Machines used against cancer

99 machine classes across 9 families, from the plain X-ray to carbon-ion synchrotrons, with 156 vendors and 150 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 scanners21 Endoscopes and clinic imaging8 Radiotherapy machines18 Radiotherapy guidance and quality10 Particle therapy6 Ablation and energy devices19 Surgical machines6 Chemotherapy delivery and supportive devices4 Laboratory and production7

99 machinesDownload

			Used for	Main advantage	Main limit
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	Aarhus University Hospital, Abramson Cancer Center, University of Pennsylvania, Advanced Centre for Treatment, Research and Education in Cancer	none	No exit dose; lower integral dose	Cost	none
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	Aarhus University Hospital, Abramson Cancer Center, University of Pennsylvania, Advanced Centre for Treatment, Research and Education in Cancer	Childhood cancers, Brain and spinal cord tumours, Medulloblastoma	No exit dose beyond the target	Cost, building size and long commissioning
Robotic & minimally invasive surgery Surgeons operate through small incisions using robotic arms with tremor-free precision and 3D vision.	Brainlab, CMR Surgical, Intuitive Surgical	A.C. Camargo Cancer Center, Apollo Hospitals, Barts Cancer Institute / Barts Health NHS Trust	Prostate cancer	Precision, shorter stay	Cost	none
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	All India Institute of Medical Sciences, New Delhi, Apollo Hospitals, Charité Universitätsmedizin Berlin	Brain and spinal cord tumours, Metastatic cancer, Brain metastases	One to five sessions	Limited to small targets
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	American Society for Radiation Oncology, Amsterdam UMC / Cancer Center Amsterdam, Cancer Care Alberta	Pancreatic ductal adenocarcinoma, Prostate cancer	Tighter margins, dose escalation in pancreas	Slow throughput	none
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	All India Institute of Medical Sciences, New Delhi, Cleveland Clinic Taussig Cancer Institute, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center	Brain and spinal cord tumours, Metastatic cancer, Pituitary tumours	Sub-millimetre accuracy and steepest fall-off	Intracranial targets only
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	Centre Antoine Lacassagne, Chinese PLA General Hospital, Chulabhorn Hospital / Chulabhorn Royal Academy	Lung cancer, Non-small-cell lung cancer	Anatomy plus biology	CT radiation added to PET dose
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	Comprehensive Cancer Center Vienna, Medical University of Vienna / AKH, European Society for Radiotherapy and Oncology, Fudan University Shanghai Cancer Center	Sarcomas, Pancreatic ductal adenocarcinoma	Effective in radioresistant tumours	Very few facilities	none
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	Fudan University Shanghai Cancer Center, Gunma University Heavy Ion Medical Center, Heidelberg University Hospital / NCT / DKFZ	Chordoma, Sarcomas, Pancreatic ductal adenocarcinoma	Higher biological effect for radioresistant tumours	About a dozen facilities worldwide
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	Advanced Research Projects Agency for Health, Chang Gung Memorial Hospital, Chao Family Comprehensive Cancer Center, UC Irvine	none	Fewer positive margins and re-operations	Millimetre depth penetration	none
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	Apollo Hospitals, Charité Universitätsmedizin Berlin, Georgetown Lombardi Comprehensive Cancer Center	Brain and spinal cord tumours, Metastatic cancer, Prostate cancer	Frameless with real-time tracking of skull, spine and fiducials	Long sessions and low throughput
HIPEC / PIPAC (intraperitoneal chemotherapy) Washing the abdominal cavity with heated chemotherapy during surgery to kill microscopic peritoneal deposits.	Belmont Medical Technologies, Capnomed, UNICANCER	European Society of Gynaecological Oncology, European Society of Surgical Oncology, First Affiliated Hospital of Sun Yat-sen University	Ovarian cancer, Colorectal cancer, Gastric & gastro-oesophageal junction cancer	High local concentration	Morbidity, centre expertise	none
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	Erasmus MC Cancer Institute, International Association for the Study of Lung Cancer, National Cancer Center Korea	none	Fast, ubiquitous	Anatomic only; cannot distinguish scar from live tumour
Mammography & tomosynthesis Low-dose breast X-ray used for screening. Newer 3D versions find more cancers with fewer false alarms.	ECOG-ACRIN Cancer Research Group, FUJIFILM Healthcare, GE HealthCare	Hospital de Amor, Kaiser Permanente Division of Research, National Cancer Center Korea	Triple-negative breast cancer, HR-positive / HER2-negative breast cancer, HER2-positive breast cancer	Proven mortality benefit	Reduced sensitivity in dense breasts	none
