1

– the Convergence between Clinical Needs and Technology Breakthrough

2

Convergence Between Needs and Technology Breakthrough

Technical R&D

Technical specificationsUpdated / modified

Clinical needs

Clinical needs

Specifications Scalability

& flexibility

The breakthrough zone

Clinical R&D

3

Conformal Energy Delivery

Conformal ablation - energy deposition is performed along the acoustic beam where energy density is the highest, utilizing the very large axial electronic steering of the ExAblate; benefiting from heat conduction as well as the absorption along the beam to obtain significant treatment rate enhancement

Conformal 3D packing – the conformal sonications are of variable sizes: 0.03cc to 5cc per sonication and are adjusted automatically by the 3D planner to span the target in a single sonication.

The system packs the conformal sonications in 3D to fully ablate the tumor in the shortest possible treatment time

4

Cooling Time – Interleaved Sonications

Cooling between sonications to allow tissue in the acoustic beam path to cool down to baseline temperature can significantly impact treatment time.

Minimizing cooling time could be achieved by reducing the overlap of acoustic beams so the tissue in the path zone doesn’t accumulate heat.

Interleaved sonication mode- sonications jump from one treatment area to another so while one beam path is cooling, treatment takes place in another place, eliminating need to wait for spot cooling before treating

5

Acoustic Beam Shaping

The human anatomy generates a complex medium through which the acoustic beam needs to propagate to reach the target.

Some of the organs are sensitive to acoustic radiation and/or block it (bone, air etc). The ability to treat the complete tumor requires the ability to shape the beam to conform to the anatomy avoiding sensitive zones and transmitting through “anatomic windows”

Combining conformal sonications, beam shaping, 3D planning and interleaving into an optimized treatment

50

Scalability - Very High Density Acoustic Beam Forming

Fully utilizing the potential of ultrasonic ablation one would like to get the highest flexibility from this “thermal scalpel”.

Ability to place the focus in the widest possible anatomical envelop without the need to reposition the patient requires large electronic steering.

Overcome obstacles in the anatomy by accurately shaping the beam to conform with “anatomic apertures”

Minimizing energy dispersion into the body that is not propagating towards the target (focus) as is the case in the use of sparse array

Current ExAblate systems range between 200 elements to 1,000 elements. The next step of abdominal systems will be in the range of couple of thousand of elements requiring the development of miniaturized beam formers.

2nd, 3rd and 4th generation beam formers

100 channels100 channels

64 channels

Optimizing Acoustic Beam Forming to Address Multiple Indications

Bone Tumors

Liver Tumors

Prostate Cancer

Breast Cancer

Uterine Fibroids

Brain diseases

200 elements 200 to 1,000 elements 1,000 elements

200 elements1,000 elements 200 to thousands elements

The Future of MRgFUS –

Area ratio is 2.5

Fabric Like Arrays with Very high element count

Fast Treatments (very low intensity in beam path(,

Extensive abdominal coverage (very high number of small elements, large electronic steering(

Future of MRgFUS - Treatment of Dynamic Organs in Freely Breathing Patients