OBJECTIVE We have previously reported the development of a fiber-optic fluoroscopic system for on-line imaging on radiation therapy machines with beam-stops because of space limitation. While the images were adequate for clinical purposes in most cases, an undesirable grid artifact existed and distracted visualization. The resolving power of the system, limited by the 1.6 mm x 1.6 mm dimension of the input fibers, appeared insufficient in some cases. This work identifies solutions to reduce grid artifact and to improve the resolution of the system. METHODS In the clinical system, it was found that the scanning mechanism of the newvicon camera was deflected differently at various gantry positions because of the different orientation of the earth's magnetic field. The small image misregistration produced grid artifact during image normalization, particularly near boundaries of the fiber bundles. One approach taken to reduce magnetic field effects was to shield the camera with mu-metal. Alternatively, a charged-coupled-device camera was used instead of the newvicon camera. As for improving spatial resolution, fibers with smaller input dimension were used. A 20 cm x 20 cm high resolution fiber-optic prototype consisting of 250 x 250 fibers, each with an input dimension of 0.8 mm x 0.8 mm was constructed. Its performance was tested using several phantoms studies. RESULTS Both shielding the newvicon camera with mu-metal or replacing it with a charge-coupled-device camera reduced grid artifact. However, optimal shielding could not be made for our clinical system because of the space limitation of its housing. High contrast resolution was improved, the 30% value of the modulation transfer function occurred at 0.3 linepairs per mm for the clinical system and at 0.7 linepairs per mm for the high-resolution prototype. However, because of the larger degree of transmission non-uniformity of the prototype, it was less effective using the current setup in detecting low contrast objects. CONCLUSIONS The results are encouraging and demonstrate successful reduction of grid artifact and improvement of high contrast spatial resolution using the proposed methods. The less effective low contrast detection was related to reduced light collection efficiency due to use of prototype fibers whose productions were not closely monitored. The findings are being considered in our construction of a second generation clinical fiber-optic on-line image verification system.