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Cancers & treatments

Machines

99 machine classes across 9 families, from the plain X-ray to carbon-ion synchrotrons, with 151 vendors and 154 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.

Imaging scanners21Endoscopes and clinic imaging8Radiotherapy machines18Radiotherapy guidance and quality10Particle therapy6Ablation and energy devices19Surgical machines6Chemotherapy delivery and supportive devices4Laboratory and production7
99 machines
Proton therapy
Radiation using protons, which stop inside the tumour instead of passing through, so tissue behind it gets no dose.
Hitachi, IBA, Leo Cancer Care, Mevion Medical Systems, P-Cure, ProTom International, RaySearch Laboratories, Sumitomo Heavy Industries, Varian
Proton therapy machines: cyclotrons, synchrotrons and single-room systems
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.
Hitachi, IBA, Leo Cancer Care, Mevion Medical Systems, P-Cure, ProTom International, Sumitomo Heavy Industries, Varian
Robotic & minimally invasive surgery
Surgeons operate through small incisions using robotic arms with tremor-free precision and 3D vision.
Brainlab, CMR Surgical, Intuitive Surgical, Medtronic, Monteris Medical, Quantum Surgical, XACT Robotics
Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS)
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.
Accuray, Brainlab, Elekta, Nordion, Varian, ZAP Surgical Systems
MR-guided adaptive radiotherapy
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.
Elekta, Philips, RefleXion Medical, ViewRay
Gamma Knife
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.
Elekta
PET/CT
PET and CT in one machine, so hot spots on the PET are pinned to exact locations on the CT.
Canon Medical Systems, GE HealthCare, Mediso, Philips, Siemens Healthineers, United Imaging
Carbon-ion therapy
Heavier charged particles that kill even radiation-resistant tumours, available at only a handful of centres worldwide.
Hitachi, Toshiba Energy Systems & Solutions
Carbon-ion synchrotrons and facilities
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.
Hitachi, Toshiba Energy Systems & Solutions
Fluorescence-guided surgery
Injecting a dye that makes tumour glow so the surgeon can see exactly where to cut.
Blaze Bioscience, Carl Zeiss Meditec, Karl Storz, Lumicell, On Target Laboratories, photonamic, SBI Pharmaceuticals, Stryker, Vergent Bioscience
HIPEC / PIPAC (intraperitoneal chemotherapy)
Washing the abdominal cavity with heated chemotherapy during surgery to kill microscopic peritoneal deposits.
Belmont Medical Technologies, Capnomed
Sentinel lymph node biopsy
Removing just the first lymph node a tumour drains to, instead of all of them, to check for spread.
Lightpoint Medical, Mammotome
CyberKnife robotic radiosurgery
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.
Accuray
Mammography & tomosynthesis
Low-dose breast X-ray used for screening. Newer 3D versions find more cancers with fewer false alarms.
FUJIFILM Healthcare, GE HealthCare, Hologic, iCAD, Kheiron Medical Technologies, Lunit, ScreenPoint Medical, Siemens Healthineers, Therapixel, Vara, Volpara Health
CT (computed tomography)
A CT scan is a fast 3D X-ray that shows the size and shape of tumours and whether they have spread.
Canon Medical Systems, FUJIFILM Healthcare, GE HealthCare, Leo Cancer Care, Nucleo, Onc.AI, P-Cure, Philips, Quantum Surgical, Siemens Healthineers, United Imaging, XACT Robotics
Focused ultrasound & histotripsy
Destroying tumours from outside the body with tightly focused sound waves, using either heat or microscopic bubbles.
HistoSonics, Insightec, Profound Medical, SonALAsense
Focused-ultrasound blood-brain barrier opening
Sound waves plus microbubbles briefly open the brain's protective barrier so chemotherapy or antibodies can get to the tumour.
Carthera, Insightec
Optical & fluorescence imaging
Dyes that glow under special light, so surgeons can see tumour edges and nerves in the operating theatre.
Bikanta, Lumicell, NearWave, On Target Laboratories, Perimeter Medical Imaging AI, Vergent Bioscience
Photoimmunotherapy & photodynamic therapy
An antibody carries a light-sensitive dye to the tumour; shining near-infrared light then bursts the cells.
Modulight
TomoTherapy and Radixact (helical radiotherapy)
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.
Accuray
Biology-guided radiotherapy (RefleXion X1, SCINTIX)
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.
RefleXion Medical
FLASH radiotherapy
Delivering an entire dose in under a second, which in animals spares healthy tissue while still killing the tumour.
Empyrean Medical Systems, IntraOp Medical, THERYQ, Varian
Intraoperative radiotherapy (IORT)
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.
Carl Zeiss Meditec, IntraOp Medical
PET (positron emission tomography)
A scan that shows where a radioactive tracer accumulates, so it images what tumours are doing rather than what they look like.
