Multimodal imaging apparatus and methods include a rotatable gantry system with multiple sources of radiation comprising different energy levels (for example, kV and MV). Fast slip-ring technology and helical scans allow data from multiple sources of radiation to be combined or utilized to generate improved images and workflows, including for IGRT. Features include large field-of-view (LFOV) MV imaging, kV region-of-interest (ROI) imaging, and scalable field-of-view (SFOV) dual energy imaging.