Gifu University

The Technology Will Play an Important Role in the Hospital's Plan to Expand Patient Access to High Precision Radiation Therapy Treatments MADISON, Wis., Sept. 10, 2024 /PRNewswire/ -- Accuray Incorporated (NASDAQ: ARAY) announced today that Gifu Prefectural General Medical Center is setting a new standard in cancer care in Japan as the first hospital in the country to treat patients with surface-guided radiation therapy (SGRT) using the company's Radixact® Radiation Delivery System and VitalHold™* package. SGRT is designed to help medical care teams to effectively position the patient and confidently monitor the accuracy of that positioning throughout treatment. The ability to confidently monitor also enables the deep inspiration breath hold (DIBH) technique, which is often used in left breast cancer treatment to help protect the heart from radiation. During treatment with SGRT, high resolution cameras continuously monitor a patient's breathing and position in real-time to create a 3-dimensional map of a patient's skin. The image enables medical care teams to easily visualize the difference between the current body position and the target position, helping to ensure the patient is appropriately positioned when radiation is delivered. "I am very pleased with the customer interest in Japan for VitalHold, our joint solution in partnership with C-Rad, since we received Shonin approval at the end of 2023. At Accuray, we are relentlessly focused on innovation that improves the value of, and patient access to, our products. The VitalHold technology reflects this focus, adding to the unique benefits offered by the Radixact System and expanding options for delivering high precision radiation treatments," said Sandeep Chalke, Senior Vice President, Chief Commercial Officer and interim CEO at Accuray. "We are proud to support Gifu Prefectural General Medical Center as they treat the first patients in Japan with the Radixact System and VitalHold. This is an important milestone that I believe will accelerate their team's efforts to improve access, outcomes and the patient experience." Approximately 50 percent of all cancer patients need radiotherapy at least once to cure their cancer, increase the chance of cure or relieve symptoms caused by cancer1. The Gifu Prefectural General Medical Center team is focused on driving a fundamental change in the way cancer is managed. "We are delighted to announce the commencement of our hospital's use of the Radixact System with VitalHold. In our efforts to enhance the availability of radiation therapy delivered in our department, which has long been a challenge, we have constructed a new building, introduced the Radixact System and will initiate treatments with the Accuray CyberKnife® S7™ System at a later date. One of the reasons we decided to switch from an older C-arm linear accelerator, which we have been using for many years, to the Radixact System, is to take advantage of the unique benefits of helical imaging and delivery in combination with the capabilities of VitalHold," said Yuichi Kajiura, M.D., department of radiation oncology, Gifu Prefectural General Medical Center. Continued Dr. Kajiura, "By using VitalHold, we can set up patients faster than initially anticipated and monitor the patient's position throughout the radiation treatment. With the use of hypofractionation, or the delivery of increased dose per session, monitoring the patient's position during irradiation has become extremely important. These factors enable us to deliver highly accurate treatments and will help us to provide the highest quality medical services to our patients." At Gifu Prefectural General Medical Center, the team is using ClearRT™ to produce diagnostic-like quality images that will empower them to make more informed decisions about all aspects of their patients' treatments. To date, ClearRT has facilitated accurate patient alignment - with clearer images - than conventional MVCT. ClearRT has also enabled the Gifu team to plan and deliver more precise treatments, by providing them with the ability to clearly see changes in the contours of the body and the shape of the tumor due to daily radiation therapy. Important Safety Information For Important Safety Information please refer to . About Accuray Accuray is committed to expanding the powerful potential of radiation therapy to improve as many lives as possible. We invent unique, market-changing solutions that are designed to deliver radiation treatments for even the most complex cases—while making commonly treatable cases even easier—to meet the full spectrum of patient needs. We are dedicated to continuous innovation in radiation therapy for oncology, neuro-radiosurgery, and beyond, as we partner with clinicians and administrators, empowering them to help patients get back to their lives, faster. Accuray is headquartered in Sunnyvale, California, with facilities worldwide. To learn more, visit or follow us on Facebook, LinkedIn, X, and YouTube. Safe Harbor Statement Statements made in this press release that are not statements of historical fact are forward-looking statements and are subject to the "safe harbor" provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking statements in this press release relate, but are not limited to, expectations regarding the company's products and upgrades; expectations regarding patient access and cancer management in Japan; clinical applications; clinical results; patient experiences and patient outcomes. These forward-looking statements involve risks and uncertainties. If any of these risks or uncertainties materialize, or if any of the company's assumptions prove incorrect, actual results could differ materially from the results expressed or implied by these forward-looking statements. These risks and uncertainties include, but are not limited to, the company's ability to achieve widespread market acceptance of its products, including new product innovations and releases; the company's ability to develop new products or improve existing products to meet customers' needs; the company's ability to anticipate or keep pace with changes in the marketplace; and the direction of technological innovation and customer demands and such other risks identified under the heading "Risk Factors" in the company's quarterly report on Form 10-Q, filed with the Securities and Exchange Commission (the "SEC") on May 8, 2024, and as updated periodically with the company's other filings with the SEC. Forward-looking statements speak only as of the date the statements are made and are based on information available to the company at the time those statements are made and/or management's good faith belief as of that time with respect to future events. The company assumes no obligation to update forward-looking statements to reflect actual performance or results, changes in assumptions or changes in other factors affecting forward-looking information, except to the extent required by applicable securities laws. Accordingly, investors should not put undue reliance on any forward-looking statements. Media Contact: Beth Kaplan Public Relations Director, Accuray +1 (408) 789-4426 [email protected] *VitalHold availability is subject to regulatory clearance or approval in some markets. 