ESTRO 2026: Engineering Innovation Companies to Watch

Leo Cancer Care is presenting upright treatment setups at ESTRO 2026, including breast and pelvic positioning. The engineering interest is not only that the patient is upright; it is that imaging, immobilisation, patient rotation, treatment-room layout and workflow evidence all change when the patient rather than the gantry becomes the moving geometry.

The company is also connected with RaySearch activity around upright adaptive planning workflows. Grace should be described carefully as a future photon therapy concept under development; Leo states that Grace is not cleared or approved for sale. For engineers, the useful question is how upright simulation, adaptive planning and fixed-beam delivery could be validated as one controlled clinical workflow.

Mevion Medical Systems

Compact proton therapy

Press release

Mevion describes the MEVION S250-FIT as a proton therapy system designed for installation in a standard radiotherapy or LINAC vault. That wording matters: the article should not independently claim broad infrastructure savings or universal installation suitability. The safe interpretation is that Mevion is presenting an engineering approach intended to reduce the scale and complexity often associated with proton therapy facilities.

For radiotherapy engineers, the interesting part is the relationship between accelerator design, shielding, access, cooling, service space, vault integration and operational workflow. Compact proton therapy could influence how cancer centres think about proton access in the future, but any site-specific feasibility remains a matter for local planning, regulatory review and official vendor documentation.

RaySearch Laboratories

Treatment planning, oncology informatics and online adaptive radiotherapy

Official source

RaySearch is showcasing RayStation and RayCare for adaptive workflow, including vendor-neutral online adaptive radiotherapy. Its ESTRO page also includes market-specific clearance language for online adaptive functionality, so availability and permitted clinical use should always be checked from official documentation.

The engineering significance is that treatment planning and oncology informatics are becoming more connected to delivery. Adaptive radiotherapy depends on image acquisition, registration, segmentation, dose calculation, plan approval, record-and-verify behaviour and treatment delivery working as a controlled sequence. RaySearch is therefore a useful example of software becoming part of the treatment delivery architecture, not simply a planning workstation.

Radformation is presenting ChartCheck Adaptive and workflow automation for offline adaptive assessment. The company describes automation around adaptive assessment, in-vivo monitoring and daily treatment insight. In practice, this places the engineering focus on data flow, alerts, integration with clinical systems and the evidence trail behind automated checks.

For engineers, automation should not be understood only as time saving. A useful automation system has to make the right information visible at the right point in the workflow, with appropriate human review, traceable decisions and clear handling of exceptions. That is why adaptive workflow checks are an engineering safety topic as much as a software productivity topic.

MVision Workspace+ brings together contouring, synthetic imaging, dose prediction and offline adaptive support. The broader signal is that AI in radiotherapy is moving beyond single-task auto-contouring toward wider workflow support across imaging and planning processes.

That shift is important for biomedical and radiotherapy engineers because it increases the need for model validation, version control, data governance, integration testing and failure-mode thinking. AI-assisted workflow is only useful clinically when teams understand where it helps, where it needs review and how its output is documented.

GE HealthCare / MIM Software

Imaging, AI-supported workflow and RT software

Official source

GE HealthCare is highlighting Intelligent Radiation Therapy and MIM software solutions at ESTRO 2026, including AI-supported workflow management and oncology software. The company frames these tools around connectivity, workflow coordination and support for complex oncology pathways.

The engineering story is interoperability. Modern radiotherapy involves CT simulation, image transfer, contouring, treatment planning, oncology information systems, QA systems and treatment delivery platforms. Any software layer that sits across that pathway has to deal with multi-vendor data, timing, user permissions, audit trails and clinical handover points.

Sun Nuclear

Machine QA, dosimetry and imaging/positioning QA

Official source

Sun Nuclear is showing Daily QA 4 Pro and Plan AI. Daily QA 4 Pro is described as combining dosimetry and imaging/positioning checks in a single indexed device. That makes it relevant to everyday machine release workflows, where repeatable setup, efficient measurement and reliable documentation matter.

