53 machine classes across 6 families, from the plain X-ray to carbon-ion synchrotrons, with 91 vendors and 146 centres from the corpus. Each row says what the machine does, what it is used for, its main advantage and limit against the alternatives, who makes it and where the rare ones are. Click any family to filter, any vendor or centre to open its page.
Proton centres are built around one of three accelerators, a cyclotron, a synchrotron or a compact synchrocyclotron, feeding one or several treatment rooms through magnets and a rotating gantry the size of a house. Single-room systems have cut the price of entry, and upright treatment chairs may shrink the building again.
A single very high dose, or a few doses, aimed at a small brain or spine target with millimetre precision, replacing whole-brain radiotherapy for most brain metastases.
An MR-linac is a radiation machine with an MRI scanner built in, so images taken during setup let the plan be re-optimised in minutes to that day's anatomy. It allows tighter margins and higher doses in pancreatic and prostate cancer, but treatment is slow and costly, and whether daily adaptation improves cure rates rather than only toxicity is unproven.
The original radiosurgery machine: about two hundred cobalt-60 sources arranged in a shielded helmet whose beams cross at one point inside the brain, so a metastasis or benign tumour a few millimetres across receives a destructive dose in a single visit while the brain around it is spared.
Carbon ions are twelve times heavier than protons, so every clinical facility uses a synchrotron ring tens of metres across and fixed or huge rotating beamlines. Only about a dozen centres exist, in Japan, Germany, Italy, Austria, China, South Korea and Taiwan.
A small accelerator on an industrial robot arm that aims hundreds of pencil-thin beams from any direction and follows the tumour as the patient breathes, so brain, spine, prostate, lung and pancreatic tumours can be treated in one to five sessions without a head frame.
Radiotherapy delivered the way a CT scan is taken: a small accelerator circles the patient while the couch slides through, painting the dose slice by slice with a fast shutter-like collimator. It handles very long or oddly shaped targets and images the patient with the same beam before each session.
A radiotherapy machine with PET detectors built in: the tumour's own radioactive tracer signal tells the beam where to fire, hundreds of times a second, so moving tumours and several metastases can be tracked and treated without external markers.
Giving a single large dose of radiation directly to the tumour bed during surgery, with normal organs moved out of the way; used mainly in breast cancer as an alternative to weeks of external radiotherapy.
A self-shielded brain radiosurgery machine: a compact accelerator swings around the head on two nested gantries inside its own steel shell, so it needs no concrete bunker and no radioactive cobalt, and can be installed in an ordinary outpatient building.
The standard radiotherapy machine: an electron accelerator in a rotating arm that makes high-energy X-rays or electron beams, shapes them with moving metal leaves, and takes a CT of the patient before each dose. Most people who have radiotherapy are treated on one.
The machine that made curative radiotherapy widely available from the 1950s: a sealed cobalt-60 source in a rotating head. Linacs replaced it in rich countries, but cobalt units still treat many patients where power and servicing are unreliable.
Killing a tumour by freezing it through one or more needles, with the ice ball watched live on CT, ultrasound or MRI. It hurts less than heat, spares nearby nerves and collecting systems better, and is the usual choice for small kidney tumours, painful bone metastases and, in trials, small breast cancers.
CT scanned at two X-ray energies at once, so the scanner can tell iodine contrast from calcium and soft tissue, show exactly how much a tumour enhances, and remove the contrast digitally to save a second scan.
Two upgrades to the ordinary ultrasound machine: elastography measures how stiff a lump is (cancers are usually hard), and microbubble contrast shows how blood flows through it in real time, with no radiation and no kidney-toxic dye.
Brief electric pulses applied to a tumour open pores in cell membranes so that a tiny dose of bleomycin or cisplatin floods in; used for skin metastases and, increasingly, for deep tumours.
A machine that streams cells one at a time past lasers and reads the fluorescent tags stuck to each one, counting tens of thousands of cells a second. It is how leukaemias and lymphomas are typed, how residual disease is measured after treatment, and how cell therapies are checked before infusion.
Scanners built into or next to the operating theatre, so the surgeon can check during a brain tumour or spine operation how much tumour is left and remove more before closing.
Laser interstitial thermal therapy guides a laser fibre through a small skull hole, monitored by real-time MRI, to heat and destroy deep brain tumours a surgeon could not safely reach.
