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1 The TrueBeam System Clinic Name Presenter s name Clinic location Date 1

2 Welcome 2

3 Unlocks Treatments Fast and Precise Enhanced Patient Comfort

4 Unlocks Treatments

5 Unlocks Treatments New Architecture The TrueBeam system has been designed from the ground up to optimize radiotherapy and radiosurgery Delivers powerful cancer treatments with pinpoint accuracy and precision Seamless integration of treatment, imaging and motion management 5

6 Unlocks Treatments New Beam Generation System All new accelerator guide Variable energy switch Simplified and integrated bend magnet New energy/foil carousel and target system Real-time electron gun gating Maximum flexibility in dosimetry <5 MU/min up to 2400 MU/min 6

7 Unlocks Treatments More Treatment Options Provide more options for treating complex cancer cases including lung, breast, liver, abdomen, head and neck IMRT, IGRT, RapidArc, Gated RapidArc, SBRT, SRS 7

8 Unlocks Treatments Gated RapidArc Next evolutionary step Compensates for tumor motion Expands application of RapidArc treatments to moving tumors Enables fast treatments of tumors that move with respiration Minimizes exposure to healthy tissues 8

9 Gated RapidArc 9

10 Fast and Precise

11 Fast and Precise Synchronized Imaging & Delivery = Fast & Precise Treatments 11

12 Fast and Precise Enhanced Image Guidance Simplified, Automated Imaging Modes Image Acquisition during Treatment kv and MV Respiration synchronized kv and MV Imaging 12

13 kv Paired Imaging 13

14 Cone Beam CT - CBCT 14

15 MV Imaging 15

16 Fluoroscopy 16

17 Fast and Precise Less Dose % IGRT with CBCT in 60% less time* Added imaging functionality can allow 25% less dose* *Comparisons, Data on file, Trilogy system, Varian Medical Systems,

18 Diagnostic CT vs. CBCT Diagnostic CT CBCT 18

19 Fast and Precise Pinpoint Accuracy Mechanical and Imaging Isocenter Accuracy < 0.75 mm Gantry rotational: < 0.3 degrees Collimator rotational: < 0.5 degrees 19

20 Fast and Precise Minutes Gated RapidArc Lung Treatment 18 Gy, 2 arcs, 10X High Intensity Mode 20

21 Fast and Precise Minutes 5 field IMRT prostate, 1.8 Gy 5 large field IMRT head and neck, 1.8 Gy 21

22 Fast and Precise Higher Dose Rate Enables fast hypofractionation Fast High Intensity Mode 6X: max ~1400 MU/min Yields higher dose rates* *Compared to current Varian technology 22

23 Fast and Precise Faster % One button image acquisition and full automation of beam delivery make treatments 50% faster* With faster treatments, there is less patient movement *Comparisons, Data on file, Trilogy system, Varian Medical Systems,

24 Fast and Precise Unrivaled Treatment Precision Accuracy in increments of less than a millimeter Submillimeter alignment for imaging and treatment isocenter Performs accuracy checks every 10 milliseconds throughout treatment 24

25 Fast and Precise Multiple Energy Support 6 X-ray energies 8 electron energies Tailor treatments to individual patients Optimal energy selction for specific clinical need 25

26 Enhanced Patient Comfort

27 Enhanced Patient Comfort Built with Patient Comfort in Mind Quiet operation provides for more comfortable environment Shorter treatment times, less interruption to patient s daily lives Music can be played during treatments to increase patient comfort 27

28 Enhanced Patient Comfort Enhanced Patient Interaction Constant interaction between the patient and therapist New communication system enables the therapist to monitor the patient from outside the treatment room 28

29 Enhanced Patient Comfort Allow more time with patient Guided workflow Streamlined tasks Prompted and predicted next steps Common user interface for Console, Pendant and Couch controls 29

30 Treatment Console 30

31 Radically Different

32 Summary Radically Different Designed to optimize radiotherapy and radiosurgery Integrates and choreographs powerful imaging and treatment systems Unparalleled accuracy and speed Unlocks new treatment options Enhanced patient comfort 32

33 Thank You Varian Medical Systems 33

Tom Wilson Product Marketing Manager Delivery Systems Varian Medical Systems International AG. CERN Accelerator School, May 2015

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