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  5. > Radiology Oncology Surgical Robots: Market Shares, Strategies, and Forecasts, Worldwide, 2016-2022

Worldwide Radiology Oncology surgical robot markets are poised to achieve significant growth as next generation systems provide a way to improve traditional open surgery and use radiology for cancer surgery. New systems pinpoint the delivery of radiation precisely, eliminating the radiological overdosing that has been such a problem previously, limiting the quantity of radiation that can be delivered. Radiosurgery robots take cancer surgery far beyond what has been available, promising a cure for cancer. Radiology oncology surgical robots use mechanical mobility and continuous image guidance to remove tumors. The Accuray CyberKnife® robotic system follows the oncology target throughout treatment, intelligently delivering sub-millimeter precision, sparing healthy tissue. A robotic manipulator and a compact, lightweight linear accelerator, can deliver beams from thousands of noncoplanar, isocentric or non-isocentric angles. Treatments have excellent tumor coverage, steep dose gradients, and tight dose conformality.

The radiation oncology market is growing globally due to a number of factors centered around the aging of the population and the benefits accrued from new technology. The number of new cancer cases diagnosed annually is projected to increase from 14.9 million in 2015 to 20 million by 2025. The increase in new cases is due to a steadily aging population. Both developed and developing countries have aging populations.
Technology advances improve the precision and applicability of radiotherapy and radiosurgery. Expanding uses of radiotherapy and radiosurgery equipment occur because the units are able to treat a broader range of cases. Advances in hardware and software are creating a market for replacing an aging installed base. New designs are able to deliver higher standards of care. The rise in cancer cases, together with the increase in sophistication of new treatment protocols, have created demand for more automated products. Automation depends on integration of several devices into clinically practical systems. Integrated systems make treatments rapid and cost effective. Technology advances lead to improvements in patient care. The availability of advanced, automated and efficient clinical tools in radiation therapy has brought more precise forms of radiotherapy treatment (IMRT, IGRT, VMAT, SRS, SBRT, brachytherapy and proton therapy). Technology includes the EDGE™ and Truebeam™, and the Accuray TomoTherapy H Series and CyberKnife M6 platforms that enable treatments that reduce treatment times and increase patient throughput .

International markets are under-equipped to address the growing cancer incidence. Patients in many foreign countries must frequently endure long waits for radiotherapy. 9,000 additional treatment machines will be required by 2020 in developing countries. China, India and Brazil are estimated to require over 3,800, 1,200 and 400 additional machines. Demand in emerging markets, coupled with ever increasing incidences of cancer, represent additional drivers for continued growth. Radiology oncology surgical robot market driving forces relate to an opportunity to achieve change in medical practice regarding the treatment of cancer. Change would lead to utilization of stereotactic body radiosurgery more regularly as an alternative to surgery or other treatments. Radiosurgery is poised to revolutionize the treatment of cancer by eradicating tumors while not harming surrounding healthy tissue. The ability to use high doses of radiation to precisely eliminate a tumor while leaving healthy tissue unharmed is compelling. It means that high doses of radiation can be delivered without killing the person, that doses of radiation delivered can be enough to kill the cancer without killing the person, this represents a change in what has been possible previously. The Varian, Elekta, and Accuray radiology oncology surgical devices offer robust clinical treatment capabilities. Flexibility of the Accuray InCise™ Multileaf Collimator and robotic delivery permit treatment of tumors previously thought untreatable. With radiosurgery and SBRT cancer can be treated efficiently and effectively. The device offers accuracy.

