Ablation energy and a cleared placement robot, now under one roof. The robot's next market may not be ablation.
Quantum Surgical acquired NeuWave from J&J in February 2026, and both now sit under Precision IO. NeuWave has its market and its team. Epione is a placement robot, and the specialty that places the most needles to deliver dose, radiation oncology, has no one at Precision IO calling on it.
Three numbers that frame the opportunity.
| 70%+Source | of the top US cancer centers already use NeuWave. That market has its own team, and this proposal stays out of it. Radiation oncology departments in those same hospitals are a different buyer. |
| 1,500+Source | patients treated with Epione worldwide. FDA cleared for CT guided ablation in abdominal organs. CE marked for abdomen, chest and musculoskeletal.Source |
| $0.9 to 1.1BSourceSource | global brachytherapy market in 2025, by two analyst estimates that disagree on growth, from 3.5% to 7.3% a year. North America is the largest region. A placement robot would sell into this market's procedures, not its seeds and sources. |
A year that changed the company.
| Sep 2025Source | J&J finds a buyer. J&J MedTech names a buyer for NeuWave after signaling an exit. |
| Feb 2026Source | Precision IO is formed. Quantum Surgical acquires NeuWave. Kurt Azarbarzin, formerly of Verb Surgical, becomes CEO, backed by Ally Bridge Group. |
| Apr 2026Source | EPIOS opens. The first US patient is treated in the Epione bone lesion study. |
| Jul 2026Source | Remote program. Epione and remote intervention are presented at the Society of Robotic Surgery. |
| Sep 2026Source | AI and imaging. AI segmentation and GE HealthCare angiography integration are unveiled at CIRSE. |
Why I see it.
I spent years selling into radiation oncology, around procedures where needle placement, physician confidence, workflow and adoption decide whether a technology sticks. In brachytherapy, a few millimeters change the plan and a hard case changes who will do it. When I look at Epione, I see the same problem solved in a different suite, and a department I know how to reach.
Placement
Template brachytherapy taught me what accuracy and repeatability mean to the physician holding the needle.
Adoption
New capital wins with a champion, a physicist or tech who believes, and a committee that sees the math.
Markets
At Polarean I landed the first adopters of a technology nobody had bought yet. That is the work here too.
My thesis on robotic placement, and what the evidence says so far.
The commercial case for a placement robot rests on a handful of benefits. Some have early evidence. Some are hypotheses I would test with physicians before using them in a sales conversation.
| Possible value | What public evidence shows | Status |
|---|---|---|
| Fewer complications | A 2026 randomized trial of a different robot for CT guided biopsy: lung complications of 4.9% versus 16.9% freehand, targeting error 1.7 versus 4.5 mm.Source The closest evidence to fiducial placement in the chest. | Early evidence |
| Dose coverage | Robot assisted seed templates held conformity at 0.95 versus 0.91 conventionally; phantom error 1.04 versus 2.55 mm.Source Different systems, mostly in China. | Early evidence |
| Placement accuracy | Epione, 41 patients: 1.6 mm final tip to plan distance after adjustments, no manual comparison.Source A randomized trial of a different robot: 5.9 mm versus 10.1 mm freehand on out of plane paths.Source | Early evidence |
| Fewer needle adjustments | Epione liver series: 71% of tumors needed no adjustment.Source Randomized trial: no repositioning with the robot versus a median of one freehand. | Early evidence |
| Difficult anatomy | The accuracy gain shows up most on oblique, out of plane trajectories, the cases physicians find hardest freehand. | Early evidence |
| Procedure time | Mixed. Insertion is fast, but the randomized trial ran longer with the robot (36 versus 19 min). I would not lead with speed. | Mixed |
| Radiation dose | One lung study with a different robot reported about half the dose. I found no Epione dose data.Source | Hypothesis |
| Consistency across operators | Plausible, and it is how I would sell training and community programs, but there is little direct data. | Hypothesis |
| Patient outcomes | Not established for robotic guidance. Single arm series report local control, but there is no comparative outcome data. | Not claimed |
One gap matters more than any of these: no one has tested Epione in radiation oncology. No published data covers Epione for fiducials, brachytherapy catheters or seeds. Closing that gap, through medical affairs and four centers, is the first job of the role I am proposing.
Five ways in. One has no owner today.
The robot could be more than a NeuWave add on. Four of these ways in belong to teams Precision IO already has. The fifth, radiation oncology, has no owner, and it is the one I am proposing to build. It sits on the inner ring because the relationships and studies can start now, even though selling waits for the label.
NeuWave accounts: add the robot.
Interventional radiology teams already running NeuWave cases. No cold introduction, and a disposables relationship to build on.
Now · 70%+ of top US cancer centersCompetitor accounts: get in with the robot.
Based on public information, sites on Medtronic, AngioDynamics or Boston Scientific energy have no placement robot from their vendor. Epione is designed to work with other energy, and NeuWave can follow. I would confirm which probes are validated.
Now · Open architecture, compatibility to confirmNew organs bring new physicians.
Kidney, covered by the abdominal label according to the company, brings urology. Bone could bring orthopedic oncology, and lung thoracic teams, if clearances arrive. Each is a new buyer inside an account we already serve.
Next · EPIOS US bone study since Apr 2026Community hospitals.
Programs without a deep interventional radiology bench. Robotic planning may help newer physicians take on complex cases, so more patients could stay close to home. A hypothesis I would test.
Next · Remote intervention programRadiation oncology: a new department, with no owner.
Its own CT needle work, fiducials, interstitial catheters and seeds, could make radiation oncology an Epione buyer in its own right, separate from ablation and NeuWave. Relationships and studies can start now; selling waits for the label.
Now for evidence · Later for sales · The role I am proposing
Analysts disagree on the size, not the direction.
| Analyst | Market | 2025 size | Growth a year |
|---|---|---|---|
| IMARC GroupSource | Brachytherapy, global | $920M | 3.5% to 2034 |
| Towards HealthcareSource | Brachytherapy, global | $1.12B, about 42% in North America | 7.3% |
| Mordor IntelligenceSource | Tumor ablation, global, for context | $1.76B | 10.2% to 2031 |
Device market sizes are a poor proxy for a placement robot's opportunity, and these reports conflict. No national count of CT guided fiducial or interstitial procedures exists. In the first 90 days I would build one from the four launch centers' volumes and Medicare claims, not from analyst reports.