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A method for delivering radiation therapy to a patient using a three-dimensional planning image for radiation therapy of the patient wherein the planning image includes a radiation therapy target includes the steps of: determining a digitally reconstructed radiograph from the planning image; identifying a region of the target's projection in the digitally reconstructed radiograph; capturing a radiographic image corresponding to the digitally reconstructed radiograph; identifying a region in the captured radiographic image; comparing the region of the target's projection in the digitally reconstructed radiograph with the identified region in the captured radiographic image; and determining a delivery of the radiation therapy in response to this comparison.