Table Of Contents

Radiology Oncology Surgical Robots: Market Shares, Strategies, and Forecasts, Worldwide, 2016-2022
Radiology Oncology Surgical Robot Executive Summary 20
Radiology Oncology Surgical Robot Market Driving Forces 20
Surgical Radiology Robotics Market Driving Forces 23
Radiology Surgical Robot Key Procedures As Elements Of Strategy 27
Radiosurgery As Stereotactic Radiotherapy 28
Radiology Oncology Surgical Robots Market Share Analysis 29
Radiology Surgical Robots Market Forecasts 31
1. Radiology Surgical Robot Market Description and Market
Dynamics 35
1.1 Radiotherapy, Radiation Therapy, Radiosurgery, And Brachytherapy Market
Description 35
1.1.1 IMRT 36
1.1.2 VMAT 37
1.1.3 IGRT 37
1.1.4 SRS and SBRT 38
1.1.5 Brachytherapy 38
1.1.6 Proton Therapy 39
1.2 Current Radiation Therapy Limitations 40
1.3 Radiology Robotic Surgical Clinical Facilities and Clinical Diagnosis 42
1.3.1 Cancer Robotic Surgery Learning Curves 44
1.3.2 Robotic Radiological Surgery Equipment 44
1.3.3 Medicare and Medicaid Impact 46
1.3.4 Medical Robotic Surgery by Segment 46
1.3.5 Robotic Cancer Surgery 46
1.3.6 Cancer 47
1.4 Brain Tumors 48
1.4.1 Causes of Brain Tumor 49
1.4.2 Tumor Grading 49
1.4.3 Types of Treatment 50
1.4.4 Biopsies 51
1.4.5 U.S. Markets For Diagnostic Oncology-Related X-Ray-Based Imaging
Products 51
2D X-Ray Systems Market Driving Forces 53
2. Radiology Oncology Surgical Robot Market Shares and
Market Forecasts 55
2.1 Radiology Oncology Surgical Robot Market Driving Forces 55
2.1.1 Surgical Radiology Robotics Market Driving Forces 58
2.1.2 Radiology Surgical Robot Key Procedures As Elements Of Strategy 62
2.1.3 Radiosurgery Is Stereotactic Radiotherapy 63
2.2 Radiology Oncology Surgical Robots Market Share Analysis 64
2.2.1 Accuray 67
2.2.2 Accuray Clinical Studies 68
2.2.3 Accuray Goal 69
2.2.4 Accuray Revenue 71
2.2.5 Varian 75
2.2.6 Elekta 77
2.2.7 Brainlab 80
2.2.8 Radiology Surgical Robots Market Unit Analysis 81
2.3 Radiology Surgical Robots Market Forecasts 82
2.3.1 Advanced Surgical Robotic Radiation Therapy Systems 86
2.3.2 U.S. Markets For Diagnostic Oncology-Related X-Ray-Based Imaging
Products 87
2.4 Cancer Incidence and Radiology Surgery Number of Procedures 88
2.5 Radiology Surgical Robots Regional Analysis 93
2.5.1 US Radiation Oncology Market 94
2.5.2 European Radiation Oncology Market 95
2.5.3 Asia Pacific Market Radiation Oncology Market 95
2.5.4 Accuray in China 96
2.5.5 Advantages of the Accuray Cyberknife treatment in China 99
2.5.6 GE Moves X-Ray Base to China to Tap Growth 100
2.5.7 Japanese Regulatory Approval for Accuray CyberKnife Robotic Fullbody
Radiosurgery System 101
2.5.8 Japan X-ray Systems Market 101
2.5.9 Philips Expands Global Reach Of X-Ray Solutions 101
2.5.10 Reimbursement Challenges 103
3. Radiology Surgical Robots Product Descriptions 105
3.1 Accuray CyberKnife M6 Series 105
3.1.1 Accuray CyberKnife M6 FIM System 111
3.1.2 Accuray CyberKnife® M6™ System 115
3.1.3 Accuray / CyberKnife VSI System 117
3.1.4 Accuray / TomoTherapy System 120
3.1.5 Accuray Clinical Studies 124
3.1.6 Accuray TomoTherapy® System Clinical Studies 126
