One embodiment of the present disclosure sets forth a method for determining a movement of a target region using tomosynthesis. The method includes the steps of accessing a first set of projection radiographs of the target region over a first processing window defined by a first range of projection angles, accessing a second set of projection radiographs of the target region over a second processing window defined by a second range of projection angles, wherein the first processing window slides to the second processing window during treatment of the target region, and comparing a first positional information derived from the first set of the projection radiographs and a second positional information derived from the second set of the projection radiographs with the first positional information to determine the movement of the target region.