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Unity®MRI Linac system

Elekta Ltd.

Role: Lead Industrial Designer (ID / UX)

The Elekta Unity MR-linac is the world’s first radiation therapy system to integrate high-field MR imaging with radiation delivery for cancer treatments. It will enable doctors to “see” both tumour and healthy tissue in real-time and adapt radiation doses at the time of treatment.

From 2012 –2018 I acted as lead Industrial Designer on the project, with global responsibility for planning and delivery of industrial design and user interface design across all hardware systems. This leadership role included management of internal project teams, facilitation of customer engagement, and co-ordination of internal and external design services.

CASE STUDY // The user-centered design approach behind the
Elekta Unity MR-linac

The Unity MR-linacis a tangible example of how user-centereddesign practices can be brought to bear in accurately predicting and de-risking the use of fundamentally new and complex systems.

Elekta’s collaborative approach to the design process for the MR-linac involved a team of Industrial Designers, Human Factors Engineers, User Experience Designers and Design Researchers, working in collaboration with over 50 end-users from 7 world-leading cancer centers, over 6 years from 2012 –2018.

The result is a system with a range of features designed to maximize patient comfort and enhance usability for clinical and service operators.

User Research

Concepts for the system were grounded through collaborative technical review and based on an extensive body of user research. I worked alongside a small team of Design Researchers to plan and conduct studies in markets worldwide including North America, Europe and China, focusing on exploring workflow, time and motion, and stakeholder perceptions of current equipment in the field.

Insights gained from field research ranged from identifying new opportunities to drive workflow efficiencies, cataloguing workarounds and their meanings, and highlighting safety and manual handling risks caused by equipment limitations.

Highlighted left to right: Table height restrictions force Radiotherapists to adopt awkward posture during patient setup. Physicist struggles to fit heavy applicator. Radiotherapists are frequently placed at risk of musculoskeletal injury during manual handling of patients.

Participatory Design Studies

From 2014 to 2017, Elekta organised a series of participatory design workshops with over 50 representative end-users from cancer centers across Europe and North America.

The workshops were used to capture design preferences and insights from our end users, define requirements for interaction and control, and measure perceptions of the early industrial design concepts.

During these sessions I took responsibility for planning and facilitating workshops, moderating testing and ensuring research outputs were reported or captured as product requirements where needed.

Top left: Radiotherapists give feedback on 2 competing early industrial design concepts (projective research technique to determine brand alignment).

Other images; Usability workshop in 2015. Participants determining essential vs non-essential information requirements via workflow simulation.

ID Concept Development

Sketches were used throughout the design process to communicate artistic direction, system layouts and mechanical concepts, and to demonstrate alternative models for interaction and control.

Following stakeholder review, a single industrial design concept was selected for development (see Keyshot render – below)

Renders and final form development A. Wolfenden (Top) early sketch directions A. Baker

Sketch Prototyping & Early User Testing

Interactions between users and the system were initially explored in context through role-playing of treatment scenarios using low-fidelity, full scale wooden mock-ups of the treatment environment, including paper-based representations of user interfaces (later replaced with interactive UIs displayed on iPads).

Gradually increasing the fidelity of the prototypes throughout the design process enabled the information requirements model to be repeatedly refined and tested, allowing the design team to iterate quickly towards a preferred embodiment of the design.

Above: Open bore profile refined through user testing

Top to bottom; early wooden mock-ups with paper based representations of the UI were later replaced with high fidelity prototypes using production-intent parts. User interfaces were later tested using iPads.

Detail Development & Usability Testing

As the engineering detail of the design became clearer, prototypes were tested iteratively and often. ‘Formative’ usability testing accelerates the design process and reduces the risk of surprises towards the end of the project. At this stage of the project I worked with clinical specialists and human factors engineers to create test protocols designed to draw out rich feedback from representative end-users. The insights observed during testing were used to perfect the details of the industrial design.

Top to bottom (L to R); twisted headphone hoses, indexing number is blocked by clip, clip requires too much force to locate, awkward to handle, trapped cable.

User Interface Research

A linac system has 2 key UI hardware touchpoints; one is in the treatment room close to the machine itself, the other is located in a separate control room. The images to the right show the legacydesign for the Elekta ‘Function Keypad’ (FKP). This device is located in the linac control room and is used to control radiation, as well as moving the patient table and allowing communication between the control room and the treatment room.

Some of the challenges we discovered with the Elekta design, (and some of the competitor designs), are highlighted in the images. The legacy FKP has a bulky profile and an awkward button layout that requires the operator to adopt an unnatural posture, as shown here (bottom right).

Top left: Vigilance (safety) control is overridden by user action.Top right: Competitor system has inefficient ergonomics

Bottom right: Awkward posture required to activate movement controls.

User Interface ID Concept

We had the following goals in the beginning of the FKP design. The first was to provide a generic solution for both Unity and conventional linacs. The purpose of the generic design is to provide users consistent user experience and lower the cost. Other aspects like ergonomics, and efficient, intuitive interaction were key goals throughout the design phase.

Above: Slim, compact ‘vertical’ footprint allows convenient positioning next to the keyboard

User Interface Testing and Refinement

User testing can mean many things. Early reviews of the FKP were conducted in workshops with practising Radiotherapists, using non-functioning, physical block models and renders of the proposed design, along with a questionnaire to help us to understand high-level user preferences early in the development.

Above: FKP Design workshop in 2017 with practising Radiotherapists

Right: Samples from questionnaire given to representative users.

Far right: Changes to design details introduced, based on user feedback.


Single-hand use coil connectors

Connectors are designed for single-handed use, to allow therapists to multi-task more effectively. Click the image above for video.

Sliding RF coil

A unique ‘Sliding’ RF Coil, developed in collaboration with Philips Healthcare, delivers efficient patient setup and mitigates risk of finger traps during couch movements.

Rapid maintenance access

For service users; serviceable components have been positioned for rapid access via hidden doors in the machine covers

Maintaining patient engagement

Clinical user interfaces are located close to the side of the patient table, supporting the therapist in maintaining a close engagement with their patient and reducing unnecessary footfall.

Safe, comfortable patient unloading

The treatment couch can be positioned as low as 400mm for loading and unloading of patients, accommodating even the smallest of patients (5th%ile Japanese female equivalent)

Ambient experience

Ambient ‘light track’ delineates the therapist’s working zone, and communicates a more personal space for the patient in large rooms. Lighting and ventilation can be adjusted to a patient’s preference.