Alpha-9 Oncology, Evergreen Theragnostics, RefleXion Medical, SOFIE Biosciences
PET/MRI
PET combined with MRI instead of CT, giving biology plus the best soft-tissue detail, at lower radiation dose.
GE HealthCare, Siemens Healthineers, United Imaging
SPECT & bone scan
SPECT and the bone scan are an older type of nuclear scan, still used for bone metastases and to check where a radioactive drug went after treatment.
Atomic Alchemy, GE HealthCare, Mediso, MIM Software, Siemens Healthineers
Tumour treating fields (TTFields)
Wearable electrodes that deliver alternating electric fields disrupting cancer cell division.
Novocure
Hyperthermia
Hyperthermia heats tumours to 40-43 °C to make radiation and chemotherapy work better.
Oncotherm, Pyrexar Medical
Irreversible electroporation (NanoKnife)
Irreversible electroporation uses short high-voltage pulses that punch permanent holes in tumour cells while sparing nearby vessels and ducts.
AngioDynamics, IGEA
Scalp cooling (cold caps: DigniCap, Paxman)
A tightly fitted cap chilled to a few degrees above freezing, worn before, during and after each chemotherapy infusion, narrows the blood vessels of the scalp so less drug reaches the hair roots. In a randomised trial about half of women on taxane-based chemotherapy kept most of their hair, compared with none who went without.
Dignitana, Luminate Medical, Paxman
Thermal ablation (RFA, microwave, cryo)
Thermal ablation kills a tumour with heat or cold delivered through a needle, with no incision required.
Ananya Health, AngioDynamics, Boston Scientific, IceCure Medical, Johnson & Johnson, Medtronic, Monteris Medical, Quantum Surgical, XACT Robotics
Transcranial focused ultrasound systems (Exablate Neuro, SonoCloud)
A helmet of a thousand ultrasound emitters, or a small implant under the skull, that sends sound through the bone into the brain. Approved for tremor, it is being tested in brain tumours to open the brain's protective barrier for a few hours so that drugs can reach the tumour.
Carthera, Insightec
ZAP-X gyroscopic radiosurgery
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.
ZAP Surgical Systems
Accelerator-based BNCT systems (NeuCure, nuBeam, NeuPex)
Boron neutron capture therapy used to need a nuclear reactor. These hospital-sized accelerators make the neutron beam instead, and in 2020 Japan approved the first one, with its boron drug, for head and neck cancers that have come back or cannot be removed.
Neuboron Medtech, Neutron Therapeutics, Stella Pharma, Sumitomo Heavy Industries, TAE Life Sciences
AI polyp detection in colonoscopy
Real-time software that highlights polyps on the colonoscopy screen, helping doctors find more of the growths that could become bowel cancer.
Medtronic, Olympus
AI-assisted mammography screening
Software that reads screening mammograms alongside or before radiologists, catching more cancers and cutting the reading workload in large trials.
none
Boron neutron capture therapy
In boron neutron capture therapy a boron drug accumulates in tumour cells, then a neutron beam makes only those cells explode from inside.
Neuboron Medtech, Neutron Therapeutics, Stella Pharma, Sumitomo Heavy Industries, TAE Life Sciences
Breast MRI coils and abbreviated breast MRI
Breast MRI is the most sensitive breast scan, done lying face down with the breasts in a special coil. Abbreviated protocols cut the scan from half an hour to a few minutes, which makes MRI screening of women with dense breasts or high risk affordable.
Canon Medical Systems, GE HealthCare, Philips, Siemens Healthineers, United Imaging
C-arm medical linear accelerators (TrueBeam, Versa HD and others)
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.
Elekta, Varian
Capsule endoscopy (PillCam, EndoCapsule, CapsoCam)
A camera the size of a large vitamin pill that the patient swallows; it photographs the whole small intestine, which ordinary endoscopes cannot reach, and newer versions look at the colon as an alternative to colonoscopy for people who cannot or will not have one.
CapsoVision, Medtronic, Olympus
Closed-system transfer devices for hazardous drugs (PhaSeal, ChemoLock, Equashield)
Sealed connectors that let a pharmacist or nurse draw up and give chemotherapy without any drug vapour or droplet escaping, protecting the staff who handle these drugs every day.
B. Braun, Baxter International, BD, Equashield, ICU Medical, Loccioni, Omnicell
Cobalt-60 teletherapy
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.
Nordion
Colposcopes and digital cervical screening devices (DYSIS, EVA System, AVE)
The magnifying camera a gynaecologist uses to examine the cervix after an abnormal smear or HPV test, and the new portable and smartphone versions with software that scores the picture, built for clinics with no specialist in reach.
Carl Zeiss Meditec, DYSIS Medical, MobileODT
Confocal microscopy and optical coherence tomography for skin (VivaScope, VivoSight, deepLive)
