Median Technologies is a high-risk, high-upside medical AI inflection story: a stable iCRO backlog funds the bridge while FDA-cleared eyonis® LCS attempts to transform the company into a scalable diagnostic software platform.
Median Technologies SA is a medical imaging software developer leveraging proprietary artificial intelligence (AI), computer vision, and signal processing technologies to extract clinically actionable biomarkers from medical scans.[1] The company operates in two primary business segments: its legacy imaging Contract Research Organization (iCRO) business unit and its emerging eyonis® (formerly known as iBiopsy®) Software as a Medical Device (SaMD) precision diagnostics portfolio.[2, 3] The iCRO segment provides central imaging services to manage and analyze medical images in clinical trials, helping biopharmaceutical sponsors standardize imaging endpoints, optimize trial workflows, and objectively assess drug efficacy in oncology studies.[1, 2, 4] Eyonis® is a clinical suite of AI- and machine learning-powered diagnostic applications focused on early-stage cancer detection, led by its flagship eyonis® Lung Cancer Screening (LCS) software.[3, 5]
The company currently generates 100% of its revenues through the iCRO division.[4] This unit monetizes multi-year service contracts with biopharmaceutical sponsors to standardize imaging data across more than 2,500 clinical sites and healthcare institutions globally.[1, 4, 6] While revenues are currently service-based, the commercial deployment of eyonis® LCS is projected to transition the company’s financial profile toward highly scalable SaaS licensing and revenue-sharing models.[3, 4] Geographically, the company is globally diversified, operating in North America, Europe, and Asia.[1] North America remains the primary driver of the company's recent record-high booking activity, while China represents an increasingly critical footprint where Median continues to expand its clinical trial market share.[7]
Median's primary customer base spans two distinct profiles. The iCRO segment sells directly to global biopharmaceutical companies—deepening relationships with top-3 and top-10 oncology pharmaceutical sponsors—and emerging biotechnology organizations.[4, 7] Conversely, the eyonis® segment targets clinical end-users, including hospital imaging networks, outpatient imaging centers, and multidisciplinary thoracic oncology clinical teams.[5, 8] The most critical end markets are oncology therapeutic drug development and large-scale public health screening initiatives, particularly lung cancer screening programs.[5, 9]
Biopharma sponsors select Median’s iCRO services over traditional contract research alternatives due to its highly differentiated, AI-enabled central imaging technology and proven operational execution across complex, global multi-site trials.[1, 7, 10] In the diagnostic space, clinical providers choose eyonis® LCS because it represents the only FDA-cleared CADe/CADx software capable of simultaneously detecting and characterizing parenchymal pulmonary nodules from a single low-dose CT (LDCT) scan without adding disruptive steps to the existing radiology workflow.[5, 11] The clinical utility is further validated by a manufacturer-reported sensitivity of 93.3%, specificity of 92.4%, and an exceptional 99.9% Negative Predictive Value (NPV).[5] This clinically high NPV minimizes the occurrence of false positives (only 1 per 1,000 scans), providing clinical teams with the diagnostic confidence to avoid costly, invasive follow-up diagnostic procedures such as biopsies.[5, 12]
Median Technologies commercializes its clinical expertise through two distinct product platforms [3, 13]:
Median's competitive advantage is built on high customer switching costs, regulatory barriers, and distribution alliances:
The macro opportunity is driven by the rapid growth of the oncology imaging AI market, which is projected to expand from $604.7 million in 2023 to $7.74 billion by 2032, representing a compound annual growth rate (CAGR) of 32.7%.[9] This rapid growth reflects a structural shift as AI transitions from an experimental budget item to an operational necessity in clinical workflows.[9, 17]
The addressable market for eyonis® LCS is exceptionally large:
| Market Metric | U.S. Opportunity Details | Source |
|---|---|---|
| Eligible Screening Population | 14.5 Million individuals meeting USPSTF criteria (ages 50–80 with 20-pack-year history) | [5] |
| Reimbursement Code Framework | Category III CPT codes 0721T and 0722T under New Tech APC 1508 | [5] |
| Reimbursement Payment Range | $601 to $700 per scan paid by Medicare | [5] |
| Operational Catalyst | Severe nationwide shortage of radiologists managing rising screening volumes | [5] |
The oncology imaging and diagnostic AI market is highly competitive and fragmented across multiple product clusters.[9, 17] Within the clinical trial imaging services segment, Median competes with established, specialized software providers and imaging CROs, including Bracco, Guerbet, and Quibim, which use quantitative AI to standardize endpoints.[9, 17] Median has held its ground in this segment, as evidenced by its expanding iCRO backlog, which grew to €79.8 million by March 31, 2026, driven by market share gains with top-tier pharmaceutical companies, particularly in the United States and China.[4, 7, 10]
