Imaging arrays with sub-millimeter detector pixels that count and allocate energy to each detected photon are now being introduced into biomedical computed tomography scanners. Consequently, bremsstrahlung x-ray can provide the advantages of simultaneous recording of multiple quasi-monochromatic x-ray images which can be used for identification of various materials within the image field. This capability increases the inherent contrast within biomedical CT images and also introduces the ability

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... to use high atomic weight "foreign" elements (e.g., strontium) which are surrogates for "native" biological elements (e.g., calcium) to monitor tissue function (e.g., bone deposition). Challenges for this methodology include limited maximum fluence due to photon pile-up, charge-sharing between contiguous pixels and heterogeneous pixel characteristics due to manufacturing difficulties.