Sentinel lymph node biopsy Removing just the first lymph node a tumour drains to, instead of all of them, to check for spread.	Alliance for Clinical Trials in Oncology, Lightpoint Medical, Mammotome	European Society of Surgical Oncology, IEO, Keio University Hospital	Triple-negative breast cancer, HR-positive / HER2-negative breast cancer, Melanoma	Avoids lymphoedema from full dissection	False negatives in ~5-10%	none
Focused ultrasound & histotripsy Destroying tumours from outside the body with tightly focused sound waves, using either heat or microscopic bubbles.	HistoSonics, Insightec, Profound Medical	Sunnybrook Odette Cancer Centre, University College London Hospitals / UCL Cancer Institute, UVA Comprehensive Cancer Center	Hepatocellular carcinoma, Prostate cancer, Pancreatic ductal adenocarcinoma	Completely non-invasive	Acoustic window (ribs, bowel gas)	none
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	Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Sunnybrook Odette Cancer Centre, UVA Comprehensive Cancer Center	Glioma & glioblastoma	Non-invasive or single implant	Volume treated per session	none
Optical & fluorescence imaging Dyes that glow under special light, so surgeons can see tumour edges and nerves in the operating theatre.	Bikanta, Lumicell, NearWave	Cancer Center at Illinois, Chao Family Comprehensive Cancer Center, UC Irvine, Montefiore Einstein Comprehensive Cancer Center	none	Real-time intraoperative	Penetration depth of millimetres	none
Photoimmunotherapy & photodynamic therapy An antibody carries a light-sensitive dye to the tumour; shining near-infrared light then bursts the cells.	Modulight	National Cancer Center Hospital East, Pharmaceuticals and Medical Devices Agency, Roswell Park Comprehensive Cancer Center	Head and neck squamous cell carcinoma	Highly selective, repeatable	Light penetration limits to accessible tumours	none
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	Heidelberg University Hospital / NCT / DKFZ, The Christie NHS Foundation Trust, University of Wisconsin Carbone Cancer Center	Head and neck squamous cell carcinoma, Prostate cancer, Medulloblastoma	Long and complex targets without field junctions	Single photon energy, no electrons
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	City of Hope, Stanford Health Care / Stanford Cancer Institute	Non-small-cell lung cancer, Metastatic cancer, Prostate cancer	Tumour signal tracks motion without fiducials	Needs a tracer injection and adequate uptake
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	American Society for Radiation Oncology, NCT/UCC Dresden, University Hospital Carl Gustav Carus	none	Potential to widen therapeutic window dramatically	Unproven in humans	none
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	Fundación Arturo López Pérez, Tianjin Medical University Cancer Institute and Hospital	HR-positive / HER2-negative breast cancer, Colorectal cancer, Sarcomas	Single session; completes radiotherapy during surgery	Higher local recurrence than whole-breast RT in ELIOT
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	Cancer Care Alberta, Society of Nuclear Medicine and Molecular Imaging	none	Whole-body biology in one scan	Resolution ~4 mm
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	Comprehensive Cancer Center Tübingen-Stuttgart, TUM Klinikum rechts der Isar / CCC München	none	Lower radiation	Expensive, few scanners
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	Erasmus MC Cancer Institute, Society of Nuclear Medicine and Molecular Imaging	none	Cheap, widespread	Lower resolution and sensitivity than PET	none
Tumour treating fields (TTFields) Wearable electrodes that deliver alternating electric fields disrupting cancer cell division.	Novocure	Robert H. Lurie Comprehensive Cancer Center of Northwestern University, University Hospital Zurich / Comprehensive Cancer Center Zurich	Glioma & glioblastoma, Pancreatic ductal adenocarcinoma, Non-small-cell lung cancer	Non-invasive, minimal systemic toxicity	18+ hours/day wear
Hyperthermia Hyperthermia heats tumours to 40-43 °C to make radiation and chemotherapy work better.	Oncotherm, Pyrexar Medical	Aarhus University Hospital	Cervical cancer, Sarcomas, Soft tissue sarcoma of the extremity	Radiosensitiser without added toxicity	Equipment and expertise scarce	none
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	Institute of Oncology Ljubljana	Pancreatic ductal adenocarcinoma, Prostate cancer	Safe next to vessels and bile ducts	General anaesthesia with paralysis; cardiac synchronisation	none
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	Multinational Association of Supportive Care in Cancer	HR-positive / HER2-negative breast cancer, Triple-negative breast cancer, HER2-positive breast cancer	Randomised evidence of hair preservation in about half of taxane-treated women	Much less effective with anthracyclines and not offered in haematological cancers
