Inside Biotech: 4DMedical pushes beyond hospitals as US imaging giant opens outpatient door

Over the past year, 4DMedical Ltd (ASX:4DX) has been steadily building its presence inside some of America's most influential healthcare institutions.

The respiratory imaging specialist is now taking its technology into a much larger market.

The company has signed a commercial agreement with SimonMed Imaging, one of the largest outpatient imaging providers in the United States, giving 4DMedical's CT:VQ™ technology access to a network of more than 170 imaging centres across 10 states. The agreement will see SimonMed deploy CT:VQ™ and LDAf™ across its network under a three-year commercial arrangement.

Shares in 4DX rose more than 12% by Friday afternoon following the announcement, extending a rally that has seen the stock more than double over the past six months.

Scaling beyond the hospital system

The SimonMed deal opens a new chapter for the company. It takes CT:VQ™ beyond major hospital systems and into the high-volume outpatient imaging market, where scale, workflow efficiency and reimbursement can determine whether new technologies gain widespread adoption.

The agreement also moves directly into commercial deployment rather than beginning with a pilot or evaluation phase. SimonMed will deploy the technology on commercial terms from day one, with pricing linked to scan volumes under 4DMedical's software-as-a-service model.

Although 4DMedical said the contract is not immediately financially material, access to one of the largest outpatient imaging networks in the United States could provide a significant platform for future growth.

Clinical momentum continues to build

The SimonMed announcement arrives after several months of clinical and commercial progress for 4DMedical.

Earlier this month, the company reported publication of research supporting CT:VQ™ in the American Journal of Respiratory and Critical Care Medicine, widely regarded as one of the world's leading respiratory medicine journals. The study found a CT:VQ™-guided approach could improve successful patient selection for lung volume reduction surgery from 48% to 76%, adding another layer of clinical validation for the technology.

The findings were also presented at the American Thoracic Society's 2026 Congress in Orlando, one of the most influential global gatherings for respiratory medicine specialists.

That growing body of evidence supports one of CT:VQ™'s core selling points. The technology derives ventilation and perfusion information from standard non-contrast CT scans, allowing clinicians to gain additional functional insights without requiring extra imaging procedures, radioactive tracers or contrast agents.

The appeal is that CT:VQ™ extracts more information from scans patients are already receiving. As hospitals and imaging providers face increasing pressure to improve efficiency while maintaining clinical outcomes, technologies that fit seamlessly into existing workflows are attracting growing attention.

The reimbursement opportunity

One of the more significant aspects of the SimonMed agreement lies in its potential impact on reimbursement.

For emerging imaging technologies, clinical validation is only one part of the commercial equation. Broad adoption often depends on securing support from insurers and demonstrating that a technology can improve outcomes while reducing costs across the healthcare system.

Under the agreement, SimonMed will help develop reimbursement evidence for CT:VQ™ by sharing insurance and claims data across its network. The information will support engagement with both public and private payors and could help strengthen the economic case for wider adoption.

That could prove particularly valuable as 4DMedical works to expand beyond early adopters and establish CT:VQ™ as a routine part of respiratory imaging workflows across the United States.

Management has consistently highlighted reimbursement as a key driver of long-term value, making SimonMed's involvement notable beyond the immediate commercial deployment.

From validation to adoption

One of the biggest challenges for emerging medical technologies is moving from clinical validation to routine clinical use.

4DMedical now has a growing body of peer-reviewed evidence, a widening network of academic medical centre users and its first major outpatient imaging partnership. The company has spent years proving the technology works. The focus is increasingly shifting towards adoption, utilisation and reimbursement.

The SimonMed agreement may not transform revenues overnight, but it broadens 4DMedical's commercial footprint and extends its reach into one of the largest outpatient imaging networks in the United States.

For investors, the next phase of the story will be less about validation and more about scale — whether agreements like SimonMed can translate into meaningful scan volumes, reimbursement progress and sustained revenue growth.