Devices that look beneath the skin surface without cutting: one scans cells with a laser at microscope resolution, another builds a cross-section with infrared light. Both help decide whether a suspicious mole or patch needs a biopsy, and which edge to cut to.
Caliber Imaging and Diagnostics, Canfield Scientific, DAMAE Medical, FotoFinder Systems, Michelson Diagnostics
Contrast-enhanced mammography
A mammogram taken after an iodine contrast injection, at two X-ray energies, so that a tumour's blood supply shows up as a bright spot. It gives much of what breast MRI gives on a machine most breast units already own.
FUJIFILM Healthcare, GE HealthCare, Hologic, Siemens Healthineers
Cryoablation systems
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.
Boston Scientific, IceCure Medical, Varian
Cyclotron isotope production (F-18, Ga-68, Cu-64, Zr-89, At-211)
Proton-rich isotopes for PET scans and some therapies are made by hitting a target with a beam from a cyclotron. Fluorine-18 is made every morning within driving distance of the scanner; gallium-68 comes from either a generator or a cyclotron; copper-64 and zirconium-89 last long enough to ship across a country.
Cardinal Health Nuclear & Precision Health Solutions, Curium, Eckert & Ziegler, GE HealthCare, IBA, IRE, Jubilant Radiopharma, Lantheus, Nusano, PETNET Solutions, RadioMedix, Siemens Healthineers, SOFIE Biosciences, Telix Pharmaceuticals
Cystoscopy, blue-light imaging & TURBT
Cystoscopy and TURBT mean looking inside the bladder with a camera and shaving off tumours through the urethra. Blue-light dyes make flat tumours easier to see.
Karl Storz, SBI Pharmaceuticals
Dermoscopy, total-body photography & AI skin analysis
Magnified skin imaging and whole-body photo mapping, increasingly read by algorithms, to find melanoma early and avoid unnecessary biopsies.
Caliber Imaging and Diagnostics, Canfield Scientific, FotoFinder Systems
Dual-energy and spectral CT
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.
Canon Medical Systems, GE HealthCare, Philips, Siemens Healthineers
Elastography and contrast-enhanced ultrasound
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.
Canon Medical Systems, FUJIFILM Healthcare, GE HealthCare, Hologic, Mindray, Philips, Siemens Healthineers
Electrochemotherapy
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.
IGEA
Electrochemotherapy devices (Cliniporator)
A pulse generator and needle electrodes that give a tumour a few brief electric shocks minutes after a small dose of chemotherapy, opening the cells so the drug floods in. Used mostly for cancer nodules in the skin, now also for tumours inside the body.
IGEA
Electron beam therapy systems (linac electrons, total skin electron units, mobile electron IORT)
Electron beams stop within a few centimetres of the skin, so they treat surface tumours, scars and the whole skin without reaching the organs underneath. Most linacs make them; special set-ups spread them over the entire body or deliver them during surgery.
Elekta, IntraOp Medical, Varian
Endoscopic ultrasound and EBUS systems
Endoscopes with an ultrasound probe on the tip, passed down the gullet or windpipe, that see through the wall of the gut or airway to stage tumours and guide a needle into lymph nodes and the pancreas without an operation.
Boston Scientific, Cook Medical, FUJIFILM Healthcare, Olympus, Pentax Medical
FLASH research accelerators (Oriatron, Mobetron FLASH, ProBeam FLASH)
Machines built or modified to deliver a whole radiation dose in a fraction of a second, so scientists can test whether ultra-fast dosing spares healthy tissue in people the way it does in animals.
IntraOp Medical, Varian
Flow cytometers
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.
BD, Beckman Coulter, Cytek Biosciences, Thermo Fisher Scientific
Gamma probes, handheld gamma cameras and dose calibrators
The small radiation detectors that make nuclear medicine and sentinel node surgery work: a pen-sized probe that clicks when the surgeon nears the radioactive lymph node, and the well counter in the hot lab that checks every dose before it is injected.
Comecer, Lightpoint Medical, Mammotome, Sun Nuclear
HIPEC perfusion pumps and PIPAC nebulisers
The pump and heater that circulate warm chemotherapy through the abdomen at the end of an operation for cancer that has spread across the abdominal lining, and the small nebuliser that sprays chemotherapy as an aerosol through keyhole ports when surgery is not possible.
Belmont Medical Technologies, Capnomed
Hyperthermia systems (BSD-2000, EHY-2000, superficial and interstitial applicators)
Machines that warm a tumour to about 40 to 43 degrees for an hour using radio waves or microwaves from outside the body, making the radiotherapy or chemotherapy given alongside work better. Few hospitals own one.
Oncotherm, Pyrexar Medical
In vivo dosimetry and patient-specific quality assurance
