Purpose:To improve the setup accuracy of thermoplastic mask, we developed a new monitoring method based on force sensing technology and evaluated its feasibility.Methods:The thermoplastic mask setup monitoring system consists of a force sensing resistor sensor unit, a signal transport device, a control PC and an in‐house software. The system is designed to monitor pressure variation between the mask and patient in real time. It also provides a warning to the user when there is a possibility of movement. A preliminary study was performed to evaluate the reliability of the sensor unit and developed monitoring system with a head phantom. Then, a simulation study with volunteers was conducted to evaluate the feasibility of the monitoring system. Note that the sensor unit can have multiple end‐sensors and every end‐sensor was confirmed to be within 2% reliability in pressure reading through a screening test.Results:To evaluate the reproducibility of the proposed monitoring system in practice, we simulated a mask setup with the head phantom. FRS sensors were attached on the face of the head phantom and pressure was monitored. For 3 repeated mask setups on the phantom, the variation of the pressure was less than 3% (only 1% larger than 2% potential uncertainty confirmed in the screening test). In the volunteer study, we intended to verify that the system could detect patient movements within the mask. Thus, volunteers were asked to turn their head or lift their chin. The system was able to detect movements effectively, confirming the clinical feasibility of the monitoring system developed.Conclusion:Through the proposed setup monitoring method, it is possible to monitor patient motion inside a mask in real time, which has never been possible with most commonly used systems using non‐radiographic technology such as infrared camera system and surface imaging system.This work was supported by the Radiation Technology R&D program (No. 2013M2A2A7043498) and the Mid‐career Researcher Program (2014R1A2A1A10050270) through the National Research Foundation of Korea funded by the Ministry of Science, ICT&Future Planning.