Experience, Expertise and a Commitment to Excellence™

Protons - Superior Dose Distribution  The Bragg Peak is representative of a delivery of a full, localized, and uniform dose of energy in the target Relative Dose Depth in Tissue (cm) 4 60

Experience, Expertise and a Commitment to Excellence™ Integral Dose Proton vs. X-ray Beam

Experience, Expertise and a Commitment to Excellence™ System Components  The Synchrotron Accelerator  The Beam Transport System  The Stationary Beam  Gantries (Isocentric Gantries)  Patient Alignment and Digital Imaging Systems  Facility Control System

Experience, Expertise and a Commitment to Excellence™ Facility Layout The Loma Linda University Medical Center Proton Treatment Center Stationary Beam: Has two branches: Eye Tumors Head and Neck Tumors The Injector: Protons are stripped out of the nucleus of hydrogen atoms and sent to the accelerator. Synchrotron: (Accelerator) A ring of magnets, 20 ft. in diameter, through which protons circulate in a vacuum tube. Beam Transport System: Carries the beam from the accelerator to one of four treatment rooms. This system consists of several bending and focusing magnets which guide the beam around corners and focus it to the desired location. The Gantries: Resembling giant ferris wheels can rotate around the patient and direct the proton beam to a precise point. Each gantry weights about 90 tons and stands 3 stories tall. It supports the bending and focusing magnets to direct the beam. Steel- reinforced concrete walls are up to 15 feet thick.

Experience, Expertise and a Commitment to Excellence™ Proton Accelerator Control System  Conforma 3000 Integrated Solution  Treatment Control System (TCS)  Accelerator Control System (ACS)  Treatment Workstation  Integrated and Automated  “The Brain”  Software & Electronics for Treatment Precision  Accelerate  Deliver  Control

Experience, Expertise and a Commitment to Excellence™ Accelerator Control - Advantages  Automatic Beam Centering in Treatment Nozzle  Key to Active Beam Scanning  Rapid Beam Line Switching  <10 sec.  Accurate, Reproducible Beam Energy  Within 0.1 MeV  Patented Safety Systems  Ensure Beam is Delivered at the Right Place & Time

Experience, Expertise and a Commitment to Excellence™ Gantry Treatment Room  Integrated and automated  Rotates >360 o  Treatment from multiple “portals” or angles  Isocenter is contained within a sphere  to 1.0 mm in radius  Automated set up  Designed for functionality

Experience, Expertise and a Commitment to Excellence™ Image Guided Proton Therapy  Precision Patient Alignment System  Robotic patient positioner  Dual-flat panel imagers  Automated registration system  Advantages  Efficiency 10 min. treatment times  Precision Sub-millimeter accuracy  Versatility 6 axis rotation

Experience, Expertise and a Commitment to Excellence™ Conforma 3000 Passive Scattering Beam Delivery System Compensator (Bolus) and Block (Aperture) Range Modulation Wheel Second Scatterer First Scatterer Dose and Flatness Monitor(s) X-ray Tube Profile Monitor Movable Snout (cones) Beam

Experience, Expertise and a Commitment to Excellence™ Conforma 3000 Active Beam System Intensity Modulated Proton Therapy Optional Compensator (Bolus) and Block (Aperture) Movable Snout (cones) Redundant Dose Detectors Radiographic Imaging Panels (2) Scanning Magnets Beam IMPT or Active Beam Scanning (ABS)  Supports Compensator-less treatments  Variable energy controls penetration depth  Capable of continuous (raster scanning) & discrete point based (“Spot” scanning)

Experience, Expertise and a Commitment to Excellence™ Intensity Modulated Proton Therapy  Ability to Treat Complex Volumes & Multiple Target Areas  “Spot Scanning” Technique  Beam scans from the top down  Radiation deposited from side to side

Experience, Expertise and a Commitment to Excellence™ IMPT using Active Beam Scanning Intensity Modulated Proton Therapy  1 st to receive FDA clearance  Functioning in research room  Simulated & verified treatment of a large, irregularly shaped volume w/27 different energies (depths) ABS Display – Mid Treatment

Experience, Expertise and a Commitment to Excellence™ Modular Design (4 gantry, 2 Stationary)

Experience, Expertise and a Commitment to Excellence™ Treatment Planning Software

Experience, Expertise and a Commitment to Excellence™ Contact Information Jon Slater, President & CEO Daryl Anderson Chief Financial Officer David Lesyna VP Engineering Mike Martin VP of Sales Ken Rice Director of Computer Science