Measuring the dose the patient actually receives, with detectors on the skin or the imaging panel behind them, to catch errors before they cause harm.
PTW Freiburg, Standard Imaging
In-room imaging for radiotherapy (cone-beam CT, ExacTrac, CT-on-rails, HyperSight)
The scanners built into or beside the radiotherapy machine that photograph the patient seconds before the beam fires, so the tumour is where the plan expects and, on the newest machines, so the plan can be redrawn to that day's anatomy.
Accuray, Brainlab, Elekta, Siemens Healthineers, Varian
Infusion pumps, ports, and ambulatory chemotherapy devices
Infusion devices are the implanted ports, smart pumps, and take-home pumps that deliver chemotherapy safely, including 46-hour infusions patients carry home.
B. Braun, Baxter International, BD, Fresenius Kabi, ICU Medical
Intraoperative fluorescence and Cerenkov imaging systems (SPY, Firefly, LumiSystem, LightPath)
Cameras in the operating theatre that see dyes the surgeon's eye cannot: green dye lighting up lymph nodes and blood supply, pink glow marking a brain tumour, and even the faint light from a PET tracer in a removed specimen. They turn the dyes into a picture the surgeon follows.
Carl Zeiss Meditec, Hamamatsu Photonics, Intuitive Surgical, Karl Storz, Lightpoint Medical, Lumicell, Medtronic, Olympus, On Target Laboratories, Stryker
Intraoperative MRI and CT
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.
Brainlab, GE HealthCare, Medtronic, Philips, Siemens Healthineers
Knowledge-based and automated treatment planning
Software that learns from hundreds of past plans what dose distribution is achievable for a new patient, and produces a plan in minutes that a planner would have taken hours to reach.
none
Laser interstitial thermal therapy (LITT)
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.
none
Laser interstitial thermal therapy systems (NeuroBlate, Visualase)
Two commercial systems thread a laser fibre through a hole the width of a pencil into a brain tumour and cook it while the surgeon watches the temperature on live MRI. They reach tumours too deep or too risky to remove with open surgery.
biolitec, Medtronic, Monteris Medical
Lattice and GRID radiotherapy
Lattice radiotherapy deliberately treats a bulky tumour unevenly, placing peaks of tumour-destroying dose at spaced points inside it while the tissue between receives far less, relying on bystander and immune effects to extend the kill. It runs on standard linear accelerators, but evidence is mostly palliative and single-arm, and the mechanism is unsettled.
none
Long-read sequencing (PacBio, Oxford Nanopore)
Long-read sequencing (PacBio HiFi, Oxford Nanopore) reads single DNA molecules in stretches of thousands of bases, so rearrangements, repeat expansions, gene fusions and methylation appear in one run where short-read machines miss them. Nanopore can classify a brain tumour during surgery in under an hour; throughput per dollar still trails the largest short-read instruments.
Oxford Nanopore Technologies, PacBio
Magnetic nanoparticle hyperthermia
Magnetic nanoparticle hyperthermia injects iron-oxide nanoparticles into a tumour and heats them from outside with an alternating magnetic field.
none
Medical cyclotrons, hot cells, and synthesis modules
The particle accelerators and shielded robotic chemistry boxes that make PET tracers in hospital basements and commercial pharmacies.
Comecer, GE HealthCare, IBA, Siemens Healthineers, Sumitomo Heavy Industries, Trasis
Microwave and radiofrequency ablation systems
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.
AngioDynamics, Johnson & Johnson, Medtronic
MRI
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.
Adialante, Canon Medical Systems, FUJIFILM Healthcare, GE HealthCare, Monteris Medical, Philips, Profound Medical, Siemens Healthineers, SonALAsense, United Imaging
MRI field strengths: 1.5 T, 3 T and 7 T
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.
Bruker, Canon Medical Systems, FUJIFILM Healthcare, GE HealthCare, Philips, Siemens Healthineers, United Imaging
New short-read sequencing platforms
New short-read sequencing platforms from Ultima Genomics, Element Biosciences, Roche and MGI compete with Illumina by cutting the cost per gigabase, with Ultima claiming a genome under 100 dollars. Cheaper reads make whole-genome tumour-normal sequencing and deep ctDNA testing affordable in principle, but clinical assays must be revalidated and Illumina's installed base still dominates.
Element Biosciences, Illumina, MGI Tech, Roche / Genentech, Ultima Genomics
Nuclear medicine and total-body PET hardware
Nuclear medicine hardware means the scanners themselves: PET/CT, SPECT/CT, and new total-body PET that images the whole body at once.
Canon Medical Systems, GE HealthCare, Hamamatsu Photonics, Siemens Healthineers, United Imaging
Oncology information and record-and-verify systems (ARIA, MOSAIQ)
