Systems and methods include coordinated (KV) and megaelectronvolt (MV) computerized tomography (CT) 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.