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	Zhongshan Hospital, Fudan University	Hepatocellular carcinoma, Renal cell carcinoma, Colorectal cancer	Outpatient, repeatable	Size limit ~3 cm	none
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	Sunnybrook Odette Cancer Centre	Glioma & glioblastoma, Brain metastases, Brain and spinal cord tumours	Non-invasive opening of the blood-brain barrier	Small treated volume per helmet session
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	Gustave Roussy	Brain and spinal cord tumours, Metastatic cancer, Pituitary tumours	No bunker and no radioactive source	Head and upper neck only
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	none	Head and neck squamous cell carcinoma, Glioma & glioblastoma, Melanoma	Selectivity comes from the drug, so diffuse and re-irradiation cases can be treated	Very few machines and one approved indication
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	none	Colorectal cancer	Higher adenoma detection in randomised trials	More small polyps found, more resections and pathology
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	none	HR-positive / HER2-negative breast cancer, HER2-positive breast cancer, Triple-negative breast cancer	Higher cancer detection in randomised and real-world studies	Long-term effect on interval cancers and mortality still being measured	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	none	Head and neck squamous cell carcinoma, Glioma & glioblastoma	Cellular-level selectivity	Boron delivery agent limits tumour selectivity	none
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	none	Breast cancer, Ductal carcinoma in situ	Most sensitive breast imaging test	Gadolinium contrast and false positives
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	none	Breast cancer, Prostate cancer, Non-small-cell lung cancer	Treats almost every site and technique on one machine	Needs a shielded bunker and skilled staff
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	none	Small intestine cancer, Colorectal cancer, Gastric & gastro-oesophageal junction cancer	Visualises the entire small bowel	No biopsy or therapy
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	none	Breast cancer, Colorectal cancer, Non-Hodgkin lymphoma	Reduces surface contamination and staff exposure	Designs vary in vapour containment
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	none	none	Simple and robust	Source decays and must be replaced
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	none	Cervical cancer, Vulvar cancer, Anal cancer	Directs biopsy and treatment after abnormal screening	Modest sensitivity that depends on training
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	none	Melanoma, Basal cell carcinoma, Skin cancer	Cellular-level view without biopsy	Imaging depth limited to the upper dermis
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	none	Breast cancer, Ductal carcinoma in situ	Accuracy close to breast MRI for detection and size	Iodine contrast risks
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	none	Renal cell carcinoma, Breast cancer, Prostate cancer	Ice ball visible during treatment	Slower and more probes than microwave	none
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	none	none	Distributed production near scanners	Enriched target materials
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	none	Bladder & urothelial cancer	Organ-sparing	Understaging in ~25% of T1 tumours	none
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	none	Melanoma	Cheap, non-invasive, repeatable	Algorithm performance drops on darker skin and rare subtypes	none
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	none	Renal cell carcinoma, Hepatocellular carcinoma, Pancreatic ductal adenocarcinoma	Quantifies tumour enhancement and iodine uptake	Vendor-specific methods and protocols
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	none	Hepatocellular carcinoma, Breast cancer, Thyroid cancer	No ionising radiation or nephrotoxic contrast	Operator dependent	none
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	none	Melanoma, Kaposi sarcoma, Cutaneous squamous cell carcinoma	High local response with minimal systemic toxicity	Local treatment only
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	none	Melanoma, Breast cancer, Head and neck squamous cell carcinoma	High local response in skin metastases across tumour types	Pain and muscle contraction during pulsing
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	none	Skin cancer, Cutaneous T-cell lymphoma, Breast cancer	Sharp dose fall-off spares organs under the skin	Cannot reach deep tumours
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	none	Pancreatic ductal adenocarcinoma, Oesophageal cancer, Gastric & gastro-oesophageal junction cancer	Most accurate staging of wall depth and regional nodes	Operator dependent