1 INTERNATIONAL ATOMIC ENERGY AGENCY, Radiotherapy in Cancer Care: Facing the Global Challenge, Non-serial Publications , IAEA, Vienna (2017) SOURCE Accuray Incorporated

A plant common to Japan, Causonis japonica, is the first to show a newly discovered trait. Its flowers can change color depending on the stage of its maturation cycle, and then change back to its original color. Although many flowers have been shown to change color depending on their maturation phase, Causonis japonica is the only known example of bidirectional color change. The pigments involved in the colors are related to nutrient-rich colorful vegetables, so understanding the flowers' color-changing tricks could have downstream applications in improving nutrient yields in certain food crops. A plant common to Japan, Causonis japonica, is the first to show a newly discovered trait. Its flowers can change color depending on the stage of its maturation cycle, and then change back to its original color. Although many flowers have been shown to change color depending on their maturation phase, Causonis japonica is the only known example of bidirectional color change. The pigments involved in the colors are related to nutrient-rich colorful vegetables, so understanding the flowers' color-changing tricks could have downstream applications in improving nutrient yields in certain food crops. We all like flowers, and one of the most appealing things about flowers is presumably the wide array of shapes, sizes and, of course, colors they come in. But did you know that some flowers can change their colors? Although it's not all flowers, this trait has been observed in hundreds of different species for at least a number of decades. It's thought that color-changing flowers do so because it signals to pollinating insects that the flower is ready to supply nectar or pollen which rewards them. This is considered to be an "honest" signal. But the reverse can also be seen; some plants show a "dishonest" signal, with some of their flowers displaying their default color whilst others display their signal color. That behavior is thought to increase the overall visibility of the plant from a distance to would-be pollinators. But whatever the strategy of the plant in question, all examples of color-changing flowers found have been unidirectional: Once the color has changed, it does not change back. So, imagine the surprise University of Tokyo Professor Hirokazu Tsukaya must have felt when he saw a flower of the plant Causonis japonica change color, and then, change again, and again. "Even though I've studied this plant in detail, having discovered there were at least two varieties back in 2000, the bidirectional color-changing flowers were a completely unexpected finding," said Tsukaya. "My colleague Professor Nobumitsu Kawakubo from Gifu University is an expert in time-lapse, long-period video recordings of pollinating flowers. He and his student originally tried to explore the pollinating behaviors between the different kinds of Causonis japonica and expected to see the familiar change from its default orange color to bright pink. But they couldn't believe it when they reviewed the time-lapse video and saw that it not only changed back to orange again, but that this change oscillated between the two states. They informed me on this finding; this compelled us to find out why. So we started a collaboration." Thanks to the carefully captured time-lapse videos from the field and detailed observations in the laboratory, Tsukaya managed to connect what physiological changes took place in the flowers concurrent with their changes in colors. "The initial orange state is coincident with the male stage of the flower's maturation, when it is secreting nectar," said Tsukaya. "When the stamen -- male part -- becomes old and detaches, the flowers turn pink. Mere hours later, the pistil -- female part -- begins to mature, secretes nectar, and the flower turns orange again. Once that stage is over, the flower fades to pink. The main chemical responsible for the color changing is orange-yellow carotenoid; its cycle of accumulation and degradation is also the fastest known to date. That fact was another surprise to us." You probably noticed the chemical name carotenoid sounds a little like the word carrot. This is not a coincidence, as the same chemical is what gives typical carrots their orange hue. It's a good source of vitamin A, and given the color-changing flowers show the most rapid accumulation of carotenoids ever seen, it's no surprise the researchers think their discovery might have some future application in developing carotenoid-containing vegetables that mature faster or contain higher yields of beneficial vitamins. "Our next steps will be to find out what is governing the behaviors we have observed," said Tsukaya. "One big question we have is, at what level are the stages of the cycles regulated? Is it caused by proteins caught in a feedback cycle, or does something occur on a genetic level? We will continue to explore this and hope to find an explanation soon. It's strange to think that several hundred years ago, agriculturalists in Japan hated Causonis japonica because of its vigorous nature. But a novelist, Kyoka Izumi, wrote about them so favorably, I wonder if it helped maintain some interest in preserving them. Whatever the reason, I'm glad they are around now to share their secrets with us. I wonder what we'll discover next."