Okay, I think we can start now. Good morning again, everyone. Welcome to C-RAD's presentation of the year-end report. My name is Basak Karakus, I will be moderating today's webcast. Today's webcast will be presented to you by our CEO, Cecilia de Leeuw, our CFO, Lars Levin. The presentation will address the last quarter of the fiscal year 2022. In the first part, Cecilia will start off with a short introduction and comment on the financial highlights in Q4, followed by an analysis of the sales development before she finishes with commenting on the key events. Lars will guide you through the financial review before he hands over the microphone to Cecilia, who will summarize and comment on the year 2022. In case you wish to ask a question, please click the Raise Hand button.
At the end of the presentation, I will turn on your microphones. Please note that, we will not be taking any questions in the chat, so your microphones will be muted throughout the presentation. Also, a recording of the webcast will be available on our website after the presentation. That said, I'd like to hand over the microphone to Cecilia.
Thank you, Basak . Hi, everyone. My name is Cecilia de Leeuw, and I took over as CEO for C-RAD on December 21st. I truly had a flying start. C-RAD is, as most of you know, active in the field of radiotherapy, which is one of three ways to treat cancer. The other two ways being surgery and chemotherapy. In fact, approximately 50% of all cancer patients are treated with radiotherapy, as many patients get a combination. For example, surgery and radiotherapy. Customers are mainly hospitals and clinics. Our main product is in the field of Surface Guided Radiation Therapy or SGRT, and the product is well established in the market. For the patient, SGRT can improve the quality of life as the solution minimize the radiation of healthy tissue.
We have mainly three ways to go to market: direct with OEMs and our network of distributors. Often it is actually a combination of these. C-RAD has been around since 2004, reached breakeven in 2018 and is now a fully global company headquartered in Uppsala. Let me move into the results. Starting off with some financial highlights. First, all in all, we had a very strong Q4. Also, 2022 as a whole was strong in many ways. Our order intake and revenue is the best ever in the company history. Full year, we are now above SEK 300 million in turnover for the first time. Exciting. The large Italian order announced in Q3 was confirmed in November. Even without this all-time high order, our growth compared to Q4 last year was 28%.
Our order backlog has grown from SEK 425 million to an impressive SEK 616 million. This gives us stability for the future. The operating profit, excluding one-offs, was SEK 10.5 million in the quarter and SEK 26.1 million in the full year. The operating margin, excluding one-offs, was 10.5%. The operating margin excluding one-off it decreased to 10.6% in the quarter and 8.6% for the full year. The decrease compared to previous year is explained by the forward-leaning investments decided already in the first quarter in sales, but also in services, product development, and also in research corporations. We have an underlying healthy profitability. The cash flow for the quarter was on the healthy level of almost SEK 32 million, an increase of almost SEK 19 million.
With that, let's look into the market and sales performance. Starting with the order intake. For the full year, we are delivering growth in all regions except for APAC. This is mainly due to COVID restrictions in China. Order intake for the fourth quarter amounted to an all-time high of SEK 216 million or SEK 217 million actually, almost, an increase of 63%. You can strongly here see the effect of the Italian order, which amounted to SEK 46 million in the Q4. All in all, a strong quarter, a strong year for EMEA. Americas is picking up again in Q4 with a 30% growth and 16% for the full year. In APAC, we had a very strong Q3.
The fourth quarter came in weaker than last year. However, looking at the full year, APAC delivered a strong 25% growth. In the end of the quarter, we saw a positive development in China opening up after COVID. Let us now look into the order intake by product. Let's first take a look at the distributions of orders by the product category. Our most important product category, the positioning products, grew with 93% and 32% for the full year, or actually 46% for the full year. This is a very strong result, largely impacted positively by the Italian order. Life Cycle Business or services, as we call it, continues to grow.
We see an increasing interest to sign up for service contracts from new customers across the globe, especially in Americas and EMEA. Also, there is a rising number of customers that renew their service commitment after the initial period, contract period has expired. We have strengthened our teams in EMEA, US, and Australia, and invested in tools to digitalize our field support. This is important to us, as we want to secure our successful relationship between our customers and ourselves, C-RAD, over the life cycle of the product. Looking into the seasonality, this chart is displaying the order intake over the past three years. Our business is both in revenue and especially in order intake, is subject to a very distinct seasonality pattern.
As you can see, it's typically the fourth quarter that is significantly stronger. The reason for that is that many of our customers, most of our customers are hospitals and clinics, and they work on an annual budget cycle aligned to the calendar year. Let's move into revenue by market. We are closing in on the fourth quarter, the full year 2022 with revenue growth in all markets. In Americas, we continue to see the impact of the strength and organization, and there are some fluctuations over the quarter depending on the timing and the installation on the customer side. EMEA had an impressive quarter delivering on orders taken earlier.
