What is Esophageal Brachytherapy

Esophageal brachytherapy is a procedure involving the use of radiation in a very selective way to target the affected area in the esophagus while sparing unaffected tissue unnecessary radiation exposure. Prior to placing the brachytherapy applicator, a surgeon will use an endoscope (a thin flexible tube with a camera at the tip) to identify the location of the tumor. Once that location has been determined, the brachytherapy applicator will be placed into the esophagus and inflated.

The inflation of the balloons will allow the applicator to be securely located in the center of the esophagus and a very accurate of delivery of the radiation dose. The radiation is delivered using a piece of equipment called an afterloader, which contains a high dose radiation source placed at the tip of a wire.

Once the device is in place, images will be taken (CT or MRI). Using these images, a medical physicist will design a treatment plan that will best target cancerous tissue while sparing healthy tissue any exposure to radiation.


Once a radiation treatment plan is calculated the applicator is connected to the afterloader. The afterloader will deliver the radiation source into the applicator as directed by the treatment plan. The source will travel through the center of the applicator to specific locations and where it will stop and remain for specific periods of time.

The locations of these stops, combined with the length and number of these stops will determine how the radiation is delivered. This portion of treatment lasts only a few minutes. Once the radiation is delivered the applicator is removed. The Physician will determine how many treatments will be necessary (3 treatments is a commonly used number) and if it will be in combination with chemotherapy or External Beam Radiation Therapy.

The E-APP™ is a first of its kind, disposable brachytherapy applicator designed specifically for the treatment of upper GI cancers. Five independently operable balloons are designed to maintain the central position of the source catheter in both straight and curved anatomy allowing for closer proximity of the target to the source while maintaining distance for healthy tissue.

E-App Unique Device Properties

  • Central source catheter surrounded by 5 equally spaced, 2cm (inflated) balloons create, ABS consensus recommended, mid-dwell distance of 1cm to target
  • 12 optimally spaced X-Ray, CT, and MRI compatible markers.5cm catheter diameter for ease of placement
  • Greater than 10cm effective treatment zone allows treatment of entire tumor


  • Radio-opaque contrast markers visible under X-ray, CT and MRI ensure consistent device placement


  • Muli-balloon configuration is designed to ensure precise, consistent source catheter positioning
  • Twelve radio-opaque markers and exterior catheter markings ensure consistent placement relative to target
  • Consistent fill volumes ensure desired tissue spacing


  • Compliant balloons designed to ensure optimal catheter location and conformity
  • Device construction and materials designed to take full advantage of MRI guided brachytherapy
  • Central catheter surrounded by balloons ensures accurate dose distribution to intended target.


Our disposable brachytherapy applicators are designed specifically for the treatment of esophageal, anal and rectal cancers. Our balloon technology offers precise, simple, elegant solutions for your treatment needs.