Image quality evaluation of imaging skins, a novel stretchable X-ray detector for intraoperative tumour imaging

This paper presents the development of a novel X-ray detector composed of silicone elastomer and GOS:Tb, which we refer to as imaging skins. These detectors were integrated into a custom X-ray system to convert radiation into visible light. Our study focused on how fabrication parameters such as thickness and concentration impact sensor linearity, considering their potential application directly on the skin or organs to identify tumour margins during surgery. In addition, we examined how the stretching capabilities of these detectors influenced the image quality. Our imaging detection stack demonstrated consistent linearity across various fabrication parameters with the coefficient of determination () more than 0.99998, showing that the silicone elastomer does not affect the conversion of the X-ray into light. We achieved a spatial resolution of 1.16–1.42 lp/mm at 10% of the Spatial Frequency Response using a 0.5-mm thick sensor. This study represents a first step towards integrating stretchable X-ray detectors into clinical settings, particularly on curved surfaces, to unlock their full potential in complex surgical configurations. It also highlights the need for a deeper understanding of the interactions between X-rays and detector materials to fully interpret the observed effects. © The Author(s) 2025.