Elekta Evo is a next-generation CT-Linac designed for high-precision external beam radiation therapy (EBRT) for patients across various oncological indications. The system offers exceptional clinical versatility — ranging from conventional radiotherapy to stereotactic radiosurgery (SRS) — and supports both online and offline adaptive radiation therapy workflows.

Evo is equipped with Iris, a new high-precision imaging system featuring an AI-enhanced imaging suite. This system expands the capabilities of IGRT (Image-Guided Radiation Therapy) and adaptive treatment, ensuring a personalized approach for every patient during every session.

Clinical Capabilities and Workflow Optimization

Evo supports a wide range of EBRT techniques and enables the implementation of new clinical approaches tailored to patient needs and departmental workflows:

• Flexible switching between IGRT modes, as well as online and offline workflows.
• A universal platform for current treatment regimens — from conventional to stereotactic.
• An integrated digital control system optimized for dynamic delivery techniques.
• Increased confidence in dose delivery, enhanced patient safety, and optimized patient throughput.
• HexaPOD Evo RT System for robotic positioning with sub-millimeter accuracy, essential for SRS/SBRT.

Iris: High-Precision AI-Enhanced Imaging

Evo includes Iris, a high-precision AI-enhanced imaging solution for IGRT and adaptive protocols:

• CBCT imaging enhanced by the Polyquant CT algorithm, incorporating AI-driven scatter correction and iterative image reconstruction (GPU-accelerated).
• Anatomy-specific AI scatter models to increase accuracy and reduce noise.
• Utilization of Polyquant CT to determine material mass density and electron density for treatment planning.
• Improved HU (Hounsfield Units) measurements for more accurate quantitative image assessment.
• Significantly enhanced contrast for visualizing target boundaries and adjacent healthy tissues.

High-Precision Stereotactic Therapy with Dynamic Modulation

Evo integrates with Elekta ONE® | Planning to provide high-resolution modulation for faster and more accurate stereotactic procedures:

• Elekta IntelliBeam for intelligent high-speed treatment with flexible control point management and single-arc delivery capabilities.
• Treatment of multiple small SRS targets with a 1 mm virtual leaf width.
• A large 40 × 40 cm radiation field, allowing coverage of multiple targets while minimizing the need for multiple isocenters or arcs.
• High-speed MLC (up to 6.5 cm/s) with low leakage, combined with dynamic Y-jaws (up to 9 cm/s) and High Dose Rate Mode (6 FFF: 1400 MU/min; 10 FFF: 2200 MU/min) — enabling SRS/SBRT execution within a standard time slot.

End-to-End Quality Assurance (QA)

Elekta ONE | QA provides a centralized and comprehensive quality control suite for the equipment, automating and simplifying system performance checks:

• QA validation using the Monte Carlo dose optimization reference algorithm in Elekta ONE | Planning.
• EPID dosimetry in Elekta ONE | QA for patient-specific QA and in-vivo dosimetry.
• Elekta ONE | QA powered by ThinkQA: a 3D collapsed cone convolution algorithm for secondary dose verification in IGRT and adaptive workflows.
• Optional Integral Quality Monitor (IQM) for stereotactic QA and real-time verification.

High-Precision Positioning and Treatment Safety

Elekta Evo includes the HexaPOD Evo RT System, a robotic positioning system with 6 degrees of freedom (6DoF) that ensures sub-millimeter accuracy in patient positioning. This level of precision is critical for delivering high-dose fractions in stereotactic protocols, where reproducibility and dose delivery stability requirements are most stringent. The system is also designed to enhance clinical processes and potentially increase departmental capacity.