In the lung cancer diagnostic software market, Median competes against several venture-backed and pure-play AI vendors, including:
Despite this competition, Median’s eyonis® LCS is well-positioned.[5] Most competitors provide separate CADe tools (detection only) or CADx tools (characterization only) that require manual intervention.[11] In contrast, eyonis® LCS is the only software cleared to perform both detection and characterization within a single, end-to-end diagnostic workflow, minimizing clinical friction.[3, 5]
COMPETITIVE ADVANTAGE SECURED
On April 23, 2026, Median Technologies announced its audited consolidated financial results for the fiscal year ended December 31, 2025, alongside key operational and financial updates for the first quarter ended March 31, 2026.[4, 10]
The financial results across key metrics are summarized in the table below:
| Audited Financial Metrics (IFRS) | FY 2024 | FY 2025 | YoY Change (%) | Q1 2026 (Unaudited) |
|---|---|---|---|---|
| Revenue | €22.95M | €23.36M | +1.8% | €5.80M |
| Order Backlog | €66.90M | €76.60M | +14.5% | €79.80M |
| Operating Loss | -€22.53M | -€16.27M | +27.8% (Narrowed) | N/A |
| Staff Costs | -€23.81M | -€19.74M | -17.1% (Decreased) | N/A |
| External Costs | -€20.21M | -€17.28M | -14.5% (Decreased) | N/A |
| Operating Cash Outflow | -€18.91M | -€14.73M | +22.1% (Improved) | N/A |
| Cash & Cash Equivalents | €8.13M | €18.21M | +124.0% | €14.00M |
At constant exchange rates, FY 2025 revenue stood at €24.3 million (up 2.6% year-over-year) and the year-end backlog reached €83.1 million, reflecting a negative foreign exchange impact of €6.5 million on the backlog and €0.8 million on annual revenues.[14, 15]
Median’s financial performance demonstrates disciplined execution.[10] Operating losses narrowed by 28% year-over-year, from €22.53 million in FY 2024 to €16.27 million in FY 2025.[4] This was driven by a €4.1 million reduction in staff costs and a €2.9 million reduction in external costs, reflecting operational efficiencies and automation implemented in late 2024.[4, 14] Operating cash burn also improved, declining from €18.91 million in FY 2024 to €14.73 million in FY 2025.[4]
While sell-side analyst consensus quarterly estimates are not formally reported for Q1 2026, the results met internal expectations, with the iCRO backlog reaching a record €79.8 million.[10] Operating guidance for fiscal year 2026 was reaffirmed: management expects accelerated revenue growth and continued profitability improvement for the iCRO business, driven by higher-value imaging technology and organizational automation.[14, 15] For the eyonis® division, the commercialization timeline remains on schedule, with the first U.S. clinical sites expected to be operational in Q3 2026 and initial diagnostic revenues expected by late 2026.[10, 21]
Two highly significant events occurred in early 2026:
The offering resulted in the issuance of 10,000,000 new shares plus 480,000 shares allocated to the underwriters as a commission fee, increasing the outstanding share count from 38,202,387 to 48,682,387 shares.[24] This capital increase successfully extended the company's cash runway to the first half of 2028 (and potentially to mid-2029 if the remaining 12 million warrants issued in 2025 are fully exercised at €2.39 per share, generating up to €44.3 million in additional proceeds).[24] However, the dilutive impact of this transaction caused short-term stock pressure, with shares settling to approximately €4.80.[26] Stifel subsequently trimmed its target price to €14.00 (down from €17.00) to account for the expanded share base, while maintaining its positive outlook.[27]
Median Technologies currently trades at an Enterprise Value to LTM Sales multiple of approximately 7.8x to 10.0x.[6, 22] This premium valuation reflects the software optionality of the eyonis® suite rather than the legacy iCRO services division. To assess the core drivers of valuation, the historical 5-year sales growth from the fiscal year ended December 31, 2020, to the fiscal year ended December 31, 2025, must be examined:
$\text{5-Year CAGR} = \left( \frac{\text{Revenue}{\text{FY2025}}}{\text{Revenue}$}}} \right)^{\frac{1}{5}} - 1 = \left( \frac{23.359}{13.591} \right)^{0.2} - 1 \approx 11.44\% \quad \text{[4, 28]
While an 11.4% historical revenue growth rate is modest for a high-growth technology company, it represents a stable services-based foundation. Moving forward, the key financial driver that will determine Median’s valuation is the operating leverage generated by the transition to software licensing. The iCRO business carries significant human resource overhead, yielding lower margins.[4] Conversely, the eyonis® model leverages cloud-based PACS distribution through Tempus AI, where additional scan volumes carry near-zero marginal cost.[3] If the company successfully converts 2% of the eligible U.S. screening population over the next five years, the high-margin recurring software revenues will drive significant expansion in operating margins and net income, justifying a higher valuation.
