Monolithic CMOS integrated pixel detector (10, 20, 30, 260, 470, 570), and systems and methods are provided for the detection and imaging of electromagnetic radiation with high spectral and spatial resolution. Such detectors comprise a Si wafer with a CMOS processed readout bonded to an absorber wafer in an electrically conducting covalent wafer bond. The pixel detectors, systems and methods are used in various medical and non-medical types of applications.