News Details

By John Vandermosten, CFA

NASDAQ: MDAI

READ THE FULL MDAI RESEARCH REPORT

Spectral AI, Inc. (NASDAQ: MDAI) reported first quarter 2026 results on May 12^th after the market close. Since the previous financial update about a month and a half ago, the company has appointed David McGuire as Chief Financial Officer (CFO), presented DeepView at the American Burn Association, and received the Small Business Innovator Award in Texas. CEO Vincent Capone also participated in a podcast discussing DeepView’s opportunities, where he identified some of the company’s long-term objectives.

During its earnings presentation, the company reaffirmed 2026 research and development revenue guidance of $18.5 million. The guidance excludes product revenues. Spectral believes there will be deployments inside and outside the United States in 2026. It plans to update its United Kingdom Conformity Assessed (UKCA) burn assessment mark approval to reflect improvements, which could lead to UK sales after the updated labeling. Back stateside, Spectral confirmed that a prototype handheld version of DeepView was delivered to MTEC for review. It expects that if the agency accepts the device, MTEC may award another grant in December 2026. The search for a Chief Commercial Officer continues, and we think that an appointment could be announced in the next month.

1Q:26 Financial and Operational Results

Spectral reported 1Q:26 results in a press release on May 12^th, followed by a conference call to discuss results with investors and take questions from analysts. A Form 10-Q was subsequently filed with the SEC. For the quarter ending March 31^st, 2026, Spectral recognized research and development revenues of $4.0 million. Net loss from operations was $2.0 million. For 1Q:26 versus the same, prior year period:

• Revenues of $4.0 million fell 40% from $6.7 million, reflecting a reduction in direct labor, clinical trial, and other reimbursed study costs related to the BARDA contract. This was partially offset by work on other contracts, including the Medical Technology Enterprise Consortium (MTEC) for the handheld device;
• Cost of revenue, which can be thought of as research and development expense, totaled $2.0 million, down 45% from $3.5 million due to decreased development activity. Gross margin rose 356 basis points to 50.8%, reflecting a higher