PURPOSE: To evaluate the image quality and imaging dose of the Varian TrueBeam OBIv.1.5 CBCT system in a clinical adaptive radiation therapy environment, simulated by changing phantom thickness. METHODS: Various OBI CBCT protocols(Head, Pelvis, Thorax, Spotlight) were used to acquire images of Catphan504 phantom(nominal phantom thickness and 10 cm additional phantom thickness). The images were analyzed for low contrast detectability(CNR), uniformity(UI), and HU sensitivity. These results were compared to the same image sets for planning CT(pCT)(GE LightSpeed 16- slice). Imaging dose measurements were performed with Gafchromic XRQA2 film for various OBI protocols (Pelvis, Thorax, Spotlight) in a pelvic-sized phantom(nominal thickness and 4cm additional thickness). Dose measurements were acquired in the interior and at the surface of the phantom. RESULTS: The nominal CNR[additional thickness CNR] for OBI was-Pelvis:1.45[0.81],Thorax:0.86[0.48], Spotlight:0.67[0.39],Head:0.28 [0.10]. The nominal CNR[additional thickness CNR] for pCT was- Pelvis:0.87[0.41],Head:0.60[0.22]. The nominal UI[additional thickness UI] for OBI was-Pelvis:11.5[24.1],Thorax:17.0[20.6], Spotlight:23.2[23.2], Head:15.6[59.9]. The nominal UI[additional thickness UI] for pCT was- Pelvis:9.2[8.6],Head:2.1[2.9]. The HU difference(averaged over all material inserts) between nominal and additional thickness scans for OBI: 8.26HU(Pelvis), 33.39HU(Thorax), 178.98HU(Head), 108.20HU (Spotlight); for pCT: 16.00HU(Pelvis), 19.85HU(Head). Uncertainties in electron density were calculated based on HU values with varying phantom thickness. Average electron-density deviations (ρ(water)=1)for GE-Pelvis, GE-Head, OBI-Pelvis, OBI-Thorax, OBI-Spotlight, and OBI-Head were: 0.0182, 0.0180, 0.0058, 0.0478, 0.2750, and 0.3115, respectively. The average phantom interior dose was(OBI-nominal):2.35cGy(Pelvis), 0.60cGy(Thorax), 1.87cGy(Spotlight); OBI-increased thickness: 1.77cGy(Pelvis), 0.43cGy(Thorax), 1.53cGy (Spotlight). Average surface dose(OBI-nominal): 2.29cGy(Pelvis), 0.56cGy(Thorax), 1.79cGy (Spotlight); OBI-increased thickness: 1.94cGy(Pelvis), 0.48cGy(Thorax), 1.47cGy (Spotlight). CONCLUSION: The OBI-Pelvis protocol offered comparable CNR and HU constancy to pCT for each geometry; other protocols, particularly Spotlight and Head, exhibited lower HU constancy and CNR. The uniformity of pCT was superior to OBI for all protocols. CNR and UI were degraded for both systems/scan types with increased thickness. The OBI interior dose decreased by approximately 30% with additional thickness. This work was funded, in part, under a grant with the Pennsylvania Department of Health. The Department of Health specifically declaims responsibility for any analyses, interpretations, or conclusions.