Current-mode active pixel sensor (C-APS) circuits based on amorphous indium-tin-zinc-oxide thin-film transistors (a-ITZO TFTs) are proposed for indirect X-ray imagers. The proposed C-APS circuits include a combination of a hydrogenated amorphous silicon (a-Si:H) p(+)-i-n(+) photodiode (PD) and a-ITZO TFTs. Source-output (SO) and drain-output (DO) C-APS are investigated and compared. Acceptable signal linearity and high gains are realized for SO C-APS. APS circuit characteristics including voltage gain, charge gain, signal linearity, charge-to-current conversion gain, electron-to-voltage conversion gain are evaluated. The impact of the a-ITZO TFT threshold voltage shifts on C-APS is also considered. A layout for a pixel pitch of 50 pm and an associated fabrication process are suggested. Data line loadings for 4k-resolution X-ray imagers are computed and their impact on circuit performances is taken into consideration. Noise analysis is performed, showing a total input-referred noise of 239 e(-). (C) 2017 Elsevier Ltd. All rights reserved.