3.1.7 Accuray CyberKnife® System Clinical Study 126
3.1.8 Accuray TomoTherapy System Clinical Study 126
3.1.9 Class A User Licenses for Accuray Products Awarded to 16 Hospitals in
China 127
3.1.10 Accuray “Open Systems” Software Benefits 128
3.2 Elekta 129
3.2.1 Elekta Gamma Knife® Surgery 132
3.3 Varian 137
3.3.1 Varian Image Guided Radiation Therapy, Cone-Beam CT (CBCT 140
3.3.2 Varian Trilogy 140
3.3.3 Varian Edgeâ„¢ Radiosurgery Suite 142
3.3.4 Varian Oncology Systems 144
3.4 ViewRay 147
4. Radiology Surgical Robots Technology and Research151
4.1 Accuray Radiology to Treat Head Cancer And Spinal Cancer 151
4.1.1 Fiducial Markers Implantation 151
4.1.2 Molding Of A Plastic Body Cradle 151
4.1.3 Treatment Planning 152
4.1.4 Programming of the Accuray Cyberknife System 152
4.1.5 Treatment Procedure 152
4.1.6 Postoperative Supervision 153
4.2 Varian Medical TrueBeam® Systems Advanced Platform 153
4.2.1 Potential of High Definition Radiotherapy 154
4.3 C-Arm Surgical X-Rays 156
4.4 X-Ray Digital Workflow 157
4.5 Stereotactic Radiosurgery 160
4.5.1 Image-Guided Stereotactic Radiosurgery 160
4.5.2 Image-Guided Stereotactic Radiosurgery Safety 160
4.6 Siemens Ysio Max (Advances in X-Ray) 161
4.7 MD Anderson Gamma Knife Radiosurgery 162
4.7.1 MD Anderson Proton Therapy Center 163
4.8 Partners Healthcare Massachusetts General Hospital Radiation Cancer
Treatment 164
4.8.1 Partners Healthcare / Dana Farber 164
4.8.2 Three-Dimensional Conformal Radiation Therapy (3D-CRT) 165
4.8.3 Image Guided Radiation Therapy (IGRT) 166
4.8.4 Intensity Modulated Radiation Therapy (IMRT) 166
4.8.5 RapidArcâ„¢ Volumetric Modulated Radiotherapy 166
4.8.6 Total Body Irradiation (TBI) 167
4.8.7 Accelerated Whole Breast Radiation Therapy 167
4.8.8 Stereotactic Radiosurgery (SRS) 167
4.8.9 High Dose Rate (HDR) Brachytherapy 168
4.8.10 Robotic Transrectal Ultrasound (TRUS) Guided Radiation Therapy 168
4.9 Memorial Sloan Kettering Radiation Cancer Treatment 169
4.9.1 Memorial Sloan Kettering IMRT and IGRT 169
4.9.2 Memorial Sloan Kettering Stereotactic Radiation Therapy 170
4.9.3 Memorial Sloan Kettering Whole-Brain Radiation Therapy Stereotactic
Radiosurgery, SRS 171
4.10 U.S. Regulations 172
4.10.1 Foreign Regulations 173
5. Radiology Surgical Robots Company Descriptions 175
5.1 Accuray 175
5.1.1 Accuray Revenue for Second Quarter of Fiscal Year 2015 176
5.1.2 Accuray Revenue Three Months Ended September 30, 2015 177
5.1.3 Accuray Revenue 183
5.1.4 Accuray Non-Invasively Delivers High Doses Of Radiation To Tumors
With Extreme Accuracy And Intense Precision 186
5.1.5 Accuray Products 187
5.1.6 Accuray CyberKnife System 187
5.1.7 Accuray Strategy 189
5.1.8 Accuray International Presence 192
5.1.9 Accuray Competition 193
5.1.10 New Data Validates CyberKnife SBRT for Prostate Cancer Treatment
195
5.1.11 Accuray Recall in 2013 196
5.2 Best Theratronics, Ltd 197
5.3 Brainlab AG 200
5.3.1 Brainlab AG Revenue 202
5.3.2 Brainlab 203
5.4 Elekta 204
5.4.1 Elekta Gamma Radio Surgery System 205
5.4.2 Elekta - Interim report May - October 2015/16 206
5.4.3 Elekta Transformation program on track 207