APAC had a strong quarter with 38% growth, mainly because of the order conversions of products, won earlier in the year and the Chinese market that continues to recover. Finally, let's look into the services business. We are closely monitoring the contribution of service revenue as a function of the total revenue, which in the full year amount to 16%, and that is to be compared with 13% of last year. This is a trend that we foresee continuing to increase over time as the install base and the adoption of our service contracts continue to develop favorably. We see a potential to grow the service business further. That ends this part, and I will take you through the key events.
Looking at the key events for the quarter, already mentioned that we have been selected as the main supplier for the Italian order, and that was confirmed in November. I started in December 21st, taking over from Tim Thurn, who left after almost 10 years with C-RAD. Henrik left as CFO in November, and Lars Levin took over after him as an interim. Christopher was appointed as CFO in January and will start the second quarter of this year. With that, I will hand over to Lars for a closer look at the financials.
Thank you, Cecilia, and hello, everyone. I will now give you a brief summary with some more details about the financial performance as well as on the cash flow and our financial position. Let's start off with a P&L statement for Q4 and the full year 2022. Revenues amounted to SEK 99 million in the quarter, with a stable gross profit of SEK 68.5 million and a gross margin of 65%. Revenues for the full year amounted to SEK 301 million, also with a gross margin of 65%. Operating profit decreased to SEK 6.2 million in the quarter, down from SEK 14.9 million prior year. Operating margin was 6.3% versus 19.3% the prior year.
Excluding one-off costs linked to the changes in the group executive management team, the operating income was SEK 10.5 million and operating margin was 10.6%. Operating profit, excluding one-offs for the full year, decreased to SEK 26 million, down from SEK 36 million prior year. Operating margin, excluding one-offs, was 8.6% versus 13.8% prior year. Decrease in operating income, excluding one-offs of just over SEK 4 million in the fourth quarter, is entirely explained by our forward-leaning investments in our sales operations, something that we communicated already in the Q1 report last year, and in product development and clinical partnerships. These investments in the organization increased our costs in the quarter for areas underlying profitability is still good. As you have already noted, this cost has already started to giving back, reflected in the order intake.
In breaking down the costs, both other external expenses and personal expenses increased. Other external expenses increased to SEK 26 million in the quarter from SEK 14 million prior year. Personal expenses increased to SEK 34 million from SEK 20 million prior year. The increase of the cost is explained by several factors. First of all, by the already mentioned forward-leaning investments in the organization. Weak Swedish krona also had a negative impact on our cost, both on other external expenses, SEK 1.1 million, and on the personal expenses, SEK 1.5 million. When comparing with last year's figures, one must also keep in mind that the external costs then were affected by the pandemic, with very little traveling and no physical marketing events taking place, and therefore, lower than normal. Capitalizations during the quarter amounted to SEK 4 million compared to SEK 1 million prior year.
This is related to the continued product development and the increase is due to more efforts being put into the development of our positioning products. That said, we now move over to the next slide and a look at our strong and stable gross margin. What you see is the development of a gross margin during the last six years. The gross profit margin was 65% in the quarter versus 66% in prior year. Over the full year, the gross margin was also 65%. Our gross profit naturally varies and fluctuations can occur between periods dependent on the product mix and the variation of sales channels in our different markets. The last years, the gross margin has been very stable and above 60% for eight quarters in a row. Improving trend over time is mainly due to a larger portion of direct sales.
Growing portion of services in our revenues does also have a positive impact on the gross margin. Turn to the next slide and our cash flow. The cash flow was strong in the quarter. The cash flow from the operating activities amounted to SEK 32 million, an increase by SEK 19 million from last year. The working capital contributed positively with SEK 23 million in the quarter. This is mainly due to deliveries that we executed at the end of Q3 and were paid by our customers in Q4. Over the full year, the working capital had a negative impact on the cash flow, - SEK 22 million. This is explained by a stock build-up to secure the delivery capacity in this current global situation with shortage of components.
Summarizing the cash flow, we leave the quarter and 2022 behind us with a very stable cash position of SEK 122 million. We turn to the next slide and for a quick look at our balance sheet. As usual, our financial position is very solid, which of course is a great support to our important business. On top of our strong cash position of SEK 122 million at year-end, we also have an unused bank overdraft facility of SEK 20 million. We have no interest bearing debts. The equity ratio was + 70% at year-end. We can move on to the next slide and look at our order backlog. Order backlog represents orders that have been received but not delivered and invoiced. Obviously, as you can see, the order backlog is progressing very well.
At the end of the financial year 2022, the backlog amounted to SEK 616 million, up 45% versus prior year. The total order backlog, 58% relates to products and 42% to services. Products increased by 68% versus prior year and services by 22%. To round off the financial review, we are progressing well. The underlying business is strong, and we are clearly in a good place as we are going into 2023. With that comment, I hand over to you, Cecilia.
