Get to know Geneva

The universal gynecological applicator

An estimated 570,000 women are diagnosed with cervical cancer each year. Geneva is a universal brachytherapy applicator, that is designed to be used for all cervical cancer patients up to stage IIB. Its modular set up offers a personalized solution for each patient, enabling a faster and more effective approach to care to be achieved that provides good outcomes for patients and practitioners. The wide range of ovoid sizes and interstitial tube also allows for treatment of post-hysterectomy patients and those with small pelvic anatomies, while the click-and-go system makes assembly easy.

Book a demonstration to experience Geneva first hand and gain access to treatment delivery planning software and delivery platforms.

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Treat a diverse patient population

Geneva’s modular design makes treating a diverse patient population easier. Configured to suit every female pelvic anatomy, with an interstitial tube and wide range of ovoids (even as small as 13 mm), the universal gynecological applicator is designed to accommodate a wide variety of patients.

Speaking at the World Congress of Brachytherapy, Dr Carminia Lapuz from the Olivia Newton-John Cancer Wellness and Research Centre, highlighted Geneva’s hybrid nature which they found “very helpful” to treat a diverse patient population.

According to the radiation oncologist, Geneva is capable of treating a wide range of cervical cancer cases, assembles easily, provides excellent coverage of the uterine fundus and is less expensive than other hybrid applicators.

"It’s a hybrid applicator that we can use for a wide range of cervical cancer cases"

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Easily reach cancerous tissue following hysterectomy

Geneva’s unique interstitial tube enables clinicians to reach cancerous tissue around the vaginal cuff following hysterectomy. Combined with the ProGuide needles and Guiding Tubes, the interstitial tube facilitates accurate and reproducible dose distributions and eliminates the need for free-hand needle placement.

Geneva has been adopted by many medical centres across the globe. This includes the Leiden University Medical Centre in the Netherlands, which selected the Geneva applicator due to its wide range of ovoid sizes and needle positions. They thought the Geneva would be an attractive addition to their selection due to its wide range of ovoid sizes and needle positions.

“Geneva has enlarged our range of possibilities to choose the optimal applicator for each patient, thereby enabling excellent tumor coverage and good sparing of the organs at risk. The overall result is highly individualized cancer care.”

Leiden University Medical Centre

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Precisely plan treatment and ensure accurate dose delivery

Optimum treatment planning

Geneva’s fixed geometry ensures accurate planning and reproducible dosimetric results.

Accurate dose delivery

Geneva is compatible with state-of-the-art Elekta treatment delivery platforms, such as the Flexitron® afterloader and Oncentra Brachy treatment planning software.

Fast to use

Geneva is included in the Oncentra Brachy applicator modeling module, which means reconstruction only takes a few mouse clicks.

Quickly introduce the Geneva applicator using this commissioning paper

Physicists want to quickly introduce new medical equipment into practice but they must be able to verify the proper functioning of the device.

This white paper provides a guideline for commissioning Geneva that enables users worldwide to introduce the applicator into clinical practice swiftly, with high and reproducible quality.

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Benefit from a faster workflow with an easy to assemble applicator

Geneva is easy to assemble without the need for small screws or additional tools. Using the unique Elekta click system, the applicator is ready for use in just four clicks, ensuring a faster workflow.

Due to this, clinicians at the Olivia Newton-John Wellness and Research Centre say that Geneva has become their preferred applicator of choice, accounting for three out of every four treatments.

"Geneva assembly requires no screws – it takes literally four clicks and it’s assembled."

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Features and benefits of Geneva


  • Ovoid sizes range from 13mm - 40mm
  • Interstitial option with ProGuide needles and Guide Tubes
  • Intrauterine tube lengths (30–80 mm) with three angles (15°, 30°, 45°)
  • Adjust the ovoid spread to adjust to the patient anatomy


  • Able to treat 75% of cervical cancer cases
  • Easy to assemble and insert
  • Easy to use in current clinical workflows
  • Modular setup, providing an individualized solution for each patient

Your Geneva questions answered


What are the key benefits of Geneva?

  • Adaptable for a diverse patient population
  • Interstitial option always available
  • Precise treatment planning and accurate dose delivery
  • Easy to use in current clinical workflows

Range of use

What female pelvic anatomies is Geneva suitable for?

Geneva can be configured to suit most female pelvic anatomies. From the smallest ovoid size (13 mm) to the largest (40 mm), the intrauterine tube is available in six different lengths (0 and 30 to 80 mm) and at three different angles (15°, 30°, and 45°).

What cervical cancer cases is Geneva suitable for?

In the past, clinicians had to choose from a wide range of different gynecological applicators to treat the most common cervical cancer cases (stages I and II). Many of these applicators are challenging to assemble and require free-hand needles for patients that need treatment following a hysterectomy. Geneva addresses the inherent challenges of previous generation gynecological applicators and offers all the advantages of each of its predecessors, with enhanced functionality and user experience. Now clinicians need only one applicator to treat most cervical cancer patients up to IIB.

What image-guided brachytherapy treatments is Geneva suitable for?

