Welcome to ContextVision, and welcome to the Fourth Quarter and Full Year 2025 Report. Today, with Richard Hallström, our CFO, and myself, Gerald. The transformation of ContextVision is in full swing, so we're combining image quality and data quality into a quantitative imaging business. Our fourth quarter saw early signs of stabilization in the market, but also in our business. We have enrolled our first patient in a clinical study to collect data and test our new data quality products. We have launched a new series of clinical products at RSNA 2025, back in November in Chicago. And if we look to our financial results, the fourth quarter came in at SEK 31.7 million. If we exclude FX impacts, this is a minor growth, and rolls up to SEK 110.3 million for the year.
So quite a positive development in the last quarter that we've seen. Likewise, our margins, 24.9% for the fourth quarter, are recovering. If we look to earnings per share, we closed the year with a black zero, despite changes that we made in our sales and marketing team, and I'll talk to that in a minute. So overall, 2025 has been a demanding year for healthcare and the medical imaging business in general. We mainly saw reduced healthcare budgets, geopolitical uncertainty, we talked about in the Q3 webcast, new trade barriers, and a very cautious investment climate. And I think with the Q4 results and the total year results, we show that our business has been resilient despite those difficult market conditions for the year.
So let's go a little bit more into the long-term overview of our image quality business, which is our ongoing core business. If you look to the top line now, trailing to SEK 110 million , rolling 12, for net sales, it shows quite resilience over the years, with a growth in 2023 and 2024, and then in line with market developments, a decline in 2025, and now with some positive signs in the fourth quarter. The adjusted EBITDA and EBITDA curve has a different shape, but it's not worrying, it's more on purpose. So in 2022, as a key event, you saw the separation of the company into our digital pathology business, which we spun off, and the remaining core business at an increased profitability rate.
But then quickly, we decided to invest into our data quality venture with the point-of-care ultrasound initiative already in 2024. And you see the costs absorbed in the company with the decline in the EBITDA. But again a positive signs that we're happy to report already now in the fourth quarter, with a first patient seen in the clinic and scanned with our systems. So having that said, maybe let's go into the operational highlights for the fourth quarter, and I'll like to give you a little bit more meat on the bone. So in general, for business development, as I said, we've launched our new clinically focused product line at RSNA 2025. Now, what does that mean? The market in general is asking for more than generally good image quality.
They are looking into enhanced image qualities, in particular for organs, if not for specific disease conditions, and that's for a simple reason, to increase productivity on the clinical side, diagnosing and screening patients, especially where patients' volumes are increasing in chronic diseases. Likewise, we have engaged with more OEMs in the fourth quarter to look deeper into image processing and opportunities that we can create in exactly that more clinically focused environment. So that allows us for new strategic discussions despite the challenging market environment when it comes to units of systems. Now, in line with those opportunities out in the market, we have already taken action and adjusted our sales and marketing departments to be able to have those engagements with larger OEMs on the more technically, clinically focused engagements.
So we've adjusted the profile of our sales and marketing department, which has a cost impact, certainly, and Richard will talk to you about it in a minute. Likewise, on the data quality growth initiative, I think Q4 was a huge step forward in receiving the first patient in the clinic at University of Washington in Seattle, in the U.S. And that's particularly important for us because we're using a research ultrasound system with ContextVision processing software on it that allows us to detect those new signals that will allow us to quantitate the disease progressions. We call those digital biomarkers or imaging biomarkers for clinical diseases, and this one is focused on liver diseases, one of the biggest burdens in society when it comes to metabolic diseases.
So a huge step forward, not only for our company, but also towards, managing those patients substantially better in the future. So if we look to the market development, on the one hand, we see those global uncertainties and the general hesitations, throughout 2024, 2025, sorry, but also in the fourth quarter. Now, I'm not so worried because about just the volume impact, because we have those huge opportunities ahead of us to create even higher value, even if the market numbers are somewhat constrained. Now, having seen in the fourth quarter even positive signs of stabilization in the market, we should be more optimistic moving into 2026. Now, having that said, let's have a deeper look into the financials behind the fourth quarter and the full year 2025.
So thank you, Gerald. Looking at the revenue development for the fourth quarter, revenue amounted to SEK 31.7 million, compared to SEK 34.1 million in the same quarter of last year, representing a decline of 7.3%. The decline in the quarter can be primarily explained by translational FX effects, as currency exchange rates had a negative impact on sales of 8.5%, corresponding to SEK 2.9 million. For the full year 2025, revenue amounted to SEK 110.3 million, compared to SEK 130.7 million of last year. The decrease for the full year was driven by lower license sales, combined with negative translational FX effects. Currency exchange rates had an impact on full year sales of a negative 4.4%.
While short-term revenues are affected by market conditions and currency movements, we remain confident in our long-term strategic direction. Looking at our profitability, starting with the fourth quarter, adjusted EBITDA amounted to SEK 7.9 million, compared to SEK 11.4 million last year, corresponding to a decline of 30.9%. The adjusted EBITDA margin was 24.9%, compared to 33.4%. The lower profitability compared to last year can primarily be explained by lower revenue in line with the continued challenging market environment. Transactional FX, which had a negative effect on SEK 0.5 million on the quarter. A one-time restructuring cost of SEK 2.2 million related to the changes in our sales and marketing department, and increased R&D investments, mainly related to data quality.
EBITDA for the quarter amounted to SEK 5.2 million, corresponding to an EBITDA margin of 16.5%. Adjusted earnings per share amounted to SEK 0.08 , compared to SEK 0.11 of last year. Now, looking at our cash flow and financial position in Q4. Cash flow from operating activities amounted to SEK 4.9 million before changes in working capital and SEK 4.6 million after changes, compared to SEK 9.1 million of last year. Total cash flow for the quarter amounted to SEK 2.3 million, compared to -SEK 2.3 million of last year. At the end of the quarter, the cash position amounted to SEK 69.8 million, reflecting a continued solid financial position.
For the full year, total cash flow amounted to SEK -4.5 million, compared to SEK 16.2 million of last year. The main drivers behind the negative cash flow for the year were lower revenues, continued investments in R&D, and the continued share buyback program. To sum up, despite negative cash flow for the year, our cash position remains solid, providing us with ample headroom to continue executing on our long-term plans. Our strong balance sheet enable us to continue investing in both image quality and data quality, explore potential M&A opportunities, and carry out shareholder value initiatives, such as the share buyback program. With that, I will hand back to Gerald.
Well, thanks, Richard, for the details behind the financials. Let me summarize and close with a brief outlook. So I think important to highlight that we accomplished in our transformation towards quantitative imaging, a major milestone in data quality, with recruiting the first patients and having it clinically scanned with our developed software for quantitative ultrasound. So likewise, the continued collaborations that we see with our OEM customers are pretty promising when it comes to image processing and image chain opportunities moving forward. Another highlight, clearly, was the launch of a new line of clinically focused products, a huge add-on to our existing portfolio, showing the more clinically focused steps, even in image quality.
I think the most important part, relating back to the financials that you've shown, is that we have seen early signs of stabilization in the market, which should be reflected in our business moving forward.
Yeah.
With that, stay tuned, and looking forward to talk to you for the next quarter.
Thank you.