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In ablation, Precision IO can tell both stories. In radiation oncology, the race is between robots.
Based on public information, none of the large ablation vendors offers its own placement robot today, and the robot vendors rely on someone else's energy. In radiation oncology the picture flips. Energy doesn't matter there, and two rival robots already hold broader CT clearances than Epione. Being first with physicians and data is the advantage to win.
The field.
| Company | Ablation | Robot or navigation | Imaging and focus | Where Precision IO could differentiate |
|---|---|---|---|---|
| Precision IO NeuWave and Epione | Microwave | Robot, FDA clearedSource | CT; abdomen in the US. Ablation confirmation software. | The combined offer, plus an installed base at more than 70% of top cancer centers. Open architecture is designed to work with other energy. |
| Medtronic Emprint | Microwave | No robot. Earlier ultrasound navigation option; lung navigation for bronchoscopy | Soft tissue, liver; bronchoscopic lung | The largest microwave rival with deep hospital contracts. Offer placement Medtronic does not sell, then compete for the energy.Source |
| AngioDynamics Solero, NanoKnife | Microwave, IRE | None announced | Soft tissue; NanoKnife cleared for prostate tissue, Dec 2024 | IRE needs several parallel needles at set spacing. That is a planning problem a robot is built for.Source |
| Boston Scientific Visual ICE cryoablation | Cryo | No navigation; isotherm planning | CT or MRI; kidney, lung, bone | Cryo cases use many probes. Robotic planning may help most here, and the company says kidney falls within the Epione abdominal label.Source |
| XACT Robotics XACT ACE | None of its own | Robot that inserts and steers the needle | CT; cleared for CT guided percutaneous procedures, plus ablation in liver, kidney and adrenal since 2022 | The most direct rival, with strong biopsy accuracy data.Source Its general CT clearance could cover fiducial placement before Epione's does.Source In ablation, win with the energy bundle; in radiation oncology, win on relationships and data first. |
| Perfint Healthcare MAXIO | None of its own | Robot that positions a needle guide | CT; cleared for CT guided percutaneous procedures in the thorax, abdomen and pelvis | A broader US label than Epione and an older system with little US presence. Also a likely predicate for Epione's own expansion.Source |
| Interventional Systems Micromate | None of its own | Compact patient mounted robot | CT, cone beam CT, fluoro; chest, abdomen, MSK | Smaller and likely cheaper. Compete on the full workflow, ablation confirmation and support.Source |
| Biobot Surgical iSR'obot Mona Lisa | None | Transperineal needle positioning robot | MRI and ultrasound fusion; prostate | The cleared robot closest to prostate brachytherapy, sold mainly for biopsy. A reminder that prostate needs different imaging than Epione uses.Source |
| GE HealthCare Imactis CT Navigation | None | Stereotactic navigation, no robot | CT | A lower cost guidance option, from the imaging vendor Precision IO now integrates with. Partner and competitor at once.Source |
| Philips XperGuide Ablation | None | Planning and live needle guidance | Angio suite | Software that comes with the room. Precision IO has to show what a robot adds over guidance alone.Source |
| Siemens Healthineers Varian | Microwave, cryo | None for ablation | Linacs and SBRT (stereotactic body radiation therapy), plus IntelliBlate microwave and cryoablation | Sells the linacs, brachytherapy afterloaders and planning systems radiation oncology already runs, plus ablation. No placement robot today, but its reps own these relationships. A partner, or a rival, to watch.Source |
| Accuray and Elekta CyberKnife, linacs | None | None | Stereotactic radiation for lung, liver, oligometastases | Their stereotactic programs drive fiducial demand. Elekta once sold FIRST, one of very few commercial robotic brachytherapy systems.Source No placement robot from either today. |
Status reflects public information as of October 2026. Medtronic's earlier Emprint navigation option may no longer be sold. I would confirm every row in the field before building battlecards. Prostate focal therapy rivals (EDAP, Profound) are on the Radiation oncology page.
Why radiation oncology could buy a robot.
Budget and habit
Radiation oncology buys capital to improve dose delivery, through committees and physicists who know how to judge it. Capital for placement fits a habit that already exists.
Proof they already measure
Physicists review dose coverage case by case. Better catheter and seed placement shows up in the plan they already check, so the value can be measured at home.
A shared robot
Fiducials and catheters are often placed in IR's CT suite. Once a radiation oncology use is cleared, one robot could serve two departments, a stronger capital case for the hospital.
Strong hand, early integration, real rivals.
Strengths
- NeuWave installed base: used in more than 70% of top US cancer centers, with more than 100,000 patients treatedSource
- Epione: FDA cleared, more than 1,500 patients, open architecture
- One company for energy, planning, placement and confirmation
- AI segmentation and GE angiography integration shown at CIRSE 2026
- A CEO who has led surgical robotics companies before
Weaknesses
- US label: CT guided abdominal ablation only
- Integration: a company formed in February, likely bringing two sales teams together
- Evidence: accuracy series, no comparative outcome data
- Economics: robotic guidance is not paid separately
- Workflow: setup competes with a full CT schedule; one trial of a different robot ran longer than freehand
- Awareness: few US sites to visit today
- Radiation oncology: no data, label or relationships there yet
Opportunities
- Pull through of Epione into NeuWave accounts
- Conquest of accounts on Medtronic, AngioDynamics and cryo energy
- COLLISION may move small liver metastases from surgery to ablation
- New labels: bone through EPIOS, then lung
- Radiation oncology as a new Epione buyer: fiducials, interstitial HDR and seeds
- Prostate brachytherapy as the long horizon
- Reference sites at academic centers such as Rush
Threats
- Large incumbents with bundled contracts
- Robot rivals with broader CT clearances, XACT and Perfint, could reach radiation oncology first
- Navigation software from imaging vendors at lower cost
- Bronchoscopic lung platforms such as Intuitive Ion
- SBRT winning head to head comparisons, and Varian selling ablation inside radiation oncology
- Capital cycles of 9 to 18 months and tight budgets
- Customer doubt after the ownership change