A system and a method for monitoring anatomical changes in a subject in radiation therapy are provided, as well as an arrangement for medical imaging and analysis and a computer program product for carrying out the method. For monitoring anatomical changes in a subject in radiation therapy, the following steps are performed. First anatomical image data and subsequent anatomical image data of the subject are received. The first anatomical image data and the subsequent anatomical image data are analyzed. This analysis comprises registering the subsequent anatomical data to the first anatomical data. Changes between the first anatomical image data and the subsequent anatomical image data are identified as change states, and the identified change states are matched to corresponding qualitative descriptions. A monitoring report is provided, which comprises the qualitative descriptions of the identified changes.