5.5 Mitsubishi Heavy Industries 210
5.5.1 Mitsubishi Heavy Industries Vero Sterotactic Body Radiotherapy 210
5.6 Varian Medical Systems 212
5.6.1 Varian Oncology Systems Business Segment 212
5.6.2 Varian Revenue 213
5.7 ViewRay 216
5.8 Accuray Locations 220
5.9 2D X-ray Equipment Leading Vendors 546
Table ES-1 23
Innovative Radiology Surgical Robot Features 23
Table ES-2 24
Surgical Robotics Market Driving Forces 24
Table ES-3 25
Radiology Surgical Robot Market Positioning 25
Table ES-4 26
Accuray CyberKnife M6 Series Systems Adoption Trends 26
Table ES-5 28
Radiological Surgical Robot Medical Sub-Specialties 28
Figure ES-6 30
Radiology Surgical Robots Market Shares, Shipments, Dollars, Worldwide 201530
Figure ES-7 34
Radiology Surgical Robot Systems Forecasts, Dollars, Worldwide, 2015-2021 34
Table 1-1 40
Current Radiation Therapy Process and Limitations 40
Table 1-2 43
Advanced Clinical Decision Support 43
Table 1-3 45
Radiological Surgical Robots Benefits 45
Figure 1-4 47
X-ray Diagnosing and Tracking Cancer 47
Table 1-5 48
Factors That May Increase The Risk Of Complications With Radiology Cancer
Surgery 48
Table 1-6 53
X-Ray Equipment Market Driving Forces 53
Table 2-1 58
Innovative Radiology Surgical Robot Features 58
Table 2-2 59
Surgical Robotics Market Driving Forces 59
Table 2-3 60
Radiology Surgical Robot Market Positioning 60
Table 2-4 61
Accuray CyberKnife M6 Series Systems Adoption Trends 61
Table 2-5 63
Radiological Surgical Robot Medical Sub-Specialties 63
Figure 2-6 65
Radiology Surgical Robots Market Shares, Shipments, Dollars, Worldwide 201565
Table 2-7 66
Radiology Surgical Linear Accelerator Market Shares, Dollars, Worldwide, 201566
Figure 2-8 70
Accuray Patient Station 70
Table 2-9 71
Accuray CyberKnife Features 71
Table 2-10 72
Accuray Regional Revenue Shifts 72
Table 2-11 77
Elekta Gamma Knife Benefits 77
Table 2-12 78
Elekta Gamma Knife® Positioning 78
Table 2-13 79
Elekta Gamma Knife Perfexion Treatment Benefits 79
Table 2-14 80
Elekta Gamma Knife Features 80
Table 2-15 81
Radiology Surgical Linear Accelerator, Market Shares, Units and Dollars,
Worldwide, 2015 81
Figure 2-16 85
Radiology Surgical Robot Systems Forecasts, Dollars, Worldwide, 2016-2022 85
Table 2-17 86
Radiology Surgical Robot Market Segment Forecasts, Dollars and Units,
Worldwide, 2016-2022 86
Table 2-18 89
New Cancer Cases in US, 2015, 1,658 Thousand 89
Figure 2-19 90
Cancer Incidence and Mortality, Worldwide 90
Table 2-20 91
Accuray Surgical Robotic Advantages 91
Figure 2-21 93
Radiology Surgical Robots Regional Analysis 93
Table 2-22 94
Radiology Surgical Robots Market Segments 94
94
Table 2-23 96
Accuray Regional Revenue Shifts 96
Table 2-24 98
Accuray Cyberknife Radiosurgery System Treats The Following Diseases In China:
98
Table 2-25 99
Advantages of the Cyberknife Treatment in China 99
Radiology Surgical Robot Regional Market Segments, Dollars, 2015
In Millions of Dollars
MM$
2015 %
United States 2,624.1 65.0
Europe 807.4 20.0
China 403.7 10.0
Asia Pacific / Japan 161.5 4.0
Rest of World 40.4 1.0
Total 4,037.1 100.0
Source: WinterGreen Research, Inc.
