Cherenkov radiation is emitted when charged particles pass through the patient at the speed greater than the velocity of light in that medium. (Conceptually similar to the sonic boom.)
During radiation therapy, Cherenkov light is emitted from the patient’s skin where the radiation beam enters or exits the body.
Cherenkov imaging uses highly sensitive cameras, synchronized with both the linac and SGRT, to visualize this light from the patient’s skin.