What C4 Imaging does

C4 Imaging is a privately held Texas-based medical device company founded in 2010 by Dr. Steven J. Frank, a Professor of Radiation Oncology at MD Anderson Cancer Center. The company develops and commercializes non-metallic, MRI-visible fiducial markers designed to improve image-guided cancer treatment across proton therapy, external beam radiotherapy (EBRT), stereotactic body radiotherapy (SBRT), high-dose-rate (HDR) brachytherapy, and low-dose-rate (LDR) brachytherapy. Its proprietary materials platform, spanning composite and ceramic-based marker technologies, addresses image artifacts and dose perturbation caused by conventional metallic fiducials, enabling cleaner MRI-CT fusion and more precise tumor localization.

The product portfolio comprises three core lines: SIRIUS (the world's first positive-signal MRI marker for LDR prostate brachytherapy), ORION (high-clarity MRI markers for HDR brachytherapy in prostate and gynecological cancers), and NOVA (non-metallic markers for EBRT and proton therapy, available in NOVA MR for MRI-based planning and the newly launched NOVA Z for CT workflows). C4 Imaging sells through direct enterprise engagement with hospitals and cancer centers, supplemented by seed-provider distribution for SIRIUS. Pricing is quote-based and not publicly disclosed, and the company is privately held with cumulative disclosed funding of approximately $8.67M across multiple exempt offerings.

Operationally, the company is small (1-10 employees), U.S.-only, and founder-led, with named reference customers including Houston Methodist Hospital, MD Anderson Cancer Center, and Callaway-Young Cancer Center Valley View. Its go-to-market relies heavily on peer endorsements from leading radiation oncologists, clinical publications, reimbursement guides, and industry conference participation. The competitive position is anchored by FDA-cleared, clinically validated materials technology rather than software or AI capabilities.

Name

C4 Imaging

Legal name

C4 Imaging, LLC

Website

https://c4imaging.com

Company type

Private

Founded year

2010

Operating status

Operating

Headcount range

1–10 employees

Short description

C4 Imaging is a Texas-based medical device company developing non-metallic, MRI-visible fiducial markers (NOVA, ORION, SIRIUS) that enable precise image-guided proton therapy, brachytherapy, and radiotherapy for cancer treatment at hospitals and cancer centers.

Ownership category

akta.pro rank

Product category

Radiation Oncology Medical Devices

NAICS

Surgical and Medical Instrument Manufacturing (339112), Medical Equipment and Supplies Manufacturing (3391)

SIC

Surgical & Medical Instruments & Apparatus (3841)

akta.pro primary industry

Radiation Therapy Planning & Simulation Imaging (CT Sim/MR Sim) (HLAHABAH)

Keywords

• MRI fiducial markers
• Radiation oncology devices
• Image-guided brachytherapy
• Proton therapy markers
• Cancer treatment imaging

Headquarters

HQ city

Bellaire

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Hardware or Manufacturing

Cost components

Technology or R&D, Supply Chain, Marketing or Sales, Operations, Personnel

Revenue model

1. Medical Device Sales: Sale of MRI-visible fiducial markers (NOVA, ORION, SIRIUS) to hospitals, cancer treatment centers, and radiation oncology departments. Products are sold through direct engagement with healthcare providers and clinical support staff.

Pricing tiers

Go-to-market motion1 record

Distribution channels2 records

Marketing channels8 records

Core offering

C4 Imaging develops and sells MRI-visible fiducial markers used by radiation oncologists and cancer treatment centers to localize tumors and verify treatment delivery in proton therapy, external beam radiotherapy, stereotactic body radiotherapy, and HDR/LDR brachytherapy procedures. Its non-metallic composite and ceramic markers (NOVA, ORION, SIRIUS) provide positive MRI signal without metallic artifacts, enabling precise MRI-CT fusion treatment planning.

Product overview

C4 Imaging is a medical device company offering a portfolio of MRI-visible fiducial markers for cancer treatment. The product family includes three core offerings: NOVA (available in MR and Z variants) for Proton Therapy, Radiotherapy, and image-guided surgery; ORION for HDR Brachytherapy in Prostate and GYN cancers; and SIRIUS for LDR Brachytherapy in prostate cancer. All products are non-metallic markers designed to reduce imaging artifacts and improve treatment precision.

