An image-guided radiotherapy system adapted to be juxtaposed adjacent a CT scanner comprises a frame having an orifice adapted to permit passage therethrough of a couch on which a patient is positioned, together with a gantry assembly rotatably mounted on the frame in which the gantry assembly comprises a shielding cylinder having an orifice therethrough in alignment with the orifice in the frame. The shielding cylinder has affixed thereto a linac-based treatment head configured to provide radiotherapy, and a beamstop positioned angularly opposite the treatment head to absorb radiation from the treatment head. The shielding cylinder provides sufficient shielding of radiation scattered from the patient and the remainder of the system to not require a conventional vault. In some embodiments an arch may be used instead of a cylinder.
