Embodiments of the invention provide systems and methods for evaluating treatment parameters for a patient undergoing radiotherapy. The method includes the step of generating a portal dosimetry image showing differences between a planning image obtained prior to a treatment session and a portal image obtained during the treatment session. A database of prior portal dosimetry results is accessed, and a processor is used to perform a similarity measurement between the portal dosimetry image and the prior portal dosimetry results. Based on the similarity measurement, the system determines whether radiation was delivered as planned during the treatment session.