VALUATION DRIVERS INFLECTING
The near-term investment thesis relies heavily on the commercial rollout of eyonis® LCS in the United States, scheduled for Q3 2026.[8, 10] Execution risks include potential delays in clinical site onboarding, slow PACS integration within major hospital networks, and friction in radiologist training and adoption. If clinical sites are not successfully activated by Q3 2026, or if initial revenue generation is delayed past the end of 2026, the market may lose confidence in management's commercial capabilities.[10, 21]
The medical imaging AI space is highly competitive, with established healthcare technology conglomerates and agile, venture-backed players vying for clinical market share.[9, 17] Competitors like RevealDX, which obtained FDA clearance for its CADx tool in February 2026, and Optellum represent direct threats in the pulmonary nodule risk assessment market.[18, 19] If these competitors secure exclusive distribution agreements with major imaging networks or outpace Median in clinical relationship-building, Median's market penetration could be constrained.
The iCRO segment relies on clinical trial budgets from global biopharmaceutical companies and emerging biotechnology organizations.[4, 7] Clinical research budgets are highly cyclical and sensitive to broader funding conditions. A slowdown in oncology clinical trial starts or a structural shift in biopharma R&D capital allocation could result in cancellations or delays in backlog conversion, directly impacting near-term revenue visibility.[10] For the eyonis® segment, demand is dependent on public health screening compliance. If lung cancer screening rates remain low, the addressable market will be structurally constrained.[16]
While Median has secured FDA 510(k) clearance for eyonis® LCS, the European regulatory decision for CE marking remains pending (anticipated in Q2 2026).[5, 14] Any delays in achieving CE marking would defer European commercialization efforts.[10] Additionally, because eyonis® LCS operates as a CADe/CADx diagnostic tool, any future product liability claims arising from missed diagnoses (false negatives) or unnecessary surgical interventions (false positives) could lead to costly litigation, reputational damage, and potential regulatory intervention.
Historically, Median has operated with high cash consumption, with cash outflows from operating activities of €14.73 million in FY 2025 and €18.91 million in FY 2024.[4] Although the €50 million capital raise completed in June 2026 secures the runway through H1 2028, the transaction resulted in a dilutive event for existing shareholders, increasing the share count by roughly 27%.[24] If the cash burn is not checked by organic software revenues, the company may be forced to execute further dilutive capital increases or draw down expensive debt facilities, eroding long-term shareholder value.[24]
The diagnostic imaging industry is characterized by complex, fragmented sales cycles and a high reliance on third-party software platforms.[9] Median's commercial model is highly dependent on its distribution agreement with Tempus AI and the integration of eyonis® LCS into the Tempus Pixel platform.[3] This structure exposes Median to platform dependency risk. If Tempus AI alters the revenue-sharing agreement terms or shifts its strategic focus to internal imaging algorithms, Median’s primary U.S. commercial channel could be compromised.[3]
Median is sensitive to foreign exchange fluctuations, particularly between the Euro and the U.S. Dollar. In FY 2025, the company suffered a negative foreign exchange impact of €6.5 million on its order backlog and €0.8 million on annual revenues.[14, 15] Additionally, macroeconomic environments characterized by high interest rates can compress biotechnology venture capital funding, indirectly reducing trial bookings for the iCRO segment as early-stage biotech sponsors scale back their clinical pipelines.
