ACCURAY INC

Accuray Incorporated

Overview

Accuray Incorporated designs, manufactures, sells and supports radiation therapy systems, planning, imaging and data management solutions for treating cancerous and benign tumors, and select neurologic and endocrine disorders where clinically appropriate. The product portfolio combines a robotic platform (CyberKnife) with a helical platform family (Accuray Stellar, Radixact, Accuray Helix and Tomo C, where available) to deliver precise radiation with motion management, image guidance, adaptive workflows and data integration across the patient treatment journey.

Core platforms and capabilities

Robotic Radiation Delivery (CyberKnife)

• CyberKnife S7 System with Synchrony real-time adaptive target tracking and dynamic delivery for moving targets.
• Configurations include fixed collimators, Iris Variable Aperture Collimator and InCise multileaf collimator (MLC).
• Supports treatment across brain, spine, lung and other body sites with sub-millimeter precision and non-isocentric beam delivery.
• Workflow and planning features such as VOLO optimization in the Accuray Precision Treatment Planning System (TPS) and VOLO Ultra for fast planning.
• Clinical applications include radiosurgery and radiotherapy for brain, spine, prostate and other locations; supports frameless and outpatient treatment where appropriate.

Helical Radiation Delivery (TomoTherapy lineage and successors)

• Helical systems deliver radiation in a 360-degree helical pattern around a moving patient, enabling TomoHelical, TomoDirect and other delivery modes.
• Platform variants include Accuray Stellar (adaptive radiotherapy), Radixact (flexible delivery), Accuray Helix (entry-point helical system) and the Tomo C System produced in China (Made-in-China JV).
• Imaging and delivery features include ClearRT helical kVCT imaging on select configurations and TomoEDGE delivery for beam width modulation.
• Integrated planning, imaging, delivery and data management with software such as VOLO Ultra, PreciseART (adaptive RT) and PreciseRTX (retreatment planning).

Software, planning and data management

• Accuray Precision Treatment Planning System (TPS) with iDMS Data Management System:
  • Multi-modality image fusion, deformable image registration, AutoSegmentation, plan comparison and evaluation.
  • Supports TomoHelical, TomoDirect, IMRT and 3D CRT planning modes on helical platforms and CyberKnife planning for frameless intracranial SRS, fiducial-free lung tracking, SBRT and IMRT.
  • Dose engines include Monte Carlo for InCise MLC and VOLO planning for CyberKnife and selected helical systems.
• VOLO and VOLO Ultra optimization engines for fast, high-quality plan generation.
• iDMS provides centralized storage and access to treatment plans, platform connectivity, OIS Connect option for oncology information systems, encrypted data storage (Storage Vault) and reporting.
• Additional tools: PreciseART (adaptive workflows), PreciseRTX (retreatment), Delivery Analysis (pretreatment QA), TQA for trend and reporting, and integration with third-party SGRT options via VitalHold where available.

Services and support

• Customer support, installation, training and professional services.
• Remote diagnostics, workflow optimization and analytics.
• AI-enabled tools under development to support predictive maintenance and faster diagnostics.

Geographic presence and customers

• Global operations with international offices in Morges (Switzerland), Hong Kong, Shanghai and Tokyo.
• Direct sales in Western Europe, Japan, India, Korea and Canada; distributors across Europe, the Middle East, Africa, Asia Pacific and Latin America.
• China-based joint venture CNNC Accuray Tianjin manufactures and sells radiation oncology systems in China. Accuray Asia holds 49% and CNNC High Energy Equipment (Tianjin) Co., Ltd. holds 51% of the JV.
• The JV represented about 16% of total net revenue for the year ended June 30, 2026, and about 26% for the year ended June 30, 2025.
• Key customer and distributor relationships influence revenue and backlog, including historical reliance on a major customer for a substantial portion of revenue.

Intellectual property

• As of June 30, 2026: exclusive field-of-use licenses or ownership of 623 U.S. and foreign patents and 52 U.S. and foreign patent applications.
• Protection strategy includes patents, trade secrets, trademarks, copyrights and confidentiality agreements, together with collaboration, licensing and development arrangements.

Manufacturing and quality

• Major components are sourced from outside suppliers; some components are single-sourced (examples include couch, magnetron and solid-state modulator for TomoTherapy; robot, couch and magnetron for CyberKnife).
• Primary manufacturing in Madison, Wisconsin (U.S.); CyberKnife and TomoTherapy linear accelerators manufactured in Chengdu, China.
• Quality and regulatory compliance include ISO 13485:2016, FDA QSR compliance and MDSAP participation; facilities support component integration, testing and system commissioning.

Regulatory and market reach

• U.S. regulatory pathway primarily uses FDA 510(k) clearances; some modifications require new 510(k) submissions. The PMA pathway is not currently used for Accuray devices.
• International approvals include CE marking under EU MDR, MHLW in Japan, NMPA in China and clearances or registrations in other countries such as Canada, Taiwan, Korea and Russia.
• Sales cycles are long due to the capital equipment nature of products, regulatory approvals and construction/installation timelines. Revenue recognition typically occurs upon shipment, with certain installation elements deferred.

Financial snapshot highlights (period covered)

• Employees: 809 as of June 30, 2026 (392 outside the United States).
• Indebtedness: $182.0 million outstanding under a five-year Term Loan Facility; $5.0 million under a Revolving Credit Facility; $18.3 million under a Delayed Draw Term Loan; maturities through 2030; $10.3 million in accumulated paid-in-kind interest.
• Convertible and other warrants: multiple tranches issued in connection with financing agreements (June 2025 Premium and Penny Warrants; December 2025 Super Premium, Premium and Penny Warrants; May 2026 Super Premium, Premium and Penny Warrants).
• Net revenue contribution from the China JV: 16% in 2026; 26% in 2025.
• Accumulated deficit: $568.5 million as of June 30, 2026, reflecting a history of net losses and an expectation of continued losses in the near term.
• Notable collaborations and partnerships: Brainlab (2023), GE Healthcare (2023), Oncopole Claudius Regaud (IUCT-Oncopole) and Airbus (AI collaboration) in 2024, and a 10-year collaboration with the UW School of Medicine and Public Health announced in 2026 to advance Stellar adaptive radiation therapy.

Business focus

Accuray focuses on delivering precise, adaptable radiation treatments through robotic and helical delivery platforms, integrated planning and data management software, imaging, motion management and adaptive workflows. The company emphasizes global sales and service, ongoing product development and clinical collaboration, international manufacturing and regulatory compliance, and strategic partnerships and joint ventures to expand access, particularly in China through the CNNC JV. Financially, the company operates with a significant accumulated deficit, substantial indebtedness and a revenue mix that includes a meaningful contribution from its China JV, with exposure to macroeconomic, currency, supply chain and regulatory risks.