixel size and active area characteristics of
CCD, CMOS flat-panel sensors and amorphous silicon flat panel sensors.

Panoramic imaging

Besides CBCT, panoramic imaging also uses CMOS technology. Dentists use the
panoramic mode to image the entire set of teeth and parts of the jaw in a single view
for placement of dental implants and assessment of TMJ disorders, sinus infections and
other problems. As with a CBCT machine, a panoramic machine has an x-ray source
and a sensor placed 180° apart on a rotating arm. The arm rotates around a patient’s
head and scans the entire jaw, generating an x-ray image. Within a minute, the entire
process is complete, without causing any discomfort.

Solid-state sensors used in digital panoramic machines are generally a CCD image
sensor or a CMOS flat panel sensor. A common CCD readout technique for panoramic
imaging is TDI. In this mode, the rotation of the x-ray source is synchronized with the
readout of the CCD, enabling continuous imaging and accumulation of signal.
A CMOS flat panel sensor can be used for panoramic imaging by reading out only a
narrow strip of its active area. This sensor has both advantages and disadvantages
compared with a TDI-CCD. The main advantage is ease of use for the system designer.
The output of CMOS devices is already digital, so external signal processing and
digitization are unnecessary. The main disadvantage of a CMOS flat panel sensor is
higher readout noise than a TDI-CCD and higher signal accumulation in the digital
domain, adding to the total noise.

CMOS technology is versatile and meets the needs of the dental industry for simple and
complex imaging modes.

References
1. D.A. Miles (2009). The agony and ecstasy of buying cone beam technology, Part 1:
The ecstasy. Journal of Implant & Advanced Clinical Dentistry, Vol. 1, No. 1, pp. 19-
31.

2. D.A. Miles and R.A. Danforth (2007). A Clinician’s Guide to Understanding Cone
Beam Volumetric Imaging (CBVI). Pennwell Press.