Table 3-1 105
Accuray CyberKnife M6 Series Benefits: 105
Table 3-2 106
Accuray CyberKnife M6 Series Functions 106
Table 3-3 107
Accuray CyberKnife M6 Series Uses 107
Table 3-4 108
Accuray CyberKnife M6 Series Features 108
Table 3-5 109
Accuray CyberKnife M6 Patient Comfort Features 109
Figure 3-6 110
Accuray Radiology Surgical Robot 110
Figure 3-7 111
Accuray CyberKnife M6 FIM System 111
Table 3-8 112
Accuray CyberKnife M6 FIM System Features 112
Figure 3-9 113
Accuray CyberKnife M6 FM System 113
Table 3-10 114
Accuray CyberKnife M6 FM System Design Features 114
Figure 3-11 115
Accuray CyberKnife M6 FI System 115
Figure 3-12 117
Accuray / CyberKnife VSI System 117
Table 3-13 118
Accuray CyberKnife VSIâ„¢ Radiosurgery System Functions 118
Table 3-14 119
Accuray CyberKnife VSIâ„¢ Radiosurgery System Treatment Options 119
Figure 3-15 120
Accuray TomoTherapy® System 120
Table 3-16 121
Accuray TomoTherapy System Benefits 121
Table 3-17 123
Accuray Cancer Conditions Treated via Surgical Robot 123
Table 3-18 128
Accuray Open Systems Software Benefits 128
Table 3-19 129
Accuray Open Systems Software Challenges 129
Figure 3-20 130
Human Brain with Cancer Tumors 130
Figure 3-21 131
Elekta Lexsell Gamma Knife® PERFEXIONTM System 131
Table 3-22 134
Conditions for Elekta Gamma Knife® Efficacy 134
Table 3-23 135
Advantages of Elekta Gamma Knife® 135
Figure 3-24 136
Elekta Market Leading Solutions Portfolio 136
Figure 3-25 137
Varian Radiosurgery System 137
Figure 3-26 139
Varian Radiation Surgery Capabilities 139
Figure 3-27 141
Varian Trilogy 141
Table 3-28 145
Varian Oncology Product Set 145
Table 3-28 (Continued) 146
Varian Oncology Product Set 146
Figure 3-29 147
ViewRay On-Table Dose Prediction And Re-Optimization 147
Figure 3-30 149
ViewRay MRIdian® System 149
Table 3-31 150
ViewRay MRIdian® System Functions 150
Figure 4-1 157
X-Ray Digital Workflow 157
Figure 4-2 158
Digital X-Ray Equ9pm3n35 Part of Paperless Workflow in Hospital 158
Figure 4-3 159
Departmental Picture Archiving And Communication System PACS: Clinical
Productivity 159
Table 4-4 162
Elekta Gamma Knife Surgery Targets 162
Accuray Regional Revenue Shifts 176
Table 5-1 190
Accuray Strategy 190
Table 5-2 191
Accuray Key Elements Of Strategy 191
Table 5-3 198
Best Theratronics, Ltd Radiation Therapy - Gammabeamâ„¢ 500 Total Body
Irradiator Features 198
Figure 5-4 199
Best Theratronics, Ltd Radiation Therapy - Gammabeamâ„¢ 500 Total Body
Irradiator 199
Figure 5-5 200
Brainlab Collaborative Workspace 200
Figure 5-6 201
Brainlab AG Worldwide Presence, Headquarters in Germany 201
Figure 5-7 205
Elekta Gamma Radio Surgery System 205
Figure 5-8 211
Mitsubishi Heavy Industries Vero RadioTherapy 211
Table 5-9 218
ViewRay Early Adopters: 218

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