4DMedical: Mapping the S-Curve of Lung Diagnostics Infrastructure

For any new medical technology to achieve exponential adoption, it must solve the workflow bottleneck. 4DMedical has positioned itself as a foundational software layer by turning the ubiquitous chest CT scanner into a functional lung imaging tool. The company's CT:VQ™ software is the world's first non-contrast, post-processing technology that transforms routine chest CTs into quantitative ventilation and perfusion maps. This eliminates the need for nuclear medicine scans, which require specialized facilities, radioactive tracers, and complex scheduling.

The brilliance of this approach is its seamless integration. CT:VQ™ is delivered as a cloud-based SaaS solution that plugs directly into existing radiology workflows. It integrates with existing PACS and DICOM, returning quantitative results alongside the original CT images without disrupting the radiologist's daily routine. This design leverages the massive installed base of approximately 14,500 CT scanners in the U.S., giving the company a built-in path to scale. By operating on this existing infrastructure, 4DMedical bypasses the significant adoption friction that typically hinders new hardware-based diagnostics.

This infrastructure layer targets a large, underserved market. The company's complete FDA-cleared portfolio focuses on conditions like unexplained dyspnea and COPD, where functional imaging is critical but access is limited. With CMS confirming reimbursement under Category III CPT codes, the economic model is clear. The technology levels the playing field, bringing advanced diagnostics to community and rural hospitals without nuclear medicine capacity. In essence, 4DMedical is building the essential rails for a new paradigm in lung diagnostics, where functional assessment becomes as routine as anatomical imaging.

Exponential Adoption Triggers and Moat

The infrastructure layer is only as strong as its adoption curve. For 4DMedical, two powerful catalysts are now accelerating that curve from a slow ramp to a potential exponential surge. The first is a clear economic signal: the company has secured U.S. CMS reimbursement for CT:VQ. This confirmation, layered on top of existing chest CT payments, removes the primary financial barrier for hospitals. It enables cost-efficient uptake by making the technology a straightforward add-on service, directly translating clinical value into a viable revenue stream.

The second catalyst is a massive distribution advantage. The partnership with Philips will distribute CT:VQ across the U.S. and Canada, providing access to Philips' established commercial network. More importantly, the deal allocates dedicated sales and clinical specialists-over 200 trained professionals-to commercialize the solution. This bypasses the slow, expensive process of building a direct sales force and instantly embeds the product within the workflow of thousands of healthcare systems.

Together, these catalysts create a powerful flywheel. The reimbursement approval validates the economic model, while the Philips partnership ensures rapid, scalable reach. This combination is particularly potent because the technology itself levels the playing field. By bringing functional lung imaging to sites without nuclear medicine capacity, CT:VQ™ expands access to community and rural settings nationwide. This isn't just about selling software; it's about democratizing a critical diagnostic capability, which is the hallmark of a paradigm-shifting infrastructure layer.

The resulting moat is built on three fronts. First, there's the network effect of the Philips distribution and the growing installed base of clinical adopters like Stanford and the University of Miami. Second, there's the regulatory and reimbursement moat secured by FDA clearance and CMS approval. Third, there's the workflow integration moat-the seamless PACS/DICOM integration that makes adoption frictionless. These layers protect the company as it moves from early validation to broad market penetration, positioning it to capture a significant share of the functional lung imaging market as it crosses the chasm into mainstream adoption.

Financial Scalability and Infrastructure Economics

The true test of any infrastructure play is its financial scalability. 4DMedical's model is built for exponential growth, where the software layer itself becomes the primary asset, and the underlying hardware (the CT scanner) is already paid for by the hospital. This SaaS delivery model requires minimal infrastructure investment from healthcare systems. The technology is cloud-based, seamlessly integrates into existing radiology workflows, and operates on the massive installed base of CT scanners. This creates a low-friction adoption path for hospitals and a high-margin revenue stream for the company, as the marginal cost of serving an additional site is negligible once the platform is built.

The financials reflect this scalable model. In the full year 2025, the company reported SaaS revenue grew 95% year-over-year, while total revenue increased by 56%. This explosive growth in the core software segment is the hallmark of a product that is being rapidly adopted across a network. The infrastructure is already deployed at 388 sites globally, with nearly 200,000 scans delivered. This scale demonstrates early network effects-the more sites that use the platform, the more robust the clinical data and workflow integration become, further reinforcing its value.

The economics are compelling. By layering its software onto existing CT capacity, 4DMedical avoids the capital-intensive model of selling new hardware. Its revenue is recurring and high-margin, driven by subscription fees. The recent CMS reimbursement approval and Philips distribution partnership accelerate the path to profitability by ensuring a steady, scalable customer base. In this setup, the company is not just selling a diagnostic tool; it is monetizing the universal infrastructure of medical imaging. This positions 4DMedical to capture a disproportionate share of the functional lung imaging market as adoption crosses the chasm, turning its technological S-curve into a powerful financial one.

Catalysts, Risks, and the Next S-Curve

The path forward for 4DMedical is now defined by a clear sequence of milestones. The primary near-term catalyst is the commercial rollout and adoption rate of CT:VQ™ following the landmark FDA 510(k) clearance and CMS reimbursement. The company is moving from validation to scale, with pilot programs planned across CT fleets to demonstrate real-world integration and clinical utility. Success here will determine the steepness of the adoption curve. The recent capital raise, while providing a runway, underscores the financial commitment required to fund this aggressive expansion. The risk is a mismatch between the pace of adoption and the company's capital needs, a classic tension for infrastructure plays in the build-out phase.

The next paradigm shift, however, is already in development. It is represented by the investigational XV Scanner™, the world's only fully dedicated lung function scanner. This device targets a fundamental limitation of current modalities by capturing a single, full-breath cycle in motion from four angles simultaneously. It promises to deliver unprecedented insights into lung structure and function, moving beyond the anatomical snapshots of CT or the functional maps of CT:VQ™ to a dynamic, regional assessment of airflow. This is the next layer of the lung diagnostics S-curve-a dedicated hardware platform that could redefine the standard of care for conditions like COPD and asthma.

The company's strategy is a masterclass in infrastructure sequencing. It is first monetizing the universal CT infrastructure with its software layer, building a scalable revenue stream and clinical footprint. This foundation then funds the development of the next-generation hardware, the XV Scanner. The vision is to eventually integrate the software from the XV Scanner with the existing CT:VQ™ platform, creating a unified ecosystem. For now, the focus remains on executing the commercial rollout and managing the capital intensity of growth. The ultimate payoff is not just a new product, but the creation of a new technological paradigm for lung diagnostics, where functional assessment is continuous, dynamic, and accessible.