ViewRay files for bankruptcy

[Tall_Allen]

I don't know what effect this will have. They manufacture the MRIdian linac. They intend to sell off assets, in whole or in part. That may mean a competitor like Accuray, Siemens/Varian, or GE may snap them up to get into the MRI-guided linac business. Or maybe Elekta will use it to merge with their Unity platform. It may have implications for parts, inventory, maintenance, support and training.

radiologybusiness.com/topic...

[Schwah]

Hey TA. For us ignorant folk, can you please advise what these guys do that perhaps no others can do as well?

[Tall_Allen in reply to Schwah]

Prostates move a lot - e.g., gas passing through colon, other organ motion, gravity, etc. The challenge is to aim the healing X-rays to the contours of the prostate, as planned. With fiducials, they use stereo X-rays or cone beam CT to match up the actual prostate position to the planning imaging. Still, there are small positioning errors. So, when they are used for SBRT, margins of about 4mm (maybe less on the rectal side) allow for positioning errors and to treat any cancer that has already migrated into the prostate bed. The larger the margin, the less the chance of missing some infiltrating cancer cells, but the greater the chance of causing irritation to nearby organs, like the bladder.

MRI-targeting matches the contours of the prostate in real time to the planned contours (called "gating".). It adjusts the X-ray beams to the contours as they actually are (within a certain margin of error). Using MRI targeting, Kishan feels comfortable in reducing the margin to 2 mm.

Preliminary results of his MIRAGE trial showed that there was a statistically significant reduction in toxicity using MRI-gating. However, the advantage was short-lived (first couple of months). The outstanding questions I have are:

1) Will there be a reduction in late-term side effects? The acute side effects reduced have been low grade and only briefly noticeable from the patient POV.

2) You can always reduce toxicity by reducing margins, but are oncological results being sacrificed? Only time will tell.

3) He compared MRIdian to an arc linac where he adjusted the arc only at the beginning of each treatment. When I was treated, there was readjustment every half-arc (4 readjustments per session). I don't know why he didn't compare it to intrafractional tracking.

So is MRi-tracking a major technological advantage? IMO, it's nice but probably not as big an improvement as some think.

[drmoose]

So sad - I hope they find a good home. I just did an SBRT treatment round (5X sessions) on their machine in Zurich ... was impressive (and of course I hope it actually works ...). I will write up and share my experience eventually.

[Fiddler2004]

Thanks for the information... So much in the cancer world seems to be in flux lately, both for the better and not so good. From what I gather from the article ViewRay intends to continue servicing it's existing customer base. New CEO and strategy so who knows where things are headed for them. Like you said maybe this valuable tech will be picked up by another major player 🤷

[Don_1213]

According to the article - their assets exceed their liability - how does that qualify for Chapter-11 bankruptcy? (I have virtually no knowledge of bankruptcy law.)

[maley2711 in reply to Don_1213]

solvency?

[backbonz in reply to Don_1213]

voluntary reorganization. Trying to sell.

Disappointed to see. I had this done by Dr. Nagar at NY Presby back in March.

Looks like they will continue to keep people to service the systems they have in the field. I was told by an employee of VR, that several other major centers were in the process of buying the system. I’d guess that’s on hold for now.

[j-o-h-n]

CY Not SY. (Chapter 13)...

I guess the incorrect spelling reminds me of something I chased when I was young.

bankruptsy

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 07/20/2023 5:59 PM

[Tall_Allen in reply to j-o-h-n]

Thanks! I edited it.