Accuray Incorporated

Radiation oncology specialist. Two distinct product families, both non-traditional linac architectures:

• CyberKnife — 6 MV compact linac mounted on a 6-axis industrial robotic arm. Real-time image-guided tracking.
• TomoTherapy / Radixact — helical megavoltage delivery with integrated MVCT imaging.

Company history

• 1990 — founded by Dr. John Adler (Stanford neurosurgeon). Goal: apply Leksell Gamma Knife-like stereotactic accuracy to the whole body, not just the brain.
• 1999 — first CyberKnife FDA clearance.
• 2011 — acquires TomoTherapy (TomoTherapy Hi-Art had shipped in 2003 under a separate company).
• 2017 — Radixact launches (TomoTherapy successor).

Product line

• CyberKnife: S7 (current), M6 (widely deployed), VSI (legacy). Robotic radiosurgery.
• TomoTherapy / Radixact: Radixact (current), TomoTherapy Hi-Art (legacy).
• Accuray Precision — treatment planning system, unified across both platforms.
• iDMS — oncology information system.

What makes Accuray different from Varian / Elekta

• CyberKnife is architecturally unique — the robotic arm can deliver beams from hundreds of non-coplanar angles, enabling dose distributions that conventional linac gantries can't achieve. Primary indications: SRS, SBRT, prostate.
• TomoTherapy delivers helically — patient moves continuously through the bore while the linac rotates. Produces extremely conformal long-target treatments (craniospinal, head+neck, total marrow).

Market position

Specialty player in rad onc. Not a volume competitor to Varian + Elekta in general radiotherapy; meaningful share in SRS/SBRT (via CyberKnife) and specific geometries where TomoTherapy's helical delivery excels.