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	none	Cutaneous T-cell lymphoma, Bone metastases and skeletal-related events, Skin cancer	Tests a potentially large normal-tissue sparing effect	Electron beams reach only superficial targets
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	none	Acute lymphoblastic leukaemia, Acute myeloid leukaemia, Chronic lymphocytic leukaemia	Tens of thousands of cells a second, many markers per cell	Needs fresh viable cells within hours	none
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	none	Breast cancer, Melanoma, Prostate cancer	Enables sentinel node surgery and radioguided resection	Depends on isotope supply and a nuclear medicine department
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	none	Appendiceal cancer and pseudomyxoma peritonei, Peritoneal mesothelioma, Ovarian cancer	Direct exposure of the peritoneal surface at high concentration	Benefit depends on complete cytoreduction
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	none	Cervical cancer, Sarcomas, Breast cancer	Randomised evidence of benefit with radiotherapy in cervical cancer and with chemotherapy in sarcoma	Even heating of deep tumours is hard
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	none	none	Catches gross errors	Adds workload
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	none	Prostate cancer, Non-small-cell lung cancer, Head and neck squamous cell carcinoma	Daily verification of tumour position	Cone-beam soft-tissue contrast is poorer than diagnostic CT
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	none	none	Enables outpatient and home regimens	Catheter-related thrombosis and infection	none
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	none	Glioma & glioblastoma, Breast cancer, Ovarian cancer	Real-time view of perfusion, lymphatics and tumour margins	Sees only millimetres deep
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	none	Glioma & glioblastoma, Brain and spinal cord tumours, Pituitary tumours	More complete glioma resection in a randomised trial	Expensive suite and compatible instruments
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	none	none	Consistent plan quality	Inherits biases of the training plans
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	none	Glioma & glioblastoma	Minimally invasive access to deep lesions	Lesion size limit (~3 cm)	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	none	Glioma & glioblastoma, Brain metastases, Brain and spinal cord tumours	Reaches deep and eloquent-area tumours through a burr hole	Lesion size limited by heat spread
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	none	none	Debulks large tumours that cannot tolerate uniform ablative dose	Mechanism is not settled	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	none	none	Structural variants and methylation natively	Higher per-base error historically (improving)	none
Magnetic nanoparticle hyperthermia Magnetic nanoparticle hyperthermia injects iron-oxide nanoparticles into a tumour and heats them from outside with an alternating magnetic field.	none	none	Glioma & glioblastoma, Prostate cancer	Heat is generated only where particles sit	Requires direct injection and a specialised field applicator	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	none	none	On-site supply of short-lived isotopes	Capital and shielding cost ($2-5M per site)	none
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	none	Hepatocellular carcinoma, Colorectal cancer, Renal cell carcinoma	Curative for small liver cancers, matching resection in small tumours	Size limit and incomplete ablation at the margin	none
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	none	none	No ionising radiation	Slow and expensive
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	none	Prostate cancer, Brain and spinal cord tumours, Glioma & glioblastoma	3 T: higher resolution or faster scans for prostate, brain and breast	Artefacts and heating grow with field strength	none
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	none	none	Falling cost per genome	Clinical assay revalidation on new platforms	none
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	none	none	Sensitivity and speed	Capital cost (total-body >$10M)	none
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	none	Breast cancer, Prostate cancer, Head and neck squamous cell carcinoma	Blocks delivery when machine settings do not match the plan	Single point of failure for the department
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	none	none	Worker safety	Capital and throughput	none
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	none	Breast cancer, Brain metastases, Head and neck squamous cell carcinoma	Tattoo-free set-up and continuous motion monitoring	Skin is only a surrogate for deep targets
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, Galderma, Modulight	none	Skin cancer, Basal cell carcinoma, Oesophageal cancer	Repeatable and tissue-sparing	Light penetrates only millimetres