The risk profile can be categorized across distinct horizons:
* Near-Term Disruptions (What could go wrong): A delay in securing the CE marking for eyonis® LCS past Q2 2026, or technical friction during early U.S. site integrations in Q3 2026.[10, 14]
* Early Warning Signs: A flat or declining iCRO backlog over consecutive quarters, a slowdown in the exercise of the outstanding 2025 warrants, or a slow ramp-up in commercial site activation announcements with Tempus AI.[3, 4, 10]
* Severe Long-Term Damage: Stagnant clinical adoption of eyonis® LCS in the United States despite established reimbursement and distribution agreements, forcing Median to remain a lower-margin, services-based iCRO business while carrying a heavily diluted capital structure.[4, 24]
OPERATIONAL RISK ANALYSIS
To model potential outcomes for Median Technologies SA over a 5-year investment horizon (FY2026 to FY2031), three detailed operating scenarios have been constructed.
These scenarios are calculated using the current post-offering capital structure:
* Current Share Price: €4.80.[26]
* Post-Offering Non-Diluted Share Count: 48,682,387 shares.[24]
* Outstanding 2025 Warrants: 12,379,615 warrants exercisable at €3.58 per share (gross proceeds of €44.4M), expiring January 31, 2028.[4, 10]
In this scenario, eyonis® LCS achieves rapid, high-impact clinical adoption in the United States and Europe:
* Operating Performance: Driven by the Tempus AI partnership, eyonis® LCS captures a 3.0% penetration rate of the 14.5 million eligible U.S. screening population by Year 5, generating 435,000 scans annually.[3, 5] At a net revenue-share to Median of approximately $100 per scan (out of the $650 Medicare reimbursement), the U.S. diagnostic business generates €43.5 million.[5] European operations and adjacent indications (IPN, HCC) contribute €31.5 million.[14] The iCRO segment converts its record backlog and expands into CNS/MSK trials, reaching €55.0 million in annual revenues.[10]
* Financial Assumptions: Total Year 5 Revenue reaches €130.0 million. Due to the high mix of SaaS-like software licensing, operating leverage drives a 25% Net Income margin, yielding Net Income of €32.50 million.
* Valuation & Share Count: The high growth profile and SaaS revenue mix support an exit P/E multiple of 30.0x. It is assumed that all 12,379,615 outstanding warrants are fully exercised, generating €44.4 million in additional cash and increasing the share count to 61,062,002 shares.[10] The implied Equity Value is calculated as follows:
$\text{Equity Value} = \text{Net Income} \times \text{P/E Multiple} = \text{€32.50M} \times 30.0 = \text{€975.0M}$
$\text{Implied Future Share Price} = \frac{\text{€975.0M}}{\text{61.06M shares}} \approx \text{€15.97}$
In this scenario, the company executes steadily on its core strategic plans:
* Operating Performance: Under steady commercialization, eyonis® LCS captures a 1.2% penetration rate of the U.S. eligible screening population by Year 5, generating 174,000 scans annually.[5] At a net revenue-share of $80 per scan, the U.S. business generates €13.9 million.[5] European and alternative clinical indications contribute €16.1 million.[14] The iCRO division maintains stable growth, translating its backlog to achieve €50.0 million in Year 5 revenue.[10]
* Financial Assumptions: Total Year 5 Revenue reaches €80.0 million. Net Income margins improve to a healthy 18%, yielding Net Income of €14.40 million.
* Valuation & Share Count: The business trades at a hybrid software/services exit P/E multiple of 25.0x. It is assumed that only half of the outstanding warrants are exercised, increasing the outstanding share count to 54,872,194 shares.[10] The implied Equity Value is calculated as follows:
$\text{Equity Value} = \text{Net Income} \times \text{P/E Multiple} = \text{€14.40M} \times 25.0 = \text{€360.0M}$
$\text{Implied Future Share Price} = \frac{\text{€360.0M}}{\text{54.87M shares}} \approx \text{€6.56}$
In this scenario, eyonis® LCS fails to achieve meaningful clinical traction:
* Operating Performance: Due to severe execution friction and competitive pressures from RevealDX, eyonis® LCS fails to scale, generating only €5.0 million in annual revenues.[18] The iCRO segment remains the sole viable business unit, but growth slows due to biopharma R&D funding cuts, leaving Year 5 iCRO revenue flat at €25.0 million.[4, 7]
* Financial Assumptions: Total Year 5 Revenue stands at €30.0 million. The company remains unable to achieve sustainable profitability, recording a net margin of -10% (loss of €3.0 million).
