Data presentations at AAPM 2016 highlight potential of Elekta’s high-field MR-linac to enable real-time treatment adaptation

Transformative technology featured in 27 abstracts, reflecting growing interest
in MR-linac and robust progress of consortium researchers
WASHINGTON, DC, August 5, 2016 – Elekta (EKTA-B.ST) today announced that its
high-field MR-linac was featured in 27 abstracts presented at the 58th American
Association of Physicists in Medicine (AAPM) Annual Meeting & Exhibition, July
31 - August 4 in Washington, DC.

Elekta’s MR-linac fully integrates three subsystems to achieve unparalleled
precision and accuracy in radiotherapy: an advanced linear accelerator, a 1.5
Tesla magnetic resonance imaging (MRI) system and online adaptive workflow
software. Combined, these systems allow for simultaneous radiation therapy
delivery and high-field MR tumor monitoring, enabling online treatment adaptions
in response to changes in the targeted tumor position.

Three abstracts highlight the changing environment during radiotherapy treatment
resulting from breathing, digestion and other physiologic activity, and
demonstrate how MR-linac can be used to respond to these changes and to ensure
accurate dosing of target tissue:

  ·  Abstract SU-D-207A-7: “The effects of inter-cycle respiratory motion
variation on dose accumulation in single fraction MR-guided SBRT treatment of
renal cell carcinoma”; Bjorn Stemkens, doctoral candidate in the Department of
Radiotherapy at the University of Utrecht Medical Center. July 31, 2:05 p.m. -
3:00 p.m. This presentation evaluated three models used to characterize and
adapt to the impact of respiratory motion on radiation dosing to the kidney
during linac-based RT: static anatomy (STATIC), adjusting for motion based on
timing of the respiratory cycle (AVG-RESP) and detection of motion using 3D
images (PCA model). Results showing different dose observances among the models
found the PCA model more effectively captured inter-cycle random motion. This
allowed for mitigation of erroneous dosing that would have occurred with the AVG
-RESP model. Such mitigation is essential for delivering the planned RT dose to
the tumor while minimizing exposure of healthy tissue.

  ·  Abstract MO-E-BRC-0: “Fast online replanning techniques”; X. Allen Li, PhD,
Professor and Chief of Medical Physics at the Medical College of Wisconsin.
August 1, 3:25 p.m. – 3:45 p.m. This invited presentation was part of an
education session titled “Online adaptive radiotherapy – Considerations for
Practical Clinical Implementation.” Dr. Li focused on the importance of speed
and high-quality imaging in online treatment replanning. High-field MR images,
such as those provided by the MR-linac’s 1.5T imaging system, are ideal for
replanning because they provide excellent soft tissue contrast and/or
physiological information, which differentiates the tumor site from healthy
tissue. High-field images also eliminate contouring uncertainties from low
signal-to-noise ratio that occur with low-field images. Dr. Li shared examples
of how online replanning was used to improve coverage and/or sparing using
smaller margins in both the prostate and pancreas.

  ·  Abstract TH-CD-202-12: “Online inter-beam replanning based on real-time
dose reconstruction”; Cornelis P. Kamerling, post doctoral training fellow in
the Division of Radiotherapy and Imaging at the Institute for Cancer Research in
London. August 4, 10:00 a.m. – 12:00 p.m. This presentation discussed the
development and implementation of an online replanning workflow used to create
and deliver conventional and reduced margin treatment plans for a patient with
prostate cancer. Results demonstrated that replanning is technically feasible
and has the potential for margin reduction. The data also suggest that
replanning can be used to reduce radiation exposure to nearby organs.

“Establishing online treatment replanning is essential to reduce margins and
optimize care for cancer patients,” said Dr. Li. “Image speed and quality are
critical to effective replanning, and both require the high-field MR imaging
that can be achieved with MR-linac. A growing body of evidence demonstrates that
MR-linac supports margin reductions in the prostate and pancreas. Additional
forthcoming research from the MR-linac consortium will provide further clinical
validation, paving the way to integrate this transformative technology into the
treatment paradigms for prostate, pancreatic and a variety of other cancers.”

An additional 24 abstracts were presented during the conference, comprising 15
oral presentations and nine poster presentations. Of these, several describe
novel tools, devices and algorithms for assessing and adjusting dose delivery
for the MR-linac platform. Findings from these studies indicate that a variety
of dosimeters function effectively in the presence of a magnetic field, and that
appropriate computer algorithms can be used to adapt additional dosimeters for
use with MR-linac. The availability of multiple dosimetry approaches is
important for ensuring development of the MR-linac technology in a manner that
allows optimized and accurate radiotherapy treatment.

“MR-linac has the potential to fundamentally transform radiotherapy by enabling
radiation oncologists to see the treatment target in real time, and to rapidly
adjust dosing in response to diagnostic quality MR images,” says Kevin Brown,
Elekta’s Global Vice President of Scientific Research. “The data presented at
this conference support the use of online adaptive workflow to compensate for
intra-session motion, increasing the likelihood that radiation dosing is
delivered as planned. We believe that MR-linac is a potentially transformative
technology and are encouraged by the significant progress of our consortium
researchers and widespread interest in the radiation oncology community.”

About MR-linac
Elekta’s MR-linac combines a linear accelerator and an MRI scanner with
sophisticated software that allows a physician to see the target tumor in real
time. MR-linac is designed to improve targeting of tumor tissue while reducing
exposure of normal tissue to radiation beams, which may enable use of higher
radiation doses without increased side effects. MR-linac will allow physicians
to precisely locate tumors, and to accurately deliver doses of radiation even
when tumor tissue is moving during treatment or changes shape, location, or size
between treatment sessions.

Elekta’s MR-linac is a work in progress and not available for sale or
distribution.

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For further information, please contact:
Gert van Santen, Group Vice President Corporate Communications, Elekta AB
Tel: +31 653 561 242, e-mail: gert.vansanten@elekta.com
Time zone: CET: Central European Time
Johan Andersson, Director, Investor Relations, Elekta AB
Tel: +46 702 100 451, e-mail: johan.andersson@elekta.com
Time zone: CET: Central European Time
The above information is such that Elekta AB (publ) shall make public in
accordance with the Securities Market Act and/or the Financial Instruments
Trading Act. The information was published at 07:30 CET on August 5, 2016.
About Elekta
Elekta is a human care company pioneering significant innovations and clinical
solutions for treating cancer and brain disorders. The company develops
sophisticated, state-of-the-art tools and treatment planning systems for
radiation therapy, radiosurgery and brachytherapy, as well as workflow enhancing
software systems across the spectrum of cancer care. Stretching the boundaries
of science and technology, providing intelligent and resource-efficient
solutions that offer confidence to both health care providers and patients,
Elekta aims to improve, prolong and even save patient lives.
Today, Elekta solutions in oncology and neurosurgery are used in over 6,000
hospitals worldwide. Elekta employs around 3,800 employees globally. The
corporate headquarters is located in Stockholm, Sweden, and the company is
listed on NASDAQ Stockholm. Website: www.elekta.com