At the Cleveland Clinic, a novel means of cancer treatment, image-directed radiation therapy (IDRT), is being explored experimentally. Using a linear accelerator manipulated by a robot and computed tumor coordinates based on machine vision, this treatment means offers the potential for more highly targeted radiation dose delivery to tumors, reducing the collateral damage to surrounding healthy tissues. This paper presents the motivation for IDRT, identification of the challenges in accomplishing IDRT, and simulated and experimental results for evaluating the potential benefits of IDRT, specifically with respect to lung cancer treatment.