The most widely used architecture in large-area amorphous silicon (a-Si) flat panel imagers is a passive pixel sensor (PPS), which consists of a detector element and a readout switch. While the PPS has the advantage of being compact and amenable toward high-resolution imaging, reading small PPS output signals requires external column charge amplifiers that produce additional noise and reduce the minimum readable sensor input signal. In contrast, on-pixel amplifiers in a-Si technology reduce readout noise by decoupling off-pixel noise sources, such as external charge amplifier and data line noise, from the sensor input. The off-pixel noise is reduced by the charge gain of the pixel amplifier, allowing for low-noise performance. Theoretical calculations and simulations of gain, linearity, metastability, pixel area requirements and noise indicate the applicability of the amplified a-Si pixel architectures for low-exposure, real-time fluoroscopy. In addition, the detailed noise results allow for the computation of noise performance as a function of transistor dimensions for both amorphous silicon and polysilicon technologies, allowing the designer to choose appropriate device dimensions when designing flat-panel imaging circuits.