4DMedical Study Shows Its CT:VQ Tech Nearly Doubles Lung Surgery Success Rates

Publication in world’s top respiratory journal validates CT:VQ for lung surgery patient selection

4DMedical has secured dual validation for its CT:VQ lung imaging technology through peer-reviewed publication in the American Journal of Respiratory and Critical Care Medicine (AJRCCM) and presentation at the ATS 2026 Congress in Orlando. The study demonstrates that CT:VQ-guided patient selection delivers a 76% response rate to lung volume reduction surgery compared to 46% under current methods, representing a near-doubling of successful surgical outcomes.

AJRCCM, known as the ATS Blue Journal, stands as the world’s leading respiratory medicine journal, whilst the ATS International Conference represents the premier global forum for respiratory research. The combination of publication in this authoritative journal and presentation at the field’s largest international meeting provides third-party clinical credibility essential for hospital procurement decisions and physician adoption.

How CT:VQ transforms lung surgery planning

Lung volume reduction surgery (LVRS) is a specialised surgical intervention for patients with severe emphysema, typically performed at advanced medical centres. CT:VQ derives functional ventilation and perfusion information from existing, non-contrast CT scans without requiring additional imaging appointments, contrast agents, or radioisotopes. The technology can analyse historical CT scans, enabling functional assessment earlier in the care pathway.

The patient selection problem CT:VQ solves

Outcomes from LVRS are strongly influenced by underlying lung physiology, including the distribution of emphysema and regional perfusion. Under current selection methods, nearly half of patients do not respond well to surgery. CT:VQ addresses this challenge by integrating functional data (perfusion) with anatomical information (emphysema) from routine CT imaging to identify optimal candidates non-invasively.

The CT:VQ workflow delivers multiple operational advantages:

1. Uses existing non-contrast CT scans
2. Requires no additional imaging appointments
3. Eliminates need for contrast agents or radioisotopes
4. Can analyse historical scans
5. Integrates into routine radiology workflows

Technology that works with existing hospital infrastructure faces lower adoption barriers than solutions requiring new equipment purchases, positioning CT:VQ as a workflow enhancement rather than a capital expenditure.

Hospital economics strengthen with improved surgical outcomes

LVRS functions as a high-value surgical intervention delivering economic benefit across the full patient pathway. As a reimbursed, high-complexity inpatient procedure, LVRS anchors specialised thoracic surgery programmes, driving incremental revenue from diagnostics, advanced imaging, multidisciplinary assessment, and inpatient surgical care whilst strengthening regional referral flows for advanced emphysema. Hospital margins from LVRS are highly sensitive to patient selection, with variability in treatment response associated with increased length of stay, complications, and overall cost.

Direct economic benefits of CT:VQ integration

CT-based functional lung imaging directly enhances LVRS economics through multiple value drivers:

• Earlier, non-invasive identification of optimal candidates using existing CT scans
• Reduced reliance on additional imaging studies
• Avoidance of low-value surgical interventions
• Improved post-operative outcomes
• Higher procedural success rates
• More efficient use of surgical infrastructure
• Improved contribution margins per case

Hospital procurement increasingly focuses on programme-level profitability rather than individual procedure costs. Technology that demonstrably improves surgical economics addresses a direct budget holder concern, particularly as healthcare providers seek to optimise utilisation of high-value surgical resources.

Study methodology and key findings

The clinical study included patients with severe emphysema undergoing bilateral LVRS and analysed pre-operative non-contrast inspiratory and expiratory CT scans using quantitative imaging techniques, including CT-derived perfusion (CT:VQ). The manuscript, titled “Enhancing patient selection for lung volume reduction surgery: A novel quantitative CT approach”, was published in AJRCCM following peer review.

Whilst the study evaluated XV technology, the findings are directly relevant to CT:VQ, which derives lobar ventilation and perfusion metrics from existing non-contrast chest CT scans. The authors concluded that integrating functional data from CT:VQ perfusion and anatomical (emphysema) information from routine CT imaging can enhance and streamline patient selection for LVRS.

Peer-reviewed methodology in a top-tier journal provides the evidence base hospitals require for clinical adoption decisions, particularly for technologies that influence high-value surgical pathways.

CEO positions validation as clinical and commercial milestone

Andreas Fouras, MD/CEO and Founder

“Seeing this work presented at ATS and published in AJRCCM, the most influential journal in respiratory medicine, is something our entire team is incredibly proud of. It represents not just scientific validation, but recognition of years of close collaboration between clinicians, engineers and commercial teams working together to solve important problems in respiratory care.”

Fouras directly linked the clinical validation to hospital economic value: “LVRS economics are highly sensitive to getting patient selection right. CT:VQ can help clinicians identify the right patients earlier, avoid unnecessary invasive assessments and focus resources on cases most likely to succeed. That translates directly into better procedural efficiency, stronger utilisation of specialist infrastructure and improved contribution margins.”

Management commentary demonstrates commercial awareness alongside scientific achievement, positioning the publication as validation of both clinical efficacy and economic value proposition.

Upcoming webinar and research presentation details

4DMedical will host a live webinar to discuss the clinical use of CT:VQ, featuring Dr Joseph Mammarappallil, Associate Professor of Radiology at Duke University School of Medicine. The discussion will include CEO Andreas Fouras and be moderated by John Hester, Senior Analyst at Bell Potter.

Webinar logistics:

• Date: Thursday 21 May 2026
• Time: 10:30am AEST
• Presenter: Dr Joseph Mammarappallil (Duke University School of Medicine)
• Participants: Andreas Fouras (CEO), John Hester (Bell Potter)

The findings from this AJRCCM publication are consistent with the growing body of research presented at ATS 2026, highlighting the importance of combining anatomical and functional lung assessment to improve patient selection and outcomes in lung volume reduction surgery. Analyst participation in the company webinar suggests institutional interest, whilst the Duke University presenter adds academic credibility to the commercial discussion.

Strategic positioning in respiratory imaging market

4DMedical’s expanding software portfolio includes the FDA-cleared XV Lung Ventilation Analysis Software (XV LVAS), CT LVAS, and CT:VQ. Delivered through a Software-as-a-Service (SaaS) model, these solutions integrate into existing hospital infrastructure, enhancing physician productivity without requiring capital equipment purchases. The 2023 acquisition of Imbio added advanced AI capabilities to the platform.

CT:VQ is designed to set new benchmarks in cardiothoracic imaging by combining ventilation and perfusion analysis from existing non-contrast CT scans. The publication validates the core technology proposition: that functional lung imaging derived from routine scans can objectively support clinical decision-making in high-value surgical pathways. The SaaS delivery model supports recurring revenue potential as adoption scales across hospital networks seeking to optimise surgical programme economics.

Ready to Explore 4DMedical’s Lung Imaging Technology Further?

4DMedical’s CT:VQ technology has now received dual validation through publication in the world’s leading respiratory journal and presentation at the premier ATS Congress. This peer-reviewed evidence demonstrates how the company’s software can nearly double surgical success rates whilst reducing healthcare costs.

For detailed analysis of 4DMedical’s technology platform, commercial strategy, and market positioning within the respiratory imaging sector, visit the 4DMedical investor centre. Access comprehensive research updates, financial performance data, and expert market commentary on this ASX-listed medical technology company.