Large area digital imaging made possible by amorphous silicon thin-film transistor (a-Si TFT) technology, coupled with a-Si photo-sensors, provides an excellent readout platform to form an integrated medical image capture system. Major development challenges evolve around
optimization of pixel architecture for detector fill factor, signal propagation performance, and manufacturability, while suppressing noise stemming from pixel array and external electronics. This work analyzes a novel vertically integrated pixel design based on signal readout and noise performance, and compares with conventional co-planar and continuous detector architectures. In addition, the analysis will consider various substrate options including glass and robust substrates such as polymer and metal foil. Our evaluation have demonstrated state-of-the-art radiographic detector system with electronic noise under 2000 electrons at 150 µs frame time for an imaging arrays on robust substrate.