Key Highlights

  • Operating revenue rose 21% to A$7.1 million, with gross margins above 90%.
  • Scan volumes reached 344,075 in FY26, up 77%, including a record 105,970 in the fourth quarter.
  • CT:VQ has a US reimbursement rate of US$650.50 per scan and is authorised in six jurisdictions.
  • Cash stood at A$278.0 million at 30 June 2026, while the statutory result includes a A$164.6 million non-cash charge.

What does it take for a medical imaging software company to move from regulatory approvals to meaningful revenue? 4DMedical Limited (ASX:4DX) reported its FY26 results on 28 August 2026, and the answer, in management's words, is "conversion". The result matters because 4DMedical has gathered a notable set of clearances, but revenue remains small relative to its Balance Sheet and its loss. The period-specific figures provide context for the company’s operating performance and execution priorities.

What 4DMedical does

4DMedical develops software that analyses lung function from medical scans. Its technology, XV, produces measures of how air moves through the lungs, and the company sells it largely on a Software-as-a-Service (SaaS) basis, meaning subscription or per-use pricing rather than hardware sales. Its newer product, CT:VQ, derives ventilation and perfusion information, which describe airflow and blood flow in the lungs, from a standard CT scan without contrast agent. That could matter for diagnosing conditions such as pulmonary embolism, a blood clot in the lungs, where alternative tests can be slower or less convenient.

The FY26 financial result

For the year ended 30 June 2026, compared with FY25:

Underlying SaaS revenue rose 23%.

Other income A$7.5 million, mostly government grants and the Research and Development tax incentive, down from A$10.6 million.

Adjusted net loss A$32.9 million, 7% better than A$35.3 million.

Cash A$278.0 million at 30 June 2026.

The statutory result includes a non-cash charge of A$164.6 million from remeasuring the Equity component of a Facility with Pro Medicus. The adjusted figure is the better guide to underlying operations, though it is the company's own measure.

Scans and sites

Usage is the metric that tracks the commercial progress most directly. The company reported 344,075 scans in FY26, up 77%, with a record 105,970 in the fourth quarter. SaaS products were deployed at 540 sites globally at 30 June 2026, up 39% on a year earlier, with 63 added in the June quarter, excluding SimonMed sites.

Scan Volume grew far faster than revenue, which grew 21%. The announcement does not reconcile the two, but possible explanations include pricing structure, the mix of customers or scans that do not yet generate per-scan revenue.

Approvals and reimbursement

CT:VQ was cleared by the US Food and Drug Administration in September 2025 as the first non-contrast, CT-based ventilation-perfusion imaging technology. The company says the Centers for Medicare and Medicaid Services (CMS) will reimburse US$650.50 per scan, payable in addition to routine chest CT fees. That is a significant commercial enabler in the United States, because providers need a payment pathway to adopt a new test.

The product is authorised in six jurisdictions: the US, the European Union (CE Mark, March 2026), the United Kingdom (UKCA, April 2026), Canada, New Zealand and Australia (TGA, June 2026). In Australia, a Medicare Benefits Schedule application is in preparation, but no approval has been granted. XV LVAS is FDA-cleared, and a multicentre study of more than 6,400 US veterans, published in Respiratory Research, supports its use in early-disease detection. A separate CMS code pays US$15.50 per coronary artery calcium study.

Partners and customers

Philips has underwritten a minimum order commitment for calendar 2026 and 2027 in North America, though the amount is not disclosed. Cleveland Clinic renewed on a three-year subscription with committed minimum utilisation.

Sector context

Medical imaging software is a field where adoption depends on clinical evidence, workflow fit and payment. Established radiology and imaging vendors have larger distribution networks, and 4DMedical's approach is to partner, as with Philips.

The company gave no numerical guidance, so there is no management forecast to test results against, only the stated priority of conversion.

Risks and what to watch

The announcement does not include a formal risk section, so the following are drawn from its content:

Adoption speed: academic adoption is described as slow to win.

Evidence and reimbursement: Medicare application is pending, and further evidence is still being developed.

Study funding: CLEAR is a prospective study with about US$2 million of committed funding, and a European clinical site is still under discussion.

Revenue conversion: scans have grown much faster than revenue, so conversion of usage into income is the main thing to prove.

Continued losses: the company remains loss-making, supported by cash and grant income.

Upcoming developments include the outcome of MBS application, quarterly scan and site counts, disclosure of Philips order volumes, progress on the CLEAR study, and whether SaaS revenue growth accelerates relative to scan growth.