Accuray Inc. unveiled the next generation of CyberKnife and TomoTherapy equipment at ASTRO 2012 in Boston this week, as promised by the company in an investor call in early October.

The Sunnyvale, Calif.-based company's newly appointed CEO Joshua Levine had revealed earlier this month it would have two major product releases at ASTRO that would be important for the business' future.

The two news lines of radiation therapy equipment to be released by the company will replace old models and have received new technology to allow faster treatment times and higher patient throughput, according to Stefan Gliessmann, vice president of product lifecycle management.

"For us it's a new era," he told DOTmed News by phone Wednesday. "Both our systems are becoming more flexible and more usable, and (we're) extending our reach."

New CyberKnife

Accuray pulled back the cover on the three models that make up its new CyberKnife M6 series, the FIM, FM and FI, all of which are pending clearance by the Food and Drug Administration.

The CyberKnife, the first iteration of which was released in the 1990s, is a stereotactic radiosurgery and radiation therapy system using a robotic arm to direct X-ray beams to treat cancer.

The biggest innovation in the new series is its highest-tier model, the FIM, and the mid-tier FM, include the addition of the Incise Multileaf Collimator. This allows for a bigger aperture for better coverage of larger lesions, such as in the liver, for stereotactic body radiation therapy, an indication of the device.

The MLC opening is 10 centimeters by 12 centimeters, Gliessmann said, compared with the 6-centimeter Iris collimator used in some earlier CyberKnife models. With the Iris, the CyberKnife uses more beams to cover the tumor, but treatment takes longer than with the new system, Gliessmann said.

Research carried out at Fox Chase Cancer Center in Philadelphia suggests theoretical time savings for the MLC of 35 to 70 percent compared with earlier models, Gliessmann said.

The MLC, however, is pretty hefty, weighing in at close to 220 pounds, just shy of the average weight of an NFL linebacker. So Accuray said it had to replace the CyberKnife's robotics to accommodate the extra pounds. The new robotics can bear a 661-pound payload, largely so it can handle moving around with the heavy collimator if in the future Accuray releases dynamic delivery applications, Gliessmann said. As a result of its greater weight, though, the MLC is not available as an upgrade for older models, he added.

The FM and the "entry level" FI are, however, upgradeable to the FIM, he said.

New TomoTherapy

Similarly, the new TomoTherapy H Series, with H standing for "helical," comes in three makes of increasing sophistication and price: the H, the HD, with the D meaning "direct" dose, and the HDA, with the A meaning "advanced."

TomoTherapy is a CT-imaging guided linear accelerator. Accuray bought the company that makes the system last year.

Arguably the most innovative new feature here, available by default in the HDA model, is what the company calls "TomoEDGE." Basically, this means dynamic beam jaws, which can open during treatments.

Again, the advantages here would be in accuracy and treatment time. Gliessmann said the average beam-on time is reduced by half using this technology. The company said it has also improved CT image acquisition and processing time, which is now faster by a factor of two. Gliessmann said with the new advancements, a typical patient would take 15 minutes to treat from entering the treatment room to being escorted out. In earlier models, more complex cases could take upwards of half an hour, he said.

Gliessmann said this makes the system more competitive. He said the company has also improved the performance of the device, to reduce wear and tear on parts and frequency of preventive maintenance -- a sticking-point with earlier models that had caused the company's service costs to be high.

Coming soon

TomoTherapy H Series received Food and Drug Administration 510(k) clearance before the show, Gliessmann said. He said the company would start offering price quotes in November and the first shipments are expected early next year. The Hi-Art series, the earlier TomoTherapy systems, would be discontinued, he said.

The CyberKnife is pending FDA 510(k) clearance, which he said the company expects, if all goes well, sometime in November. But Gliessmann said they expect to start shipping it in the European Union later this year. He said the company could not yet reveal what institutions have ordered the device.

Once CyberKnife enters the U.S. market, the plan is to discontinue making earlier CyberKnife systems, he said.

Keys to the future

The releases come at a critical time for the company. Levine, who stepped in for outgoing boss Euan S. Thomson in early October, told investors in a call shortly after taking over that the new platforms would be "keys to our revenue growth."

Gliessmann, who got his start as a medical physicist, said so far the reception has been positive.

"It's for me, personally, also very encouraging seeing the resonance of the new products in these short two and a half days," he said, referring to the ASTRO show, which began Sunday. "It's overwhelming. I've not had this experience anywhere else."

He declined to say what the company's install goals for the systems were, as Gliessmann said with the new CEO only three weeks on the job, it would be premature to comment on business plans.

ASTRO hiccups

Of course, ASTRO, which marked the public debut of the devices, did have to contend with an unwelcome visitor: Hurricane Sandy. The powerful storm, which made landfall in New Jersey on Monday, has been responsible for scores of deaths in the Caribbean and across the eastern United States and and has also racked up likely billions of dollars in damages.

Less seriously, it did disrupt ASTRO's annual event. Dangerously strong winds and flooding risk forced Boston to shut down public transportation early Monday afternoon, and partly as a result the radiation oncology meeting closed its doors early Monday, too. But the show reopened as scheduled on Tuesday, which Gliessmann said was especially hectic as a result.

"Tuesday was extremely busy," with people "trying to make up for the lost six hours of Monday," he said.