American Shared Hospital Services reported financial results for the fourth quarter and full year 2025, highlighting a year of transition marked by a strategic expansion of its direct patient care services segment and challenges in its equipment leasing business. For the full year 2025, total revenue was $28.1 million, a slight decrease from $28.3 million in 2024. The company reported a net loss attributable to American Shared Hospital Services of $1.6 million, or $0.23 per diluted share, compared to net income of $2.2 million, or $0.33 per diluted share, in the prior year.
Revenue performance was mixed across service lines. LINAC (linear accelerator) revenue grew 35.4% year-over-year to $11.5 million, driven by the company's expanded network of stand-alone radiation therapy centers. However, Gamma Knife revenue declined 5.5% to $9.2 million, and Proton Beam Radiation Therapy (PBRT) revenue fell 26.0% to $7.4 million. The financial results reflect the company's ongoing strategic shift. Executive Chairman Ray Stachowiak stated that the strategic shift toward direct patient care services strengthens long-term growth potential and creates more stable revenue streams.
Revenue from the direct patient care services segment increased 23.7% year-over-year to $15.5 million for the full year, now representing the majority of total revenue. This growth was primarily driven by the first full year of operations from three radiation therapy centers in Rhode Island and the company's center in Puebla, Mexico. LINAC treatment sessions more than doubled to 28,147 in 2025 from 14,662 in 2024. Conversely, the medical equipment leasing segment faced headwinds. Revenue from leasing declined to $12.6 million for 2025 from $15.6 million in 2024. This decrease was attributed to the expiration of three Gamma Knife customer agreements and lower PBRT volumes, which the company described as normal cyclical fluctuations.
A significant announcement was the seven-year extension of its proton therapy lease agreement with Orlando Health through 2033, underscoring a key long-term partnership. Chief Executive Officer Gary Delanois noted that the longstanding partnership of over two decades with Orlando Health highlights the long-term nature of the company's relationships. The company's website at https://www.ashs.com provides further information. Despite the overall decline in Gamma Knife procedures, same-center procedure volumes increased 11.3% following equipment upgrades that expanded treatment capabilities. The company highlighted the completion of a Gamma Knife Esprit upgrade at its facility in Lima, Peru, which positions the center for improved capabilities.
The company's balance sheet showed $3.7 million in cash and cash equivalents as of December 31, 2025, down from $11.3 million at the end of 2024, due largely to capital expenditures. American Shared Hospital Services reported that certain financial covenants under its credit facility were not met as of year-end and that it is engaged in discussions with its lender. Shareholders' equity was $24.0 million, or $3.66 per outstanding share. Looking ahead, leadership emphasized growth initiatives. These include Certificate of Need approvals for new treatment centers in Bristol and Johnston, Rhode Island. Stachowiak said these efforts, combined with momentum in Rhode Island operations and growing international business, position the company well to deliver value to patients, partners, and shareholders in 2026 and beyond. The company also anticipates contributions from a new Esprit system at its Guadalajara, Mexico Gamma Knife center. A webcast of the conference call discussing these results was available through the company's website or directly at https://event.choruscall.com/mediaframe/webcast.html?webcastid=QqZruHXQ.