For engineers, daily QA innovation is not glamorous but it is foundational. A treatment unit is only useful when its output, geometry, imaging and safety systems remain within accepted tolerances. Tools that combine measurement streams may influence how departments collect evidence, trend machine behaviour and manage routine checks over time.

ScandiDos

Patient-specific QA for SRS and SBRT

Press release

ScandiDos is unveiling Delta4 SRS Pro, described in its press material as a stereotactic QA solution for high-precision 3D measurements at isocentre. The careful way to read this is as a product announcement in the patient-specific QA space, not as an independent performance endorsement.

The engineering relevance is clear: SRS and SBRT workflows involve small fields, steep dose gradients, non-coplanar arrangements and tight margins. Patient-specific QA for these techniques depends on detector geometry, spatial resolution, setup reproducibility and meaningful comparison between planned and measured dose.

DOSIsoft is showcasing ThinkQA 3.0 as a unified PSQA platform for offline and online adaptive radiotherapy. Its announcement describes GPU-powered 3D calculation and integrated QA workflows, while also noting that ThinkQA 3 is under ongoing product regulatory approval and may not be available in all markets.

That caution is important. Adaptive radiotherapy increases time pressure because the anatomy, plan and QA evidence may need to be reviewed close to treatment. The engineering challenge is to make secondary checks, logfile analysis, EPID workflows and adaptive plan verification faster without losing traceability or independent review.

SeeTreat describes its ESTRO 2026 focus as the future of same-day adaptive re-planning. Its ART.1 software supports offline adaptive radiotherapy workflows, and the company also lists an ESTRO 2026 abstract on automated CBCT-based dose reconstruction in breast radiotherapy.

SeeTreat Medical is relevant because adaptive radiotherapy depends on reliable imaging, dose reconstruction, software integration and clinical decision support. For engineers, the important connection is between CBCT imaging, anatomical change assessment, dose reconstruction evidence and the workflow decision about whether a patient needs adaptive review or re-planning.

SeeTreat's page states that ART.1 is available for clinical use in the UK, EU and Australia, and that ART.1-US is FDA cleared for the US. Readers should verify current regulatory status from official SeeTreat documentation.

C-RAD

Surface-guided radiotherapy and patient monitoring

Official source

C-RAD is focused on surface-guided radiotherapy and Catalyst+ HD workflow. SGRT is often discussed as patient positioning technology, but from an engineering point of view it is also an optical measurement system that interacts with room geometry, calibration routines, patient setup, gating behaviour and intra-fraction monitoring.

As treatment techniques become more precise, surface guidance can influence how teams think about setup accuracy and patient motion. The engineering work sits in commissioning, ongoing QA, camera calibration, software integration and understanding what the system can and cannot verify.

Brainlab

SRS/SBRT positioning, ExacTrac and intra-fraction monitoring

Official source

Brainlab activity around ExacTrac Dynamic Surface and positioning/monitoring workflows sits in the high-precision stereotactic treatment space. These systems combine surface monitoring, patient positioning and, depending on configuration, image-guided verification concepts.

For engineers, the point is that stereotactic delivery depends on a chain of accuracy. Imaging, couch motion, surface information, beam hold logic, patient motion and QA checks all have to support the same clinical intent. Positioning technology should therefore be understood as part of the treatment safety architecture rather than a standalone accessory.

Standard Imaging is introducing QA BeamChecker Pro for routine beam QA. Daily and routine QA tools may not look as futuristic as adaptive radiotherapy or FLASH research, but they remain central to radiotherapy engineering because they provide evidence that treatment machines are performing consistently.

The engineering interest is in measurement stability, usability, data capture and trend review. Reliable routine QA helps teams detect drift, investigate faults and support controlled release to clinical use, which is why beam QA continues to be an important area of innovation.

THERYQ is focused on FLASH radiotherapy technology and the clinical translation of ultra-high dose-rate electron irradiation. This should be presented as a developing research and translation area, not as routine clinical treatment.

The engineering questions are demanding: accelerator design, ultra-high dose-rate beam monitoring, dosimetry, temporal control, QA standards and biological validation all need to mature together. FLASH is therefore a useful reminder that future cancer care is shaped not only by new machines, but by the measurement and safety systems that make new delivery methods testable.