Okay, we will now begin. Good morning, everyone. Welcome to C-RAD's presentation of the Q2 report. My name is Priscilla Kazumba, and I will be moderating today's webcast. The report will be presented to you by Tim Thurn, our CEO, and Henrik Bergentoft, the CFO. The presentation will address the first three quarters of the fiscal year 2022. Tim will start off with a short introduction and comments on the financial highlights, followed by an analysis of the sales developments before finishing with his comments on the key events. Henrik will guide you through the financial review before he hands over the microphone back to Tim. We will conclude the presentation with a short overview of the market. Before we close the webcast, you will have an opportunity to ask questions.
In case you wish to ask questions, please press the Raise the Hand button. It's right on the bottom panel. It's a yellow hand. We will open the microphone at the end of the presentation. We would also like to mention that we will not respond to any questions from the chat. If you have questions, please use the Raise Your Hand button. If you wish to watch the recording later on, we will have the webcast available on the C-RAD website after the presentation. Therewith, I hand over the word to Tim.
Great, Priscilla. Thank you very much. Let's get started with an introduction and the financial highlights. C-RAD is active in the field of cancer treatment. Our customers are hospitals that fight cancer with radiation. In modern high-precision radiation therapy, accurate tumor alignment is crucial for a safe and successful treatment. C-RAD positioning products are supporting this process and are fully integrated in the clinical workflow. Over the past years, C-RAD has been growing significantly and generated last year SEK 260 million in revenue at an operating margin of 14%. We are closing the third quarter with an all-time high revenue of SEK 83.5 million, translating into 32% of growth. Order intake was approximately on the same level as last year, giving us a solid order backlog of approximately SEK 500 million going into the fourth quarter.
The strong growth in deliveries, along with a stable gross margin, generates an operating income of SEK 14.6 million or a margin of 17.5%. Let's take a deep dive into the markets and our sales performance there. For the first nine months, we are delivering order intake growth across all regions with a very strong performance in the APAC region, growing orders by 58%. Order intake overall in the third quarter, somewhat behind my expectation. While order intake in the EMEA and Americas declined, the progress in Asia continued throughout Q3. C-RAD is in an excellent position in all important growth markets in the region, represented through our own organization, a progressive distribution network, and our OEM relationships. Our investments in the Indian market continue to deliver results, and we are building a healthy project pipeline.
We have established a network of partners in the country managed by a C-RAD team out of Delhi. During the next months, we will also be present at the most important conference in India to demonstrate our solution to potential customers. Also, our cooperation with the Australian healthcare provider, GenesisCare, develops very positive and strengthens our installed base in the region. Let's take a quick look at the distribution of orders by product category. Looking at the third quarter, it displays the, for our industry, very usual volatility between the quarters. But I think looking at the nine-month period gives us a fair view on our opportunity. Orders for our most important product category, the positioning products, grew with 21%. Certainly a good result, which supports our early assessment of surface tracking being on its way to become standard of care.
The second point that I want to make, the lifecycle business continues to grow at a high pace. We see increasing interest from new customers across the globe, but especially in EMEA and Americas, to sign up for service contracts. There's an increasing population renewing their service contracts after the initial service contract has expired. This is the ultimate confirmation of a successful relationship between the customer and C-RAD over the lifecycle of the product. This chart is displaying the order intake by quarter over the past three years. Our business, reflected in revenue, and especially in order intake, is subject to a very distinct seasonality pattern, whereas usually the second half of the year is significantly stronger than the first two quarters. This is since many customers are hospitals and clinics which have annual budget cycles that are aligned to the calendar year.
We saw substantial revenue growth across all geographies during the third quarter as a result of an order conversion of products and projects that were won earlier in the year and a Chinese market that continues to recover. An outstanding result really from the Americas, primarily North America, the largest market for radiation therapy equipment worldwide, delivering a growth of 63% and 49% for the quarter and for the nine-month period, respectively. Also encouraging progress in EMEA after a somewhat affected first half, we are delivering a strong revenue growth again in Q3. The year opened with a challenging situation with the return of the pandemic and subsequent lockdowns in China that entailed negative effects on our revenue as we were not able to deliver and install our systems in the cancer centers. Hence, it is encouraging returning to revenue growth again in the region.
We saw first indications of a recovery already during the second quarter, and the situation has further improved during the third quarter. We are certainly not yet back to pre-COVID levels, but see a steady progress in the recovery. Now zooming in to our service business and the service revenue. We are very closely monitoring the contribution of the service revenue as a function of the total revenue, which, for the first nine months, amounted to 17% as compared to 13% during the same period last year. This is a trend we foresee continuing over time as both the installed base and the adoption of service contracts continues to develop favorably. We see a huge potential in the service business. Established companies in our industry report service business contribution of 40%-50% of the total revenue.
