@Noddy74 and @thunderhead there's probably no-one on the planet who understands the market for commercial medical imaging software better than Sam Huppert. If he's laying out $10m, you'd have to believe that is an option fee on something he thinks could be material over time. I mean, I don't think he'd waste his time and money if he thought the potential return from the technology was a meagre 10x. Why would you, when you lead and own a business worth $33bn!

I've been monitoring $4DX for years, but as far as I can assess, its just been too early to be investible. But if Sam is prepared to tip in a small sum, then I'll follow. So today I've taken a tiny position (0.5%) in $4DX, not because I've analysed an opportunity, but rather I'm prepared to follow the smart money. (So no valuation posts from me on this one!!)

I well and truly missed the bus on $PME. I missed it by so much that even the dust it has thrown up in my face has long settled. But maybe ....

I'm also going to catch up with $M7T over the weekend. I'm a great fan of Teri Thomas, and what she's achieved at $VHT. She certainly knows how to sell to big accounts. However, I don't think it is a given that she can replicate that success at $M7T. $VHT had a clear problem on being too tech-focused and not sufficiently strong on commercials. Not sure $M7T has that issue.

@Strawman do you thiink you could ask Teri Thomas back in her capacity as CEO for $M7T? Maybe later in the year, once she has had at least 100 days in the job. (Octoberish?)

Disc: $4DX (held); $PME and $M7T both not held

I just shot off an email then @mikebrisy -- Teri has spoken with us twice before, so hopefully she'll be keen for another chat.

Sam has had more than a passing interest in the business. I am not sure if it is current now, but he has been an advisor to the board, and a shareholder over the years. So this sort of move is not entirely surprising.

I hold a tiny position, so I will be more than happy to see if prosper.

To follow up on  thunderhead & mikebrisy  Sam Hupert's involvement with 4DX has been an interesting one. Sam and 4DX CEO Andreas Fouras are both from Melbourne and clearly have known each other for some. In the 4DX prospectus from August 2020 Sam is listed as being on the 4DX advisory Board since 2019. Sam’s mug shot in the prospectus gave the E & P and Bell Potter backed float a great deal of credibility. The shares were issued at 73 cents (m/cap $193m) and quickly got away to above $2.50, and I remember the talk at the time was this was to be the next PME.  

The technology appears to be exceptional and has been used by the US Dept of Defence, various universities in the USA and some clinics in Australia.   However the problem is, the dollar amount associated with each announced of the contract win or new sales agreement, when disclosed, is near immaterial.  For example the last contract win 4DX announced was the university of Michigan Medical Center, a three-year contract renewal valued in total at AUD$155,000.  With the company consistently losing around 8 - $10m a quarter and revenue of just $1m/qtr, this is a near risible amount. 

It is interesting that PME, whom no doubt has kept a very close eye on 4DX over the years, has waited until now to invest in them. And having done so is a near immaterial amount of $10m compared to their $3.3b m/cap.  Full marks to Andreas and the team on developing the technology and keeping 4DX together for the last 5 years. But just when is this ship going to turn around? 

Maybe Big Sam sees the ship turning around in the horizon, hence the investment. Chump change though, so can't really say it is a conviction allocation of capital (expecting another Visage is a very high bar indeed!).

It's all about the CT:VQ technology, and the FDA 501K approval.

Read this from the 4C:

"Pro Medicus (ASX:PME), a leading global medical imaging software company, has invested $10m into 4DMedical. This strategic investment will provide 4DMedical with the growth capital to accelerate its commercial pipeline for existing products while advancing CT:VQ™ towards regulatory clearance in the United States. The investment is structured as a hybrid debt and equity loan that is non-dilutive if 4DMedical’s share price is rangebound, while also creating upside alignment between Pro Medicus and 4DMedical’s shareholders if the share price performs strongly over the two-year term. The agreement also provides Pro Medicus with the option of distributing 4DMedical products on terms consistent with other distribution arrangements 

Pro Medicus, renowned for its high-performance imaging software, is contributing a substantial cash injection aimed at accelerating 4DMedical’s ongoing developments, particularly in advancing the capabilities of CT:VQ™. This financial boost will fortify the Company's resources, allowing for expanded deployment of its cutting-edge ventilation and perfusion imaging technologies across varied clinical settings. The $10m capital infusion will support several strategic initiatives, including scaling production capabilities, expanding clinical partnerships, and enhancing the global deployment of 4DMedical’s innovative imaging suites."

Sam has presumably concluded that the 501K will be granted, which will allow it to deploy the CT:VQ technology through its platform and global client base. $4DX would take forever (literally) to build the market reach that $PME already has.

$4DX submitted the 501K application in May 2025, and they expect an FDA response time of 112 days (standard total approval time).

If things progress as planned, then FDA approval could come through in September, which then becomes a gamechanger. Because the next day, $4DX announces a global distributorship through $PME or $PME announces it is going to buy $4DX.

Of course, FDA queries or requests for further information could stretch out this timeline. But I think that's the play here.

So, this is less about a ship turning. There's going to be an approval decision catalyst, and $PME is positioning itself to exploit that.

Prior to the $PME deal, $4DX was being priced for another capital raise. It only had a few week cash left. with most recent options out of the money and therefore worthless in terms of their abilty to generate capital. Without $PME, it was going to be dilute, dilute, dilute.

