Total Revenue

+17% (from $5.216M in Q1 2024 to $6.112M in Q1 2025)

Revenue growth was driven by expanded radiation therapy services—primarily from the acquisition of Rhode Island facilities and the launch of the Puebla, Mexico facility—offsetting declines in the leasing segment. This expansion contrasts with the prior period’s lower direct patient services, contributing to the overall lift in revenue. " " "

Leasing Segment

Approximately 30% decline (from $4.3M in Q1 2024 to $2.99M in Q1 2025)

Leasing revenues fell due to lower Gamma Knife and Proton Beam Radiation Therapy (PBRT) volumes, stemming from contract expirations, equipment downtime, and cyclical volume fluctuations. This decline contrasts with previous periods where leasing performance was stronger. " " "

Net Income / Net Loss

Swing from a modest net income of $65K in Q1 2024 to a net loss of $912K in Q1 2025

The deterioration in net income is explained by a marked increase in cost of revenue (rising from $3.07M to $5.17M), declining gross margin (from $2.14M to $942K), and higher depreciation and interest expenses. These higher costs outweighed the revenue gains compared to the relatively modest cost base in the previous period. " "

Operating Cash Flow

Reversal from negative $1.865M in Q1 2024 to positive $2.503M in Q1 2025

Improved working capital management, notably a positive change in receivables of $2.127M (vs. a negative change of $2.138M in Q1 2024), helped turn operating cash flow positive despite the net loss. This improvement marks a significant recovery relative to the prior period’s cash outflow. "

Geographic Expansion & Acquisitions

In Q3 2024 and Q2 2024, the company detailed acquisitions in Rhode Island, investments in international markets (Mexico, Peru, Ecuador), and strategic integration of new centers. " " " "

In Q1 2025, the focus remains on significant geographic expansion with the acquisition of Rhode Island centers, new CON approvals for additional centers, and further international expansion in Mexico. " " "

Consistent emphasis on growth and diversification, with an increasingly positive outlook on expansion strategies.

Fixed Cost Structure: Scalability vs. Cost Exposure

This topic was not mentioned in Q3 2024 or Q2 2024 [—].

Q1 2025 introduced a discussion on the highly fixed-cost oriented business model in the Direct Patient Services segment, highlighting improved cost absorption with new center openings. "

New focus emerging to address scalability and cost management, reflecting proactive risk handling.

Medicaid Reimbursement Risk and Regulatory Impacts

Not addressed in Q3 2024 or Q2 2024 [—].

Q1 2025 discussed potential regulatory changes but emphasized minimal exposure to Medicaid risks due to reliance on private insurers and Medicare. "

Topic newly introduced with constructive sentiment, suggesting limited impact on future revenues.

Operational Execution & Integration Challenges

Both Q3 2024 and Q2 2024 discussed challenges related to integrating new centers, equipment upgrades, and staffing adjustments, with detailed costs and integration hurdles. " " " "

Q1 2025 continues to address operational challenges with center openings and equipment upgrades; although treatment volumes fluctuated, there is optimism about long-term integration benefits. " " "

Persistent challenges remain, but the tone is increasingly optimistic about overcoming them through integration and efficiency improvements.

Treatment Volume Volatility and Staffing Impacts

Q3 2024 noted declines in Gamma Knife volumes and staffing shortages impacting performance, although Q2 2024 did not cover this topic. " "

In Q1 2025, after an initial decline in treatment volumes (with Gamma Knife and proton beam procedures down), there were significant improvements in April and mentions of staffing strategy optimization. " " "

Recurring concerns with short-term volatility, yet the company is showing resilience and proactive staffing measures to stabilize volumes.

Regulatory Approval Delays for New Projects

In Q2 2024, there were delays in scheduling CON hearings for the proton beam center, while Q3 2024 reported progress without significant delays. " " "

Q1 2025 did not mention any delays, instead noting CON approvals for new projects in Rhode Island. " "

Improved regulatory process with previous scheduling delays resolved, contributing to a more positive outlook on new project development.

Investor Transparency & Communication Issues

Q3 2024 included analyst concerns over unexpected issues and insufficient forward guidance, while Q2 2024 did not address this topic. " "

Q1 2025 did not emphasize transparency issues; management expressed openness and invited investor queries, moving away from prior concerns. " "

Concerns have receded, indicating improved or managed investor communications and greater confidence in long-term strategy.

Management Uncertainty (CEO Transition)

Q2 2024 mentioned the passing of the previous CEO and a period of adjustment, though Q3 2024 did not emphasize it. " "

Q1 2025 does not mention any management uncertainty, reflecting stable and confident leadership under current CEO Gary Delanois. " "

Former leadership concerns have been effectively resolved, suggesting a stable management environment moving forward.

Strong Pipeline & Growth Opportunities

In both Q3 2024 and Q2 2024, strong pipeline narratives were emphasized through strategic acquisitions, international expansion, and a transition toward a retail-focused model. " " " "

Q1 2025 reiterates a robust growth outlook with further constraints in geographic expansion, new acquisitions, and additional tuck-in opportunities—all supporting a strong long-term pipeline. " " " "

The growth narrative remains consistently strong and appears to be intensifying, reinforcing confidence in the company’s long-term future.