Experience during percutaneous ion beam therapy at Gesellschaft für Schwerionenforschung showed that the treatment can be improved by in-vivo dose monitoring that is independent of the irradiation device and based on positron emission tomography. It has been studied whether a similar technique can be implemented for high energy photon therapy. Simulation shows that the dose is closely related to the distribution of the annihilation points of positrons emerging from pair production. Design parameters of a detector system have been assessed which is capable of registering annihilation radiation during treatment. A test system has been assembled which can be operated with various scintillator crystals and avalanche photodiodes. A custom digital signal processing system has been implemented. Phantom experiments at a clinical linear accelerator disclosed a severe background that does not solely stem from scattered primary photons but from radiation directly emitted from the treatment head. It was not possible to shield the detectors sufficiently and thus there was no success in identifying annihilation radiation.