Differentiator

Problem solved

Functional benefit

Brands

• NOVA: Non-metallic fiducial markers designed for accurate targeting in Proton Therapy, Radiotherapy, and image-guided Surgical procedures. Available in NOVA MR (MRI-based planning) and NOVA Z (CT workflows) variants.
• ORION
• SIRIUS

Products and services

• NOVA Non-metallic fiducial markers designed for accurate targeting in proton therapy, radiotherapy, and image-guided surgical procedures for tumor localization and treatment planning. Available in NOVA MR (MRI-based planning) and NOVA Z (CT-based workflow) variants.
• ORION High-clarity MRI markers built for precise applicator and interstitial needle visualization in HDR brachytherapy for prostate and GYN cancers, enabling catheter localization and dwell position verification without CT fusion.
• SIRIUS MRI-visible LDR brachytherapy marker for prostate cancer providing positive MRI signal for seed localization and post-implant dosimetry verification, eliminating uncertainty of CT dosimetry.
• Nova Z Fiducial Marker Non-metallic fiducial marker designed to improve cancer treatment precision in proton beam therapy, reducing MRI artifacts and enhancing image co-registration for radiotherapy planning; CT-workflow variant of the NOVA product family.

Quantifiable outcome

• Eliminates CT streak artifacts and MRI susceptibility artifacts
• +2 more outcomes

Named customers3 records

Segments3 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature5 records

Scale indicators2 records

Recent moves5 records

Expansion highlights5 records

Direct peers

• CIVCO Medical Solutions: CIVCO manufactures patient positioning, immobilization, and fiducial-related accessories for radiation oncology and image-guided procedures. It is directly comparable to C4 Imaging as a radiotherapy accessory vendor targeting the same radiation oncology customers.
• Theragenics: Theragenics manufactures brachytherapy seeds and accessories, including for prostate LDR procedures. It directly competes with C4 Imaging's SIRIUS product line within LDR prostate brachytherapy, often co-distributed through seed providers.
• IsoRay Medical: IsoRay produces Cesium-131 and other brachytherapy seeds used in prostate and other cancers. It is a direct peer in the LDR brachytherapy seed and marker supply chain where C4 Imaging's SIRIUS operates.
• Best Medical International: Best Medical International supplies brachytherapy seeds, accessories, and afterloader-related products used in prostate and gynecological brachytherapy. It is a direct competitor to C4 Imaging in the brachytherapy consumables and accessory category.

Broad incumbents

• Elekta: Elekta is a global leader in radiation therapy and radiosurgery systems (linacs, brachytherapy afterloaders, treatment planning). It is a broad incumbent serving the same radiation oncology departments as C4 Imaging, though its scope is systems-level rather than consumables.
• Varian Medical Systems (Siemens Healthineers): Varian, now part of Siemens Healthineers, supplies linear accelerators, brachytherapy afterloaders, and oncology treatment software. It serves the same radiation oncology buyers as C4 Imaging and competes indirectly through its installed base of treatment planning workflows.
• Brainlab: Brainlab provides image-guided surgery, radiosurgery, and radiation oncology software and hardware. It serves the same multidisciplinary oncology teams and overlaps with C4 Imaging's image-guided surgical and radiotherapy workflows.

Emerging players

• CivaTech Oncology: CivaTech develops polymer-based brachytherapy devices, including the CivaDot and CivaSheet, focused on directional and surface brachytherapy. It is an emerging player in novel brachytherapy technologies comparable to C4 Imaging's ORION HDR offering.
• Beokwell/Nanovi (radiotherapy fiducials): Nanovi develops bioXmark, a liquid fiducial marker for image-guided radiotherapy, including MRI visibility. It is an emerging player with a non-metallic, image-visible fiducial comparable to C4 Imaging's NOVA family targeting the same image-guided radiotherapy workflow.
• Medspira: Medspira develops endoscopy and brachytherapy-related medical devices, including products for image-guided procedures. It is an emerging player in image-guided and procedural oncology devices with partial overlap to C4 Imaging's interventional radiology and radiotherapy workflows.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat3 records

Key risks7 records

Key highlights6 records

Customer concentration

• Xx.com/C4_ImagingLLC
• Facebookfacebook.com/siriusmri
• LinkedInlinkedin.com/company/c4-imaging

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds6 records

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about C4 Imaging