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To realize the potential of artificial intelligence in medical imaging, improvements in imaging capabilities are required, as well as advances in computing power and algorithms. Hybrid inorganic–organic metal halide perovskites, such as methylammonium lead triiodide (MAPbI3), offer strong X-ray absorption, high carrier mobilities (µ) and long carrier lifetimes (τ), and they are promising materials for use in X-ray imaging. However, their incorporation into pixelated sensing arrays remains challenging. Here we show that X-ray flat-panel detector arrays based on microcrystalline MAPbI3 can be created using a two-step manufacturing process. Our approach is based on the mechanical soft sintering of a freestanding absorber layer and the subsequent integration of this layer on a pixelated backplane. Freestanding microcrystalline MAPbI3 wafers exhibit a sensitivity of 9,300 µC Gyair–1 cm–2 with a μτ product of 4 × 10–4 cm2 V–1, and the resulting X-ray imaging detector, which has 508 pixels per inch, combines a high spatial resolution of 6 line pairs per millimetre with a low detection limit of 0.22 nGyair per frame.

X-ray detectors are critical to healthcare diagnostics, cancer therapy and homeland security, with many potential uses limited by system cost and/or detector dimensions. Current X-ray detector sensitivities are limited by the bulk X-ray attenuation of the materials and consequently necessitate thick crystals (~1 mm–1 cm), resulting in rigid structures, high operational voltages and high cost. Here we present a disruptive, flexible, low cost, broadband, and high sensitivity direct X-ray transduction technology produced by embedding high atomic number bismuth oxide nanoparticles in an organic bulk heterojunction. These hybrid detectors demonstrate sensitivities of 1712 µC mGy−1 cm−3 for “soft” X-rays and ~30 and 58 µC mGy−1 cm−3 under 6 and 15 MV “hard” X-rays generated from a medical linear accelerator; strongly competing with the current solid state detectors, all achieved at low bias voltages (−10 V) and low power, enabling detector operation powered by coin cell batteries.