Very encouraging and shows the potential we have within services. Now looking into the key events. I'm pleased to report the progress in our partnership with the LINAC vendor Accuray, which was announced in October last year. On the ASTRO conference last week, the trade show, we jointly demonstrated a breast cancer treatment package on Accuray's Radixact system with a fully integrated and automated surface-guided radiation therapy solution. Breast cancer remains a significant women's health issue, and more precise treatment technologies can have a major impact on extending and improving the quality of patients' lives. This is another clear indicator of surface tracking being viewed as an important contributor in the fight against cancer. In October, we announced the decision of a country-wide tender in Italy that was released earlier this year.
C-RAD, through our local distributor, Tecnosan, has been participating in the tender and was ranked first in the surface tracking lot and third in the gating lot. The tender decision was announced and is now subject to an appeal period that is ending by the end of November. We are expecting to receive a purchase order right thereafter. In the same tender, Elekta was ranked first in the LINAC lot. I think this tender shows again the rising importance of surface tracking to deliver advanced radiation therapy, clearly pointing towards the technology becoming standard of care. Tecnosan and C-RAD have worked together over the last close to ten years. This excellent cooperation led to the successful adoption of surface tracking in Italy, where C-RAD became market leader over time. I also want to give an update on the upcoming changes in senior management here at C-RAD.
Henrik Bergentoft is going to leave C-RAD by mid of November. Lars Levin will succeed him in the position as an interim CFO. Lars is already part of the C-RAD team and is currently getting prepared to take on the position upon Henrik's departure. As probably most of you are aware, I'm going to leave C-RAD by the end of the year as well. Cecilia de Leeuw will succeed me in the position. We have a very close dialogue and are currently working on preparing the handover that will take place during December. Perhaps at this point, I want to take the opportunity to also add a personal comment. I'm very excited and proud of what the C-RAD team has achieved during the last years.
We made immense progress to build a company with a global presence and to make the technology become standard of care, a technology that really makes the difference for the patients in need of cancer care. A big, big thank you to the entire C-RAD team, our customers and partners, as well as our shareholders. With that, I hand over the microphone to Henrik, who will guide you through the financial review.
Thank you so much, Tim. Let's start off by having a closer look at our profit and loss statement for the third quarter and the nine-month period. Tim already provided excellent comments on the revenue side, so I will move on to the costs. Starting off with external expenses, that for the quarter amounted to SEK 16.6 million, an increase from SEK 12.4 million last year. The increase is driven by several factors. Last year's operating expense were significantly impacted by the pandemic, with negligible traveling and no physical marketing events taking place. External consultants have been used to a greater extent in our R&D projects as compared to last year, also reflected in the capitalized development cost. C-RAD has measurable cost in foreign currencies, primarily U.S. dollars and euros.
The weakening of the SEK has increased cost by approximately SEK 1.7 million for the nine-month period, with the main effect in the third quarter. Personnel expenses for the quarter amounted to SEK 24.3 million, an increase from SEK 18 million last year. As with the external expenses, the weakening of the SEK has increased personnel costs by approximately SEK 2.4 million for the nine-month period, again, with the main effect in the third quarter. The average number of employees amounted to 74 during the third quarter, compared to 64 corresponding period last year. At the end of September this year, the number of employees in the group amounted to 79, compared to 65 last year. This includes the announced expansion of the sales organization in our strategic markets.
The main composition of other income and expenses relates to fluctuations in the exchange rates, and thus the revaluation of our balance sheet items. Capitalizations during the quarter amounted to SEK 2 million, and are related to continued development of the positioning products. The increased capitalization, say, compared to last year, is due to more efforts being put into development as compared to maintenance, and also that external consultants have been engaged to a greater extent compared to last year. This slide displays our revenue and our gross margin over a longer period of time. For the third quarter, specifically, the gross profit margin came in at 64%. Same gross profit margin, 64%, for the nine-month period as compared to 62%, last year.
Fluctuations in the gross profit margin can be expected between periods, as it is dependent on the product mix and the variation of different sales markets or the sales channels in our different markets. The improving trend over time is mainly due to a larger portion of direct sales, and that the growing portion of services in our revenue has a positive impact on the gross margin. This graph displays revenue and operating profit over the last six years, and as seen, there is a clear positive trend over time. That said, there is a seasonal pattern in C-RAD's operations. The second half of the year is usually the strongest period, both in terms of order intake and revenue. This is due to the fact that a large number of customers are hospitals and clinics, which have annual budgets aligned to the calendar year.
