Key Highlights

• Unaudited Operating Revenue was A$2.3m, up 66% on the prior corresponding period, with gross margins above 90%.

• Operating cash outflow was A$15.2m and investing outflow was A$22.5m, mainly from the Acquisition of contextflow and an Investment in RevealDx.

• (ASX:4DX) reported record scan Volume of 119,672, a global install base of 724 sites and a cash balance of A$242.8m, which the company estimates is enough for 16.0 quarters of funding.

• Scan volume of 119,672 was up 61%, and the install base of 724 sites was up 77% year on year.

What does 4DMedical's latest Quarterly Report reveal about the progress of its lung imaging technology? For the quarter ended 30 September 2026 (Q1 FY27), released on 28 October 2026, 4DMedical Ltd. (ASX:4DX) reported record scan volume of 119,672, a global install base of 724 sites and a cash balance of A$242.8m, which the company estimates is enough for 16.0 quarters of funding. The figures point to a Business where usage is growing quickly, while revenue remains small relative to the cash it is spending.

What the company does

Its technology, including CT:VQ, extracts lung ventilation and perfusion information from imaging, and its LDAi product is aimed at detecting lung disease such as chronic obstructive pulmonary disease (COPD). Instead of selling a physical scanner, the company primarily supplies software and analysis that works with imaging equipment hospitals and radiology groups already own. Revenue therefore depends on how many scans customers process and on the commercial terms for each deployment, which makes install base and scan volume the leading indicators to follow.

Q1 FY27 operating performance

Unaudited operating revenue was A$2.3m, up 66% on the prior corresponding period, with gross margins above 90%. Scan volume of 119,672 was up 61%, and the install base of 724 sites was up 77% year on year. In Australia, CT:VQ agreements were added with Jones Radiology, Qscan and providers in the Integral Diagnostics network.

Two other items were highlighted. A US Veterans Affairs network agreement for LDAi COPD detection is expected to generate about US$800,000 over five years, and a German lung cancer screening deployment is expected to cover about 25,000 procedures over three years. Both are modest in dollar terms compared with the company's cash balance, but they show the product being used in public-sector and screening settings rather than only in private radiology groups.

The relationship between scan volume and revenue deserves attention. Scans rose 61% while revenue rose 66%, so revenue per scan is not obviously compressing, but many scans may sit within rollout or pilot arrangements, and one quarter is too short a period to establish a trend.

Cash, funding and investments

Cash fell by A$35.2m in the quarter to A$242.8m. Operating cash outflow was A$15.2m and investing outflow was A$22.5m, mainly from the acquisition of contextflow and an investment in RevealDx. The company also has a A$10m secured strategic Debt Facility from Pro Medicus at a 12.5% interest rate, maturing in July 2027.

The 16.0-quarter runway figure is the company's own estimate and should be treated as such. If further acquisitions follow, the runway could shorten even if operating burn stays stable. An encouraging cash balance does reduce near-term dilution risk, but it does not remove the need for revenue to scale.

Corporate developments

The ASX announcement list shows a 23 September 2026 announcement titled "Board transition and key personnel appointments", the FY26 Annual Report and notice of Annual General Meeting on 24 September, the AGM results on 28 October, and a "Response to ASX Price Query" together with a trading pause on 2 November 2026. The titles are the only information obtained about the last item. Readers should read the announcement directly. A further "Becoming a substantial holder" notice was lodged on 5 November 2026.

Sector and competitive position

Medical imaging software is a field with high regulatory and clinical-evidence barriers. Competitors include imaging equipment makers with in-house analytics, other AI imaging software developers and traditional nuclear medicine ventilation-perfusion techniques. 4DMedical's pitch, as described in its commercial agreements, is that CT-based assessment can be faster and more accessible than conventional alternatives. In particular, reimbursement status in the United States was not covered by the summary and is a Factor to check in primary documents.

Risks and items to monitor

- Revenue conversion: whether growth in sites and scans translates into revenue that approaches the quarterly cash burn.

- Capital allocation: returns from the contextflow acquisition and the RevealDx investment, and the possibility of further deals.

- Reimbursement and clinical evidence: progress with payers and guidelines, which can determine adoption pace in the United States.

- Customer concentration: large rollouts such as SimonMed can represent a meaningful share of scans.

- Regulatory approvals: new indications and markets depend on clearances.

- Debt maturity: the Pro Medicus facility falls due in July 2027.

- Disclosure items: the 2 November price query response and trading pause.

The next quarterly report, covering the December 2026 quarter, will show whether record scan volumes persist and whether cash use stabilises.