One of the major problems in radiation therapy is ensuring that the correct region of the patient receives the prescribed x-ray treatment and that the surrounding tissues are spared. One way to identify patient positioning errors is to make an image using the radiotherapy treatment beam. We have examined two of the factors that can influence the quality of images made with high energy x-ray beams: (i) the size of the x-ray source, and; (ii) the signal-to-noise characteristics of the detectors used to form images with high energy x-ray beams. We have developed a novel method of measuring the source distributions for 60Co machines and linear accelerators and from the measurements have been able to obtain the modulation transfer functions of their x-ray sources. We have also measured the modulation transfer functions (MTFs) and the noise power spectra (NPS) of the x-ray detectors. Based on these measurements, we conclude that images made with high energy x-ray beams are limited by film granularity and that improved images can be obtained by alternative detector systems.