Geneva supports all image-guided BT treatments, and can be used with MR and CT imaging modalities. This gives rigidity and fully supports image-guided adaptive brachytherapy (IGABT) due to the interstitial option.

Are interstitial options available with Geneva?

Geneva ensures that the option for guided interstitial brachytherapy is always available, even with the smallest ovoids, for optimal target coverage.

Is the Geneva applicator valid for post hysterectomy?

Geneva can be used post hysterectomy with the unique Interstitial Tube. You can now insert a needle in between the ovoids in a more precise way, using a Proguide needle together with an Elekta Guiding Tube.

Is Geneva MR compatible? Is the procedure done under image guidance or a blind procedure?

Geneva is MR safe, just like many other Elekta applicators. It works with Ultrasound, X-ray, CT, and MRI imaging to provide good imaging results without artifacts or distortion. Image guidance is possible under CT, ultrasound and even MR. This is unique for Elekta applicators; it contains no metal parts.


What safety certifications does the Geneva applicator have?

Geneva applicator is CE Marked and has U.S. FDA 510(k) clearance. Contact us to find out what’s available in your country

Specifications and certification

What is the Ovoid size range?

Ovoid range of 13 mm to 40 mm.

What is the configuration of Geneva? Are there predefined sets?

Geneva is a modular applicator, you can choose and set up your own set, similar to the Venezia applicator. You only purchase the components you need for your patients.

What is the length of the intrauterine tube?

The Geneva intrauterine tubes have a 4mm diameter. The offset between the tip of the intrauterine tubes and the distal dwell position has been reduced to 8mm. This allows treating closer to the fundus of the uterus with the same tandem length. Geneva also has an 80 mm intrauterine tube, which is longer than most historic applicators. The intrauterine tube is available in six different lengths (0, and 30 to 80 mm) and three different angles (15°, 30°, 45°). The integrated cervical stopper aligns with the ovoids to provide a flat contact surface and an even dose distribution.

What width is the rectal retractor?

The rectal retractor is available in three different sizes (20, 30, and 40 mm width), and can be located at three set positions to ensure optimal sparing of dose to the rectum

Can Geneva be used for either Iridium 192 or Colbat source?

The new Geneva is available for both versions of the Flexitron, the Iridium version, and the Cobalt version. Note that availability depends per country on registration. Please contact your Elekta representative for more information about availability.

Is the Geneva application compatible with Elekta microSelectron V3 HDR model or any other model other than Flexitron

Geneva is only compatible with the Elekta microSelectron Digital (V3) and Elekta Flexitron afterloader.

What is the configuration of the Geneva applicator set for Asian patients?

For Asian patients and those with small pelvic anatomies, Geneva offers the smallest Interstitial Ovoids, which were not available until now. The size is 13mm (radius 7,5) and the height is also reduced to 20mm, compared to standard ovoids, which have a height of 25mm 9 (radius 10). There are also 4mm intrauterine tubes available in angles 15, 30 and 45 degrees and lengths from 0mm to 80mm.

What is Geneva made from?

Entirely made out of non-metallic materials like PPSU & reinforced glass fiber, and therefore is MR safe.

What is the cost of Geneva?

Please contact a sales representative if you would like to know more about Geneva pricing.

Planning and dose delivery

How does Geneva support treatment planning and dose delivery?

Geneva is part of the Applicator Modeling and Implant Modeling modules in Oncentra® Brachy treatment planning. The applicator model allows rapid reconstruction in a few mouse clicks. The applicator’s fixed and stable geometry ensures accurate planning and reproducible dosimetric results. Geneva fits seamlessly into current 2D and 3D image modalities. It is compatible with Oncentra Brachy treatment planning software (version 4.5.3 and higher) and state-of-the-art Elekta treatment delivery platforms, such as the Flexitron® digital afterloader.

Interstitial needles

Can you tell me more about using interstitial needles with Geneva?

Geneva is available with an Interstitial Tube which can be used instead of an Intrauterine Tube. The Interstitial Tube is unique and enables clinicians to deliver the dose beyond the vaginal cuff following a hysterectomy.

How many interstitial channels are in the Geneva applicator? Can you insert needles in the middle of the anterior part of the ovoids?

  • 13mm and 15mm Ovoids have 6 needle channels in total (left and right 3 each)
  • 20mm and 25mm have 10 needles channels in total
  • 30mm, 35mm, and 40mm have 14 needle channels in total
  • Instead of an intrauterine tube, you can also use the Interstitial Tube to insert a needle between ovoids.

Comparison with other applicators

What are the benefits of Geneva over Venezia?

Venezia is designed for advanced cervical cancer up to stage IV, with the possibility of inserting oblique needles through the lunar shaped ovoids, and support the insertion of interstitial needles from the perineum by making use of the perineal template. Geneva is designed to treat cervical cancer up to stage IIB and has a unique interstitial tube where you can treat patients who had a hysterectomy, more accurately through a ProGuide needle and Guiding Tube. Geneva also offers the smallest ovoid of 13mm, with even an option to insert interstitial needles.

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To find out more about Geneva, speak to an Elekta expert or book a demonstration, please get in touch.

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