module 12 to position couch 2 and therefore patient 1 with all six of the aforesaid degrees of freedom this invention can be used in conjunction with image guided radiation therapy igrt in which x rays or other images are taken when the patient 1 is in the initial setup position or close thereto these images are then matched with reference images for fine tuning the initial setup position this can be done remotely and or automatically whatever type of signaling is used the position information obtained by the at least one detection device 10 is fed to command module 12 which is coupled to the detector s 10 and also has access to a prestored representation of the three dimensional coordinates of the treatment room then command module 12 taking into account the known geometrical relationship between the at least one spot 8 and the location of the tumor 13 calculates typically in a fixed three dimensional coordinate system that is correlated with the three dimensional coordinates of the treatment room a three dimensional vector representing where couch 2 needs to be moved in order to place the patient 1 into the initial setup position for fractions other than the first fraction using these calculations command module 12 sends appropriate commands to at least one motor 14 associated with couch 2 to cause couch 2 to automatically.