1. A therapy planning system comprising: at least one processor programmed to: receive a planning image of a region of a subject, the subject including a target and/or an organ at risk (OAR), and the subject associated with at least one surrogate and/or a dosimeter, the surrogate acting as a surrogate for the target and/or the OAR, and the dosimeter measuring dose delivered to the target and/or the OAR; determine a reference location and shape in the planning image for one or more of the target and/or the OAR; determine a reference location and/or shape from the planning image of each of the surrogate and/or the dosimeter; determine deviations between one or more of: the reference location and/or shape of the surrogate and a current location and/or shape of the surrogate; and, a planned dose distribution and a delivered dose distribution, the delivered dose distribution determined from dosimetric data and the reference location and/or shape of the dosimeter.