Thank you, Lars. Well, it has been indeed an intensive first month for me as CEO. I have spent a lot of time meeting my new colleagues, partners, and customers, and I'd like to take the opportunity to thank them for welcoming me into a world. There we go. For me to welcoming me into a world working with cutting-edge technology that can improve lives. One would think that it's a given to use SGRT in radiation therapy. In addition, investment is only some 5% of the total investment, and the benefits of ensuring radiation of the tumor only, and by that, enhancing the quality of life for the patient as well as making the actual work during setup and treatment in the hospital faster.
SGRT has the largest uptake, we continue to see an increasing interest in what we call the advanced markets. In addition, the unmet demand in developing markets, for example, India, is high, and we have the opportunity, long and midterm, to serve more customers and patients. So far, despite the challenging market environment, we see investments continuing. Let me see here. Here we go. Summing up the financials of 2022 and the key takeaways from our report, we have had the best ever order intake and revenue as well as good cash flow. The underlying profitability is good. However, the one-offs and growth initiatives has weakened the result. Despite the challenging environment, C-RAD has continued to invest in its product portfolio and sales organization.
This has helped us to achieve a record high order intake for the fourth quarter, as well as strong sales and good cash flow. In conclusion, with our solid financial position and our strong order backlog, and the fact that our investments are starting to show effect, we have a solid base going into 2023. I look forward to our continued strive to bring SGRT to more patients around the world. We as C-RAD have an important role to play in making SGRT becoming standard of care. With that, over to you, Basak.
Thank you very much, Cecilia and Lars. We will now open the floor for questions. I want to remind you that if you want to ask a question, please click the Raise Hand button at the bottom of your window. Erik Cassel has a question. Please go ahead, Erik.
Hello, hello. Hi, Cecilia. Hi, Lars. I have a couple of questions for you today, mostly around the order intake situation.
Mm-hmm.
First off on Italy. My interpretation is that later in last year, the Italy tenders were sort of split into fractions based on.
Mm-hmm
... the different regions. I learned from Elekta that they're gonna recognize orders across two quarters. I was just gonna ask you if there's any more potential order intake volumes coming from Italy into next quarter as well, or if all of the potential volumes for Italy has been recognized already?
In terms of orders, that is, Erik?
Yeah. Yes.
Okay. I think, you know, this is my first, four weeks as CEO. Let me take that and come back to you.
Okay. Okay.
Mm-hmm.
Um, and then, uh-
The question, Erik, was if we also recognize orders now in 2023.
Yes. Yes, basically. 'Cause as said, it was split into different regions. I was just wondering if this was for one of those regions or all of them at the same time. Then I also was curious if you know the split between you and Vision RT in this tender, and also if Varian's in-house solution managed to capture any volumes now, or if they were excluded from the tender process altogether.
I know that we have the majority of the business from this tender. The Varian question, there I have to come back.
Okay. Okay. It also seemed like it was quite limited service attached to the large Italy tenders for now. Is there any potential for you to add service to all these systems that you are gonna deliver?
Yet another very good question that I will come back to. In general, it's typically, you know, part of the tender, but I will come back to that specific question.
Okay. Thank you. I understand that there's also ongoing tenders in Spain and Czech Republic mainly. Those are the large two.
Mm-hmm
... that I know of.
Mm-hmm.
do you have any indication of potential volumes from these tenders, and then also the potential timing of that?
No. No, no projections yet that I can share here.
Okay. Thank you.
Mm-hmm.
I was also curious on the U.S. and the discussions with those hospitals.
Mm-hmm.
We've seen quite mixed messages, in terms of capital allocations and also budget for, you know, hospital equipment. I was just gonna ask if you have noticed any change of tone from speaking with them, and then also if, you know, SGRT is seemingly a prioritized area that's, in case of cuts, is going to be more prioritized.
I think also, as I, as I, as we mentioned in the report, we can see the effect in the U.S., mainly by the cost increases and so on, and that is, you know, partly slowing down the pattern. We haven't really seen anything yet, but we see that in the discussions. Whereas it affects the actual SGRT purchasing or additions to the scope, we have not seen any indications of that either that that would be the effect.
Okay. Thank you. Then a last one on China. I know you mentioned that order intake was on the weak side.
Mm-hmm.
I'm hearing from other players that a state loan discount program in Q4 have been quite supportive for them. I haven't really seen any actual numbers come out of those companies. I was just wondering if we should interpret this as the situation would have been much worse, that, you know, China is doing worse than maybe the headline numbers here indicate if that loan discount program were a big support for you. Have you actually seen someone utilizing these discounts for your products, or are those, you know, mainly for larger products that they would use that for?
I'm not aware of any connection to our products. What I can say about the Chinese market in general, however, is that we have seen a slowdown during COVID, and it is now picking up as the country is opening up. I think in general, we have a positive outlook of China.
Okay. That's perfect. That's all the questions I had for you today. Thank you very much.
Thanks, Erik.
Thank you, Erik. Any other questions? Looks like that was actually all the questions we've had today, for today. Yep. Okay. Thank you very much, everyone, for joining today. We wish you all a wonderful day and week.
Thank you.