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 increasing the precision of spatial registrations between respective image sets to allow more precise radiation treatment delivery, reducing image artifacts (e.g., scatter, metal and beam hardening, image blur, motion, etc.), and utilization of dual energy imaging (e.g., for material separation and quantitative imaging, patient setup, online adaptive IGRT, etc.).