The software that holds a radiotherapy patient's plan, checks that the machine settings match it before every beam is switched on, and keeps the record of every dose given. Almost every department runs one of two systems.
Elekta, Varian
Oncology pharmacy automation and compounding robots
Robots and closed systems that prepare chemotherapy doses safely, protecting pharmacists from hazardous drugs and patients from errors.
B. Braun, BD, Equashield, ICU Medical, Loccioni, Omnicell
Patient positioning and surface guidance systems (AlignRT, Catalyst, ExacTrac Dynamic)
Cameras that watch the patient's skin in three dimensions, robotic couches and moulded shells that hold the body still, so each radiotherapy dose lands where the plan says without tattoos and with the beam paused if the patient moves.
Brainlab, C-RAD, Varian, Vision RT
Photodynamic therapy lasers and light sources
Red or near-infrared lasers and lamps that switch on a light-sensitive drug sitting in a tumour. Each drug has its own colour, so the machine is matched to the drug: skin lamps for sun damage, fibre-optic lasers for the oesophagus, lung and bladder, and a new near-infrared laser for the head and neck.
biolitec, Modulight, Photocure, Rakuten Medical, SBI Pharmaceuticals
Photon-counting CT
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.
Canon Medical Systems, GE HealthCare, Siemens Healthineers
Radiotherapy QA phantoms and dosimeters (Sun Nuclear, IBA Dosimetry, PTW)
The measuring instruments that prove a radiotherapy machine gives the dose it claims: ionisation chambers, detector arrays, water tanks and plastic stand-in patients, checked every day, month and year and before every complex plan is delivered.
IBA, PTW Freiburg, Radformation, Standard Imaging, Sun Nuclear
Radiotherapy treatment planning and QA software
The software that calculates exactly how radiation beams should be shaped and checks the machine delivered it.
Brainlab, Elekta, PTW Freiburg, RaySearch Laboratories, Sun Nuclear, Varian
Remote afterloaders for HDR brachytherapy
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.
Carl Zeiss Meditec, Eckert & Ziegler, Elekta, Standard Imaging, Varian
Respiratory gating and tumour tracking systems (RPM, ABC, Calypso, Synchrony)
Hardware that copes with tumours that move when the patient breathes: belts and cameras that switch the beam on only in part of the breathing cycle, devices that hold the breath, and implanted beacons or X-ray tracking that let the beam follow the tumour.
Accuray, C-RAD, Elekta, Varian, Vision RT
Respiratory motion management (4D-CT, gating, breath-hold, tracking)
Ways of dealing with tumours that move as the patient breathes: image the motion, treat only in part of the breathing cycle, hold the breath, or chase the tumour with the beam.
C-RAD, Vision RT
Ring-gantry linacs (Halcyon, Ethos)
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.
Varian
Robotic and navigational bronchoscopy
A robot-guided flexible scope that reaches small lung nodules through the airways to biopsy them without a needle through the chest wall.
Intuitive Surgical, Johnson & Johnson
Spatial biology instruments
Spatial biology instruments are machines that map which genes and proteins are active in each part of a tumour slice.
10x Genomics, Akoya Biosciences, Bruker, Vizgen
SPECT/CT
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.
GE HealthCare, Mediso, Siemens Healthineers
Superficial and orthovoltage radiotherapy for skin cancer
Low-energy X-rays that stop within a few millimetres, used to cure basal and squamous cell skin cancers where surgery would scar or is not wanted.
none
Surface-guided radiotherapy (SGRT)
Cameras track the patient's skin surface in three dimensions during treatment, replacing tattoos and pausing the beam if the patient moves.
C-RAD, Vision RT
Surgical robots: da Vinci, Hugo, Versius and single-port systems
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.
CMR Surgical, Intuitive Surgical, Johnson & Johnson, Medtronic
Total skin electron beam therapy
A low-energy electron beam treats the entire skin surface, for lymphomas that live in the skin, without penetrating to the organs beneath.
none
Total-body PET for screening and ultra-low-dose imaging
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.
Siemens Healthineers, United Imaging
Ultrasound
Ultrasound uses sound waves to make live pictures; it is cheap, safe, and used to guide needles into lumps.
Butterfly Network, Canon Medical Systems, FUJIFILM Healthcare, GE HealthCare, iSono Health, Mindray, Philips, Siemens Healthineers
Whole-slide scanners and image management
The scanners that turn glass slides into gigapixel images, and the software that stores and serves them, without which pathology AI cannot run.
3DHISTECH, Hamamatsu Photonics, Indica Labs, Leica Biosystems, Philips, Proscia, Roche / Genentech, Sectra
X-ray radiography and fluoroscopy
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.
Canon Medical Systems, FUJIFILM Healthcare, GE HealthCare, Philips, Shimadzu, Siemens Healthineers