As the larger part of C-RAD cost base is fixed, fluctuations in revenue have a direct impact on the quarterly operating profit. Volatility in order intake and revenue between quarters is to be expected in our business. Here's a look at our balance sheet and our cash flow, with a couple of comments to be made. The negative cash flow in the third quarter comes from negative working capital due to mainly two factors. One being the fact that a vast part of deliveries in the third quarter were made towards the end of the quarter, meaning that the positive cash flow effect from those deliveries will come in the fourth quarter. Also that we have increased our inventory levels to secure delivery capacity in the current global situation with the shortage of components.
Still, we end the quarter with a cash position of SEK 95 million, and on top of that, an unused credit facility of SEK 20 million. The company is completely debt-free and has a solidity of 76%. Ending the financial presentation with a look at our order backlog, and as I think most of you know, the order backlog represents orders that have been received but not yet delivered or invoiced. The backlog amounted to SEK 493 million at the end of the quarter, an increase with 33% from last year. Roughly, half relates to products, and the other half relates to service contracts.
From the service contracts, SEK 41.6 million, representing 18% of the order backlog of service contracts, is to be recognized as revenue in the coming 12-month period, as service contracts are recognized as revenue over the contract period. The service contract can be up to eight years, while the most common contract period is 3-5 years. That marks the end of the financial presentation, and now back to you, Tim.
Thank you, Henrik. I would like to give a short update on the company and the business that we are working in. Our vision at C-RAD is to provide superior treatment in radiation oncology to all patients, and we get there through our mission to be the preferred partner to ensure safety and efficiency and advance radiation oncology, helping to cure more cancer patients and improve their quality of life. Cancer is among the leading causes of death worldwide. Three methods have been established to treat cancer, which is surgery, drug therapy or chemotherapy, and radiation therapy. C-RAD is active in the field of radiation therapy, and our products are used to improve patient safety and increase efficiency. The demand for our products is driven by the worldwide implementation of high-precision treatment techniques. As said, I mean, we position the product for patient safety as well as efficiency.
With the upcoming treatment techniques, they deliver an opportunity to further improve the efficiency and reduce the time that is required to treat the patient. At the same time, this might create a risk for patient safety. Here the C-RAD solution helps to ensure that the dose is delivered with highest precision to the patient or to the tumor. All this comes as an additional investment. If we are looking at the entire treatment room, additional investment for the C-RAD equipment is only 5%. The fundamental pillar of our growth journey is the adoption of our technology. We believe that the technology is on its way to become standard of care, and there are a few good examples that underline our assessment.
Well, I think we spoke about the Italy tender earlier today, and I think that is a very makes it very visible how others see the importance of surface tracking being an integrated part of such a huge LINAC project. Another example is proton therapy, which can be considered as the spearhead of precision radiation therapy. We can say essentially all new treatment centers are choosing the technology provide a safe and efficient workflow. If we look from another angle at the technology, we have seen that the clinical adoption has also been increasing over the past years. If we look five years back, 2015, in that period, surface tracking was primarily used for breast cancer patients only. Certainly a very important indication and certainly one of the largest indications of patients that receive radiation therapy.
However, over the years, the technology and the clinical research has evolved to support using surface tracking also for many other indications. If we talk to our customers today, many of them use our technology for 70% or more of the patients, if not for all of their patients. Also here, a very encouraging development, taking the technology from a niche solution to a true standard of care. C-RAD is focusing its activities in what we call the advanced markets. The advanced markets account for roughly 70% of the global radiation therapy market, which means roughly 15,000 LINACs worldwide. Seventy percent is around 10,000 LINACs. If we assume an adoption of around 80% of those LINACs being equipped eventually with surface tracking, that leaves us with around 8,000 LINACs.
If we look today, we are just a little bit north of 3,000 LINACs that are equipped with surface tracking technology. Meaning there's still a huge potential to develop the market and adopt the technology worldwide. C-RAD has sold approximately 1,200 systems worldwide. We are looking at an opportunity to bundle our technology together with the new LINAC sold, but also to upgrade existing LINACs. The dominant part of our business is related to new LINACs, meaning the customer is purchasing our technology in conjunction with the new treatment machine. With the current sales volume of new LINACs to the advanced radiation therapy market, we assess the opportunity to be approximately SEK 1 billion.
Even though it is at the moment a smaller part of our business, we believe as the technology becomes standard of care, that more customers are inclined to retrofit our technology to existing LINACs, provided the machine isn't equipped with surface tracking already. We looked into the service business earlier, which gives us a great opportunity for future growth. On top of this, the global market is growing with 6%-8% and with significantly higher growth rates in some of the Asian markets where C-RAD has a market-leading position. Looking at the development over the last five years, we have developed revenue with roughly 18.4% on an annual basis. 2018, we reached break-even, and already during last year we had an operating profit margin of 14%.