Cooking a tumour from the inside through a needle. Radiofrequency current was the first method and is proven for small liver cancers; microwave energy heats faster, makes larger zones and is less troubled by nearby blood vessels carrying the heat away, so it is now the more common choice.
MRI uses a strong magnet and radio waves, with no ionising radiation, to picture soft tissue in finer contrast than CT, so it is the standard scan for brain tumours, prostate, rectal cancer staging, liver lesions and breast screening in high-risk women. It is slow, expensive and blurred by movement.
MRI scanners are sold by the strength of their magnet. 1.5 tesla is the reliable workhorse, 3 tesla gives more signal for prostate, brain and breast imaging, and 7 tesla is a research-grade brain scanner; stronger is not simply better, because artefacts, heating and implant restrictions grow with the field.
A new kind of CT detector that counts every X-ray photon and records its energy, giving sharper pictures at lower dose and colour-like tissue information from every scan.
The machine that makes modern brachytherapy safe for staff: a shielded safe holding one tiny, intensely radioactive source on a cable, which it drives out through tubes into applicators inside the patient, dwells at programmed positions, and pulls back before anyone re-enters the room.
A radiotherapy machine built like a CT scanner: the accelerator spins inside an enclosed ring, must image the patient before every dose, and treats fast. Ethos adds software that redraws the plan to the anatomy of the day while the patient lies on the couch.
A gamma camera with a CT scanner bolted on, so a hot spot on a bone scan or a sentinel-node scan is pinned to the exact bone or lymph node, and the dose from a radioactive drug can be measured after treatment.
The surgeon sits at a console and moves wristed instruments through keyhole ports while a 3D camera shows the inside of the body magnified. Intuitive's da Vinci has dominated for two decades; Medtronic's Hugo and CMR's Versius are the first serious rivals, and single-port robots work through one incision.
Scanners sensitive enough to image the whole body in seconds at a fraction of the radiation dose, which raises the question of whether healthy people should be scanned at all.
The plain X-ray is the oldest and cheapest medical image: a single shadow picture of bone and lung. Fluoroscopy is the live-video version, used to steer needles, catheters and stents during cancer procedures.
Centres in the corpus known to run each machine, grouped by country. Proton and carbon-ion centres follow the PTCOG list of facilities in operation; the other lists name only centres OnCo could confirm, so they are a floor, not a census. Every centre links to its page.
Proton centres are built around one of three accelerators, a cyclotron, a synchrotron or a compact synchrocyclotron, feeding one or several treatment rooms through magnets and a rotating gantry the size of a house. Single-room systems have cut the price of entry, and upright treatment chairs may shrink the building again.
Carbon ions are twelve times heavier than protons, so every clinical facility uses a synchrotron ring tens of metres across and fixed or huge rotating beamlines. Only about a dozen centres exist, in Japan, Germany, Italy, Austria, China, South Korea and Taiwan.
An MR-linac is a radiation machine with an MRI scanner built in, so images taken during setup let the plan be re-optimised in minutes to that day's anatomy. It allows tighter margins and higher doses in pancreatic and prostate cancer, but treatment is slow and costly, and whether daily adaptation improves cure rates rather than only toxicity is unproven.
The original radiosurgery machine: about two hundred cobalt-60 sources arranged in a shielded helmet whose beams cross at one point inside the brain, so a metastasis or benign tumour a few millimetres across receives a destructive dose in a single visit while the brain around it is spared.
A small accelerator on an industrial robot arm that aims hundreds of pencil-thin beams from any direction and follows the tumour as the patient breathes, so brain, spine, prostate, lung and pancreatic tumours can be treated in one to five sessions without a head frame.
Radiotherapy delivered the way a CT scan is taken: a small accelerator circles the patient while the couch slides through, painting the dose slice by slice with a fast shutter-like collimator. It handles very long or oddly shaped targets and images the patient with the same beam before each session.
A self-shielded brain radiosurgery machine: a compact accelerator swings around the head on two nested gantries inside its own steel shell, so it needs no concrete bunker and no radioactive cobalt, and can be installed in an ordinary outpatient building.
A radiotherapy machine with PET detectors built in: the tumour's own radioactive tracer signal tells the beam where to fire, hundreds of times a second, so moving tumours and several metastases can be tracked and treated without external markers.
Vendors and centres come from the technology, company and institution records; a machine with no centre listed is not absent from hospitals, only not yet mapped. Field strengths, energies and years appear only where the source record states them.