This could be interesting over the coming months.

mikebrisy have been giving your comments and 4DX some further thought:

For the last 4 years 4DX has floundered financially, currently bleeding around $10m per quarter and a market cap now of around $150m.  All the while it has been a company with seemingly great technology that has made impressive advances, including:

• Ongoing contracts with US Veterans Affairs and DoD  
• Re-seller agreement with Phillips for the 4DX suite of products
• Numerous small value contracts with mainly North American hospitals.

All the while 4DX has raised cash and seen the share price continue to tank. From a post IPO high of $2.50 to currently 33 cents.  It went begging for cash only back in February with a raise at 42.5 cents ,albeit with options attached.

Sam Hupert (CEO Promedicus ASX:PME) has been on the advisory board since prior to the 4DX IPO in 2020.  Last week he suddenly decides in invest $10m into the cash strapped 4DX in the form of a convertible note and distribution agreement. Andreas on the conference call was quick to point out this is only convertible if the 4DX share price hits 50 cents (from memory). So minimising the dilutionary impact.

Which begs the question if the new (and current) 4DX technology is just so world beating, why did Sam just now finally take a bite that may only translate into a holding of less than 9% (40m shares at 24 cents). Why didn’t he grab 19.9%, like Sonic Healthcare (ASX SHL) did with Microba (ASX:MAP) when last year MAP was backed into a financial corner.  Sonic could obviously see the long term benefit of an investment in a cutting-edge gut testing outfit, albeit a loss making one and now effectively own it.

 So what’s wrong with Sam?  Well I think the answer is nothin. There is good reasons why Sam has not been more grasping.   Andreas along with his wife, through all his financial travails, still control around 16% of 4DX (via Velocity consulting). Andreas remains in a strong position, so in many respects Sam has to handle him with kid gloves.  Also Andreas is THE key executive of the whole enterprise, and not someone you would like to demotivate or worse lose. In addition I don’t think it is in mild mannered mega-billionaire Sam’s nature to make a prick of himself. All the while he has managed to stay close yet on the sidelines for 5 years now.   Softly softly catchee monkey.

I don’t know just how good is the new technology CT:VQ™ that is next month up for FDA approval.  However to do lung ventilation and perfusion testing without a contrast agent, so displacing the current radio-pharma method, seems to me to have a lot of merit.    

Whatever happens, 4DX is however still in a pretty precarious financial position. Its continued funding over the next 7 to 10 quarters is based on FDA approval for CT:VQ and a subsequent shar price rise and $23m worth of 55 cent options being exercised. Short term, a few things need to go right.

However I agree, after all these miserable years I think there may be finally some money to made from 4DX.

Last week he suddenly decides in invest $10m into the cash strapped 4DX in the form of a convertible note and distribution agreement. Andreas on the conference call was quick to point out this is only convertible if the 4DX share price hits 50 cents (from memory). So minimising the dilutionary impact.

Looks like a straight up loan with some shares thrown in at the end if the price is somewhere above 50c.

The terms of the loan are quite tough imo: $10m @12.5%. At maturity there's a minimum cash payment of $12.5m max is $20m plus if the SP is ~50c then there's an equity component too. The equity dilution increases the higher the price is. As an eg (assuming price at execution is 24c) at 50c SP at maturity shares issued would be 1.6m shares. If the SP is 80c at maturity then they'll be issuing 16.6m shares.

Not a bad deal for PME!

@Scoonie some great insghts in your note. And it makes perfect sense. It is important to keep Andreas and his team totally motivated at this critical stage. I agree with you that Sam is being smart here.

An FDA approval will pop the share price such that $0.50 is quickly in the rear view mirror, particularly now that there is a distirbution agreement with $PME, who already have a commercial relationship with what,....10% of the global addressible imaging software market?

On the call were any other details of the distribution agreement provided? I missed the call, and the recording/transcript hasn't appeared in my various feed services yet, even though marketscreener.com and quartr.com both usually get transcripts/recordings of the calls for $4DX.

If you add Andres 16%, $PME's potential 9%, and an unknown personal holding of Sam's (likely <0.5%) then if they stay aligned, together they'd control 25% of shares, whick makes a takeover by another party less likely as they'd be unable to force the sales of outstanding shares, nor even to drive through a scheme of arrangement. If the SP pops, then the options move into the money, and they will get further cash, even though that 25% holding will be diluted most likely.

I think it must be about CT:VQ approval timing. If it isn't approved, then what's the roadmap to meaningful commercial sales for $4DX? With their cash burn rate, it will be a world of pain.

Also, Sam's timing is smart. Offering $10m just as $4DX are within weeks of running out of money and weeks to run for the earliest approval and options out of the money. Surely, Andreas was a distressed buyer? $10m is enough to get past the remaining weeks to the earliest FDA decision point. So, it is a minimum bet by Sam. When that first 501k decision is made, he can re-evaluate what to do next.

Finally, I think Sam is infinitely better placed than me to judge CoS for FDA approval of the tech. I think approval unlocks all kinds of options.

Overall, this is not the kind of risk (speculation) I want to put too much money behind. But it is worth a bit, even for the entertainment value.