RefleXion Brand Guidelines: The Hayward Maker of the X1, X2 & SCINTIX Radiotherapy

An idea from a physics lecture.

RefleXion Medical is a privately held company in Hayward, California, which has described itself as a therapeutic oncology company. Its founding idea belongs to Sam Mazin, its co-founder and chief technology officer. In April 2020 Imaging Technology News reported that Mazin first thought of using positron emission tomography, or PET — a scan widely used to diagnose cancer — to guide treatment instead, while attending a radiation physics lecture during his postdoctoral years. As the lecturer explained how hard it is to see tumours during treatment, the idea began to form, and he pursued it in earnest a few years later.

Mazin described the concept as using the individual emissions that make up a partially formed PET image, generated by the tumour itself, as a homing signal to guide radiotherapy to that spot — “in essence, turning cancer on itself to destroy it,” he told the publication. The company was co-founded around that idea, and in March 2020, as its first machine reached the market, Mazin called the move from research effort to commercial company “a thrilling 10-year journey.”

RefleXion has been financed by private investors. When it announced an equity round in April 2020, led by Canada’s Public Sector Pension Investment Board, the existing investors that took part included TPG’s The Rise Fund, KCK Group, Sofinnova Partners, Venrock, T. Rowe Price, Pfizer Ventures and Johnson & Johnson Innovation, Imaging Technology News reported.

The company writes its name with a capital X — RefleXion — and uses the same letter for its machines, the X1 and the X2.

X1, SCINTIX and X2.

The first machine is the RefleXion X1. In March 2020 the company announced US Food and Drug Administration marketing clearance for the X1 for stereotactic body radiotherapy, stereotactic radiosurgery and intensity-modulated radiotherapy, Imaging Technology News reported. It described the X1 as combining fan-beam CT imaging with a linear accelerator, and its chief executive, Todd Powell, said the company had opened a new factory the year before. The first sale of an X1 went to the Stanford Cancer Institute, announced in April 2020.

The X1 was presented as a stepping stone to what the company first called biology-guided radiotherapy, or BgRT, and later named SCINTIX. On 2 February 2023 RefleXion announced that the FDA had granted SCINTIX its first marketing clearance, for patients with lung and bone tumours, whether primary or spread from other cancers; the therapy had earlier been given Breakthrough Device designation for lung tumours. In the company’s description, the patient is injected with a radiopharmaceutical just before treatment, and the X1, which pairs PET with a linear accelerator, continuously builds a map from the detected emissions that determines where to aim beamlets of radiation.

The first patient treatment with SCINTIX was completed at the Stanford Medicine Cancer Center, Applied Radiation Oncology reported in August 2023, with City of Hope in Southern California and sites in Pennsylvania and Texas named as the next to offer it, and New Jersey, Connecticut and Oregon expected by the end of that year.

In January 2026 Imaging Technology News reported FDA clearance of the second-generation RefleXion X2 with SCINTIX therapy for primary and metastatic lung and bone tumours. The company says the X2’s wider PET detector expands the imaging field of view from 5 to 20 centimetres, and that machines already installed can be upgraded to it.

How radiotherapy companies present themselves.

Radiotherapy companies sell machines that most people never see. A linear accelerator sits in a shielded treatment room, often called a bunker, and is bought by hospital physicists, radiation oncologists and administrators rather than by the public. Their brand material is therefore built for a professional audience first, and the patient appears mostly through the treatment room and the people who work in it.

The dominant image is the machine itself: a large, rounded white gantry around a treatment couch, photographed in a calm room with soft lighting and, often, a coloured wall or ceiling panel. Close-ups of the gantry head, the couch and the imaging arms stand in for the engineering inside. The palette that follows is clinical: white and pale grey for the hardware, with one or two blues, teals or purples carried through the logo, the interface and the trade-show stand.

Software has become the second subject. Treatment-planning screens show a scan of the body with the planned dose laid over it as a colour wash, usually running from cool blues at the edges to warm reds and yellows at the centre, and those images are used in brochures as freely as the machines. Physicists and radiation therapists at a console, checking a plan or a quality-assurance result, supply the human scene.

Much of the industry’s visual calendar is set by congresses. The annual meeting of ASTRO, the American Society for Radiation Oncology, and the ESTRO congress in Europe are where companies launch systems, build their stands and publish the photographs and films that then circulate for the year. For a designer, the category is a study in presenting heavy, regulated equipment in a quiet, exact register.

A vocabulary that follows the approvals.

RefleXion’s vocabulary has shifted as its product moved toward the clinic. Its announcements in 2020 spoke of biology-guided radiotherapy and BgRT; by 2023 the product name SCINTIX, set in capitals, had taken over. In 2020 and 2023 the company called itself a “therapeutic oncology company”; by January 2026 it was describing itself as an “external-beam theranostic oncology company,” Imaging Technology News reported.

Its other recurring word is autonomy. The company says SCINTIX lets each cancer’s own biology determine where the radiation goes, and in August 2023 Mazin described the Stanford treatment as the first delivery of “autonomous radiotherapy,” adding that the company had been working toward that milestone for over a decade. In 2023 RefleXion also said it planned to adapt SCINTIX to work with other radiopharmaceuticals under development for different cancer types.

The company’s announcements tend to set a named cancer centre beside each step: Stanford for the first X1 sale and the first SCINTIX treatment, City of Hope among the early adopters, and a clinical registry presented at ASTRO 2025 cited in the X2 announcement.

For a design guide, RefleXion shows how a young device maker can build an identity from its naming system — a capital X carried from the company name into the X1 and X2, and a coined product name, SCINTIX, in capitals. Compare ViewRay, another American start-up that built a new kind of radiotherapy machine around imaging, and Accuray, another American maker of specialised radiotherapy systems. For this guide we use an ink navy, a pale grey and a beacon orange with a sans, an unofficial interpretation; no product or logo is reproduced.

Keep RefleXion’s identity on hand — save it to a board in the Made Good inspiration library.