Looking at the clinical advantage of surface tracking technology. First of all, there are other possibilities to position the patient, but there are some distinct advantages of using the surface tracking technology, which are, for example, that the system operates dose-free, which means there is less impact and less side effects for the patient during the treatment. It is non-invasive, which is clearly translating into an ease of use. It is markerless, which again underlines the patient comfort. C-RAD has been particularly strong in developing the technology to integrate in the surrounding system, and thereby generate less impact on the daily workflow for the operators, which translate into usability advantage. Last but not least, the patient compliance. When we talk to our customers, many of the customers are using this technology really on the best part of their or majority of their patients.
All in all, a very strong value proposition for our customers. Our growth strategy is very well-defined and based on the three pillars of product excellence, sales excellence, and service excellence. When we look at the product, I think the product in itself has proven its functionality in a multitude of clinical research papers from customers across the globe. However, there is still work to be done to further develop the product to improve the software, integrate the software with new machines, but also to extend the functionality, as well. From a sales perspective, our focus is to roll out the technology now in our target markets, and our efforts are to get the message about the benefits out to our customers, so that they can adopt the technology. We spoke earlier about the service business, which is very important for us.
Along with the product sales comes the service sales, and we are constantly striving towards developing a relationship with the customers and eventually signing up the service contract for the systems that are installed at our customers. Perhaps I close this presentation with the main reasons from my perspective why to invest in C-RAD. First of all, what we do provides really value for the society in the fight against cancer. C-RAD has already a proven and recognized product. With our direct sales organization, our distributors, but also with our OEM relationship, we have a comprehensive market access in the most important markets. Surface tracking is becoming standard of care, and this is unleashing a significant growth potential for this company. Last but not least, we have a very stable financial platform.
The financial calendar foresees right now an invitation to the presentation of the Q4 report, which is going to be published on January twenty-sixth, beginning of next year. Therewith, I conclude the presentation and we open the Q&A session.
Thank you, Tim and Henrik, for the great presentation. Now for the Q&A session. Just as a reminder, you can use the raise your hand button. We already have one question. It's from Gonzalo. Gonzalo, I will unmute your microphone.
Hi, hope you can hear me.
Yes, we can hear you fine. Hi.
Great. Hi, Gonzalo Artiach from ABG here on behalf of Erik Cassel. I have two questions. First one, you're saying that the substantial revenue growth comes as a result of an order conversion of projects that were won earlier in the year. On this, is there any particular large project that has been converted now? And if so, what was the sales impact from it?
Yeah. That's correct. I think what we see that is one of the parameters or KPIs that we are tracking is the order conversion of our book and bill period, which has been somewhat lower compared to the long-term average. It was around five months during this third quarter. Meaning that orders or a relevant part, on average, the orders have been converted during five months that we delivered in the third quarter. I mean, it is really not one country or one region to really point out.
However, what I want to emphasize is we had in the beginning of the year a very successful project in the Middle East region, which to a large extent was delivered now already to the customer in the third quarter. This was one project, and there were many other projects as well. It is really difficult to point out one country where this is coming from. It is more the mix of different projects.
Thank you very much. Second one, second question, and it's about your order intake. You mentioned that it has declined due to a volatility between quarters. Your peers, for example, Elekta and Varian are actually seeing end market weakness affecting their order intake. I was just wondering why do you see this decrease caused by volatility and not demand softening as your peers do?
Well, I mean, if we look at the third quarter alone, it is very stable compared to last year. I mean, however, I mean, we had a very strong second quarter this year, and I think we have seen this kind of volatility also in the past. I mean, this is not very unusual for us and based on the experience that we have also quite common. Now, I mean, I can see that there is a very strong interest in our technology in the markets around the world. We have certainly seen that in certain areas the business with auxiliary products has maybe been a bit on the back burner. We have also seen that for our products, the interest is unchanged.
I think there are a few very positive developments that we have also seen now during the quarter. When we look at the Chinese market, for example, which was a very important market for us, and hence the effect in the first half of the year of this market being in a close to lockdown situation was quite significant. The market has opened up. I think I mentioned it started in Q2 and now in Q3 we saw further progress on the recovery. We are not yet back to pre-COVID times, but we've definitely made significant progress in the right direction. From that perspective, there are plenty of indicators that are showing a positive development.
Last but not least, I also want to mention, I mean, this Italy project is by far the largest order project that C-RAD has ever seen. Yes, the order is not yet booked. We are very positive about this opportunity and from that perspective, yeah, to close the question, basically, we see it more as a temporary volatility than a general trend in the market.
Thank you very much. That's all from me.
Thank you, Gonzalo.
Do we have any other questions? Looks like we don't have any other questions for now.
Good. Thank you, everyone. Thank you for joining the webcast today. Yeah, I wish you a nice Friday, and then a happy weekend.
Thank you, everyone. Have a nice day.