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	none	Non-small-cell lung cancer, Multiple myeloma, Hepatocellular carcinoma	Higher spatial resolution at the same or lower dose	Expensive and installed in few hospitals
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	none	Prostate cancer, Head and neck squamous cell carcinoma, Breast cancer	Independent proof that the machine delivers the planned dose	Consumes machine and physicist time
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	none	none	Mature, regulated software	Vendor lock-in	none
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	none	Cervical cancer, Prostate cancer, Endometrial cancer	Highest achievable conformal dose from inside the tumour	Source replacement and licensing
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	none	Non-small-cell lung cancer, Hepatocellular carcinoma, Pancreatic ductal adenocarcinoma	Smaller margins around moving tumours	Gating lengthens treatment
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	none	Non-small-cell lung cancer, Hepatocellular carcinoma, Pancreatic ductal adenocarcinoma	Smaller margins and less normal tissue dose	Longer sessions
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	none	Prostate cancer, Breast cancer, Head and neck squamous cell carcinoma	Fast treatment and set-up	No electrons or higher photon energies
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	none	Non-small-cell lung cancer	Reaches peripheral nodules safely	Cost
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	none	none	Preserves tissue architecture	Cost per section	none
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	none	Prostate cancer, Breast cancer, Melanoma	Widely available and cheaper than PET	Lower resolution and sensitivity than PET
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	none	Basal cell carcinoma, Cutaneous squamous cell carcinoma, Skin cancer	Non-invasive cure for skin cancers	Multiple visits
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	none	HR-positive / HER2-negative breast cancer, HER2-positive breast cancer, Triple-negative breast cancer	No tattoos or extra radiation	Surface does not always track internal anatomy
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	none	Prostate cancer, Endometrial cancer, Colorectal cancer	Precision and 3D vision in confined spaces	Capital and per-case cost
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	none	Peripheral T-cell lymphomas, Cutaneous T-cell lymphoma	Treats the whole skin at once	Available in few centres
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	none	none	Ultra-low-dose or ultra-fast scans	No screening evidence and likely overdiagnosis	none
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, Cook Medical	none	Triple-negative breast cancer, HR-positive / HER2-negative breast cancer, Thyroid cancer	Real-time, portable, no radiation	Operator dependent	none
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	none	none	Remote sign-out, second opinions, AI-ready archives	Storage and network cost	none
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	none	Lung cancer, Multiple myeloma, Hepatocellular carcinoma	Cheapest and most widely available imaging	Overlapping structures hide small lesions

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.

JapanGunma University Heavy Ion Medical Center QST Hospital
ChinaFudan University Shanghai Cancer Center
GermanyHeidelberg University Hospital
South KoreaSeverance Hospital, Yonsei University
TaiwanTaipei Veterans General Hospital

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.

United StatesGeorgetown Lombardi Comprehensive Cancer Center Stanford Health Care UPMC Hillman Cancer Center
GermanyCharité Universitätsmedizin Berlin
IndiaApollo Hospitals

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.

GermanyHeidelberg University Hospital
United KingdomThe Christie NHS Foundation Trust
United StatesUniversity of Wisconsin Carbone Cancer Center

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.

FranceGustave Roussy

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.

United StatesCity of Hope Stanford Health Care

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.

CanadaSunnybrook Odette Cancer Centre
United KingdomUniversity College London Hospitals
United StatesUVA Comprehensive Cancer Center

Tumour treating fields (TTFields)2 centres in 2 countries

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

Made by Novocure.

SwitzerlandUniversity Hospital Zurich
United StatesRobert H. Lurie Comprehensive Cancer Center of Northwestern University

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.

CanadaSunnybrook Odette Cancer Centre

Families at a glance

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.

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.