* Valuation & Share Count: With the loss of its software growth thesis, the company is valued solely as a service CRO at a depressed exit multiple of 1.0x EV/Sales, representing an Enterprise Value of €30.0 million. Net cash on the balance sheet is estimated at €15.0 million. The share count remains non-diluted at 48,682,387 shares as the warrants expire out-of-the-money.[24] The implied Equity Value is calculated as follows:
$\text{Equity Value} = \text{EV} + \text{Net Cash} = \text{€30.0M} + \text{€15.0M} = \text{€45.0M}$
$\text{Implied Future Share Price} = \frac{\text{€45.0M}}{\text{48.68M shares}} \approx \text{€0.92}$
The table below represents the estimated share price trajectories (in EUR) from Year 0 (Current) to Year 5:
| Year / Scenario | Year 0 | Year 1 | Year 2 | Year 3 | Year 4 | Year 5 (Exit) |
|---|---|---|---|---|---|---|
| High Case | €4.80 | €6.00 | €8.00 | €10.50 | €13.00 | €15.97 |
| Base Case | €4.80 | €5.10 | €5.45 | €5.80 | €6.15 | €6.56 |
| Low Case | €4.80 | €3.80 | €2.80 | €1.90 | €1.30 | €0.92 |
The structured outputs of the 5-year scenario analysis are summarized in the table below:
| Scenario | Year 5 Revenue | Margin / Earnings Assumption | Valuation Multiple Assumption | Current Share Price | Implied Future Share Price | 5-Year Total Return | Annualized Return | Subjective Probability |
|---|---|---|---|---|---|---|---|---|
| High Case | €130.0M | 25.0% Net Margin (Net Income: €32.50M) | 30.0x exit P/E | €4.80 | €15.97 | +232.7% | +27.2% | 30% |
| Base Case | €80.0M | 18.0% Net Margin (Net Income: €14.40M) | 25.0x exit P/E | €4.80 | €6.56 | +36.7% | +6.5% | 50% |
| Low Case | €30.0M | -10.0% Net Margin (Net Loss: €3.00M) | 1.0x exit EV/Sales | €4.80 | €0.92 | -80.8% | -28.3% | 20% |
| Weighted | €85.0M | N/A | N/A | €4.80 | €8.26 | +72.1% | +11.5% | 100% |
ASYMMETRIC GROWTH OPTIONALITY
To evaluate the non-financial and structural health of Median Technologies, a qualitative scorecard has been compiled with scores assigned on a scale of 1 to 10. Note: The following scores and analysis are for qualitative benchmarking purposes only and do not constitute financial advice or investment recommendations.
The company is led by its founder and CEO, Fredrik Brag, who has been at the helm for over 24 years.[29] This longevity ensures a deeply rooted strategic vision. Insider holdings are high: Ann-Helene & Fredrik Ljungström retain a 10.7% stake post-offering, establishing strong family and insider alignment.[24] The board of directors has also been strengthened by the addition of Didric Cederholm, Founding Partner of Lion Point Capital, aligning management decisions with major institutional shareholders.[22]
Currently, the quality of revenue is moderate, as it is 100% derived from professional service contracts within the iCRO division.[4] While the backlog of €79.8 million is at an all-time high and provides several years of clear visibility, services-based revenue requires significant human headcount and is slow to convert.[4, 10] This score will increase to 9/10 once recurring software licensing from the eyonis® suite begins to dominate the revenue mix.[3]
Median holds a strong position in its niche.[5] It is a pioneer in end-to-end CADe/CADx diagnostics, and eyonis® LCS is the only cleared device capable of simultaneously detecting and characterizing nodules in a single workflow.[5, 11] The company maintains strong relationships with top-10 biopharma sponsors in the iCRO segment, giving it solid institutional credibility.[7]
The growth outlook is highly attractive.[5, 9] The U.S. lung screening market features an underserved TAM of 14.5 million eligible patients, and the broader oncology imaging AI sector is growing at a 32.7% CAGR.[5, 9] The Tempus AI partnership provides the necessary distribution infrastructure to capture this growth.[3]
The company’s financial health has been shunted up significantly by the €50 million gross proceeds raised in the oversubscribed June 2026 capital increase.[24] This capital cushion extends the cash runway through H1 2028, removing near-term insolvency risks.[24] However, the legacy cash burn rate from operating activities remains high and requires careful management.[4]
The operational durability of the iCRO division is excellent, supported by structural automation and expansion into CNS/MSK indications.[10, 14] However, the diagnostic segment has a high dependency on the Tempus Pixel platform for distribution and the longevity of the Medicare NT-APC 1508 reimbursement code, which presents potential structural choke points.[3, 5]
