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Dr. John R. Adler Jr.

With Zap-X, the creator of CyberKnife aims to give radiation a better image

by Gus Iversen , Editor in Chief
From the October 2018 issue of DOTmed HealthCare Business News magazine

Best known as the creator of the CyberKnife and a pioneer in image-guided radiation targeting, Dr. John R. Adler Jr. is a familiar name to most people involved in radiation oncology. What many people may not know, however, is that he is currently in the process of bringing a new radiosurgical tool to head and neck cancer treatment that promises lower cost to providers.

In early July, HealthCare Business News sat down with Dr. Adler to learn about his new company, Zap Surgical Systems, and why the Zap-X radiosurgical solution could fill an important gap in the existing radiosurgical landscape.

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HCB News: Is it fair to say the Zap-X surgical solution is like a Gamma Knife combined with a CyberKnife?
Dr. John R. Adler Jr.: Technologically, and kind of in its primary design specifications, but it’s like neither one exactly. It does things slightly different from both of them but the primary objectives and some of the major design specifications are quite similar.

It uses a linear accelerator, which makes it like a CyberKnife, CyberKnife uses image guidance to target and it also uses a linac. The defining feature of the Gamma Knife, I might argue, is that it specializes on the brain and goes after a specific subset of the anatomy, which makes it like the Zap-X machine – but in the end Zap-X is its own unique animal.

HCB News: What sets it apart from other linear accelerators? Are there specific cancers it would be ideal for?
JA: It focuses on radio surgery not radiotherapy… I would argue that there is value to focusing on specific anatomy because you can optimize performance for the specific anatomy and also simplify the process of treating specific anatomy, and also focus on cost. You can strip out a lot of useless function that people don’t want.

Think about a linear accelerator that is designed to treat all parts of the anatomy. Intrinsically, that’s good, but along with that comes a lot of complexity and a lot of cost, and so our design here was to break down what we think are the cost and procedural complexity barriers that prevent the wider availability of brain radiosurgery, specifically.

A Siemens MR scanner can do head and kidney and ankles, for example, but now more and more we see more people who just want an extremity MR scanner. We are like that extremity MR scanner. We are the first ever to segment the overall radiotherapy marketplace with a linac. Zap-X is used for brain and head and neck; it goes down to the base of the neck.

HCB News: Are there any currently installed? Does it have regulatory clearance?
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