Where the rare machines are

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 therapy machines: cyclotrons, synchrotrons and single-room systems46 centres in 14 countries

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.

Made by Hitachi, IBA, Leo Cancer Care, Mevion Medical Systems, P-Cure, ProTom International, Sumitomo Heavy Industries, Varian.

Carbon-ion synchrotrons and facilities6 centres in 5 countries

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.

Made by Hitachi, Toshiba Energy Systems & Solutions.

MR-guided adaptive radiotherapy18 centres in 8 countries

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.

Made by Elekta, Philips, RefleXion Medical, ViewRay.

Gamma Knife16 centres in 7 countries

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.

Made by Elekta.

CyberKnife robotic radiosurgery5 centres in 3 countries

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.

Made by Accuray.

TomoTherapy and Radixact (helical radiotherapy)3 centres in 3 countries

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.

Made by Accuray.

ZAP-X gyroscopic radiosurgery1 centre in 1 country

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.

Made by ZAP Surgical Systems.

Biology-guided radiotherapy (RefleXion X1, SCINTIX)2 centres in 1 country

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.

Made by RefleXion Medical.

Focused ultrasound & histotripsy3 centres in 3 countries

Destroying tumours from outside the body with tightly focused sound waves, using either heat or microscopic bubbles.

Made by HistoSonics, Insightec, Profound Medical, SonALAsense.

Tumour treating fields (TTFields)2 centres in 2 countries

Wearable electrodes that deliver alternating electric fields disrupting cancer cell division.

Made by Novocure.

Transcranial focused ultrasound systems (Exablate Neuro, SonoCloud)1 centre in 1 country

A helmet of a thousand ultrasound emitters, or a small implant under the skull, that sends sound through the bone into the brain. Approved for tremor, it is being tested in brain tumours to open the brain's protective barrier for a few hours so that drugs can reach the tumour.

Made by Carthera, Insightec.

Families at a glance

Imaging scanners

How tumours are found, staged and measured.

Endoscopes and clinic imaging

Scopes, capsules and cameras that look inside the gut, airway, cervix and skin.

Radiotherapy machines

Photon and electron beams, from the everyday linac to dedicated radiosurgery units.

Radiotherapy guidance and quality

The planning software, cameras, imagers, record systems and dosimeters that make a beam accurate.

Particle therapy

Protons, carbon ions and neutrons: the machines that stop inside the tumour.

Ablation and energy devices

Heat, cold, sound, light, electric pulses and fields delivered through a needle or from outside.

Surgical machines

Robots, navigation, cameras and probes in the operating theatre.

Chemotherapy delivery and supportive devices

Pharmacy robots, sealed connectors, pumps and cooling caps around the chemotherapy chair.

Laboratory and production

The instruments behind pathology, blood tests, sequencing and tracer supply.

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.