Management has successfully directed capital toward high-value R&D, converting clinical pipelines into FDA-cleared products.[5] However, the funding of these operations has historically relied on highly dilutive equity offerings and warrant issuances, which has significantly expanded the share count and diluted long-term equity holders.[24, 30]
Sell-side sentiment is bullish.[26] Stifel, Midcap, and Portzamparc maintain active coverage, with price targets ranging from €12.00 to €14.00, representing significant upside from current trading levels.[2, 26, 27] Stifel's recent target of €14.00 highlights robust analyst conviction despite the dilutive capital raise.[27]
Profitability is currently weak.[4] The company reported an operating loss of €16.27 million in FY 2025 and is not expected to reach net profitability until eyonis® software revenue achieves scale.[4, 10] However, the 28% year-over-year reduction in operating losses demonstrates progress in cost discipline.[4]
Since its listing on Euronext Growth, Median has a long history of accumulated deficits and frequent capital raises to sustain operations.[28, 30] While the clinical accomplishments are outstanding, the financial track record has been characterized by cash consumption rather than consistent shareholder value creation.[4, 28]
On a blended basis, Median Technologies SA receives a score of 6.7 / 10. This score reflects a fundamentally strong medical technology business possessing high-value, FDA-cleared clinical software and a solid cash runway, balanced against a legacy of unprofitability, high historical dilution, and execution risks as it embarks on its commercial phase.
TRANSFORMATION IN PROGRESS
The investment case for Median Technologies SA is at a major inflection point, transitioning from a clinical research software services provider into a high-growth diagnostic AI software platform.[4, 5] The structural thesis is supported by three primary catalysts:
* De-Risked Commercial Runway: Securing FDA 510(k) clearance for eyonis® LCS, activating the Tempus AI distribution agreement, and establishing Medicare NT-APC reimbursement removes the primary regulatory and structural hurdles to commercializing the software in the United States.[3, 5]
* Capital Runway Secured: The successful, oversubscribed €50 million capital raise completed on June 3, 2026, secures the company's capital needs through the first half of 2028, eliminating financing concerns during the critical commercial launch phase.[24]
* Stable Core Backlog: The legacy iCRO division enters 2026 with a record-high order backlog of €79.8 million, providing a stable, defensive baseline of service revenues while the diagnostic segment scales.[4, 10]
However, key structural risks remain, including execution friction in hospital PACS integrations, the pending CE marking approval for European expansion, and the long-term risk of further dilution if software revenues fail to ramp up.[8, 14, 24] On balance, the company presents an asymmetric risk-reward profile, where the underlying intellectual property and commercial partnerships provide substantial growth optionality that is not fully reflected in the current compressed equity valuation. Note: This analysis is for educational and benchmarking purposes only and does not constitute a recommendation, financial advice, or a solicitation to buy or sell securities.
INFLECTION POINT REACHED
From a technical perspective, Median Technologies (ALMDT.PA) is trading at approximately €4.80, positioning the shares roughly 16.5% above their 200-day moving average.[26] This indicates a constructive, medium-term upward trend following the structural de-risking of the business in early 2026.[5, 26] In the short term, the stock is consolidating within a defined trading range as the market absorbs the dilutive impact of the 10.48 million new shares issued in the June 2026 capital raise.[24] The short-term outlook is expected to remain range-bound until the company announces its first operational U.S. clinical site activations in Q3 2026 and receives its CE marking decision in Europe, both of which serve as major near-term technical catalysts.[10]
MOMENTUM CONSOLIDATING
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