Lutetium oxide doped with europium (Lu2O3:Eu3+) has been established as a promising scintillator material with properties that are advantageous when compared to other scintillators such as cesium iodide doped with thallium (CsI:Tl). Due to high X-ray attenuation characteristics, Lu2O3:Eu3+ is an attractive material for use in high resolution digital X-ray imaging systems. However, challenges still remain especially in the area of light output for Lu2O3:Eu3+. Processing by physical vapor deposition (PVD) and manipulation of oxygen defect structure was explored in order to better understand the effect on the scintillation phenomena. PVD results were obtained using high temperature radio frequency sputtering (RF) and pulsed laser deposition (PLD) systems. Characterization of light output by radial noise power spectrum density measurements revealed that high temperature RF films were superior to those obtained using PLD. Optimization of sputtered films based on light output over a range of process parameters, namely temperature, power, pressure, and substrate orientation was investigated. Parameterization of deposition conditions revealed that: 75 watts, 10.00 mtorr, and 800°C were optimum conditions for Lu2O3:Eu3+ films. Manipulation of anionic defect structure in similar material systems has been shown to improve scintillation response. Similar methods for Lu2O3:Eu3+ were explored for hot pressed samples of Lu2O3:Eu3+; via controlled atmosphere annealing, and use of extrinsic co-doping with calcium. The controlled atmosphere experiments established the importance of oxygen defect structure within Lu2O3:Eu3+ and showed that fully oxidized samples were preferred for light output. The second method utilized co-doping by the addition of calcium which induced oxygen vacancies and by Frenkel equilibrium changed the oxygen interstitial population within the Lu2O3:Eu3+ structure. The addition of calcium was investigated and revealed that scintillation was improved with a maximum response occurring at 340ppm of calcium. PVD optimization and co-doping experimental results provided a template for the use of calcium co-doped Lu2O3:Eu3+ targets for deposition of films. Preliminary deposition results were promising and revealed that small additions (around 550 ppm) of calcium resulted in better activator efficiency. Calcium co-doped films have a predicted increase in the light yield greater than 14% when compared to analogous un-doped Lu2O3:Eu3+ films at 60keV.