The present invention is related to an apparatus and method to carry out image-guided radiotherapy or radiosurgical treatments using Kilovoltage X-ray beams one of the problems with the clinical application of this treatment consists in the absorbed dosage imparted unto a point within the subject to be irradiated depends on the local concentration of the contrast agent at that point, and the lack of properly quantifying the presence of the contrast agent at each point of the tumor or malformation to be irradiated results in a significant decrease in the quality of the treatment the method and apparatus of the present invention resolve this and other problems. The Method consists of the following steps: a) determining the geometry of the patient and the concentration of the contrast agent at each point of the same, b) planning of treatment, and c) irradiating of the tumor or malformation the apparatus includes a system to obtain three-dimensional images of the patient, a plurality of X-ray generating sources, a system to automatically position said X-ray generating sources in such a way that the radiation produced is directed towards the site to be irradiated in the patient, and a computer controlled system.