Accuray, Inc. (NASDAQ:ARAY)

CAPS Rating: 4 out of 5

The Company has developed the commercially available intelligent robotic radiosurgery system, the CyberKnife system, designed to treat solid tumors anywhere in the body as an alternative to traditional surgery.


Player Avatar pillip (< 20) Submitted: 4/1/2010 8:37:12 AM : Underperform Start Price: $6.07 ARAY Score: +6.62

Founder of company recently resigned from Board of Accuray and as a consultant to join Accuray's main competitor Varian citing poor management and business strategy at Accuray. Founder was also Accuray's largest individual shareholder.

Accuray being held back by reimbursement issuesin US for use of its only product, Cyberknife, and arrogant insular inexperienced management, Accuray lacks an effective strategy for addressing the critical reimbursemnt issue. Upper management poorly regarded internally and talented middle managers are leaving.

Stock is selling at one third of IPO price. Company has world class, game changing product but third world management. Company is doomed if current management is not replaced.

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Member Avatar PauvrePapillon (99.87) Submitted: 1/31/2011 12:59:50 PM
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A lot of Varian shareholders make big noises about Dr. John Adler (the neurosurgeon and Accuray founder who had the initial idea to liberate the radiation source from the gantry) joining Varian as VP Clinical Applications. What they are missing is that while Adler provided the initial concept for CyberKnife, he never had (and still doesn’t have) the technical background or genius to actually build a gantry-mounted system much less a robotically controlled one.

That distinction belongs to the late Dr. Russell Schonburg who invented the miniature linac, Dr. Joseph Depp who designed the three dimensional guidance system, and Dr. Mohan Budduluri who combined Dr. Schonburg’s linac with Dr. Depp’s guidance system and actually made the thing work. And all that was years ago. Today’s CyberKnife is a highly evolved and advanced robotic system which is so far ahead of Varian’s gantry-mounted systems as to have a technological mote which is insurmountable in even the distant future.

Varian has a large installed base and the political clout that goes with it. They have been able to use their “research grants” and other lobbying efforts to manipulate multiple Certificate of Need processes as well as CMS code designations and ASTRO positions and thus delay the wider adoption of competing treatments; however, they have one major problem. Their basic technology is inferior perhaps even obsolete and new advances in imaging technologies are beginning to make this fact ever more obvious.

Accuray has a huge technological advantage which, at some point, Varian’s campaign of obfuscation notwithstanding, is going to become obvious to everyone including the patient community.

When that happens, who is going to want to be treated with a gantry-mounted radiation sprayer?

For more, see:

Member Avatar PauvrePapillon (99.87) Submitted: 2/4/2011 2:56:23 PM
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From Medical Uses of Linear Accelerators:

“The treatment of cancer using radiation began in the early 1900’s with kilovoltage x-ray machines which operated at 150 to 350 kilovolts (Figure 1).

“In the mid-1950’s, with the earlier advent of microwave power tubes such as the klystron (Figure 7) and the invention of electron linear accelerators (Figure 8), accelerators appeared simultaneously in the United Kingdom and the United States. Such machines were in the range of 4-8 MeV in energy and limited by their inability to rotate totally around the patient (Figures 9 - 11).

“In 1960, the first 360º fully isocentric linear accelerator was developed at Varian and shipped to UCLA (Figures 12 - 13).”

Note the gantry-mounted designs evident in figures 9 through 13.

All that Varian has done over the past 50 years is to increase the power of the linac, figure out how to vary the size of the beam without changing parts mid-treatment (multi-leaf collumators) and add whistle and bells to the control panel.

The basic design is still a gantry-mounted linac rotating around a single plane.

Note also how in both the Stanford piece as well as the marketing materials for TrueBeam and Tomo, various radiation oncologists tout the importance of increasing the number of angles from which radiation may be fired – talking, of course, about improvements in the ability of their linacs to more fully rotate around the patient- but when Accuray completely liberates the linac from the gantry and employs a robot with six degrees of freedom thus enabling these same rotations around multiple angles as well as multiple planes as well as non-isocentric treatment patterns, what do they say?

This “gantry-mounted radiation sprayers are just as good as CyberKnife” business is one of the most outrageous lies ever promulgated in the medical community.

Fundamentally, CyberKnife represents a far greater improvement over TrueBeam than TrueBeam does over Varian's original Linac 6.

I encourage all Accuray shareholders to bring the Stanford .pdf posted above to the attention of anyone who has an interest in this space. The vested interests can spin their lie all they like but it gets harder and harder when you know the history of these devices and can see with your own eyes that the only basic design breakthrough in radiation oncology in the past 50 years is CyberKnife.

The rest of these devices really are just 1950s-style radiation sprayers with multi-leaf collimators, more powerful linacs, fancier control panels and more up-to-date-sounding trade names.

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