systems and methods include coordinated and megaelectronvolt computerized tomography imaging . kv and mv data are combined using a normalization process in order to generate ct images . the resulting ct images can include an improved signal to noise ratio in comparison to ct images generated using either kv or mv imaging alone . the coordinated kv and mv imaging process may be accomplished in significantly less time than using kv or mv imaging alone . this time savings has advantages in treatment verification . the mv projections are optionally generated using mv x - rays configured for x - ray treatment . in these cases the combined projections will reflect the treatment volume .