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In this paper we present a review of recent advances in the field of ultra-sensitive imagers with ultra fast detection capability. Photon counting capability in these sensors is generally available, along with time-of-arrival analysis, thus enabling an increasingly broad range of diagnostics applications. The current trend is to migrate the designs with nanometric feature sizes and to push integration to new highs, so as to enable placing more functionality and more processing on pixel and ondoi:10.1007/978-3-642-04850-0_23 fatcat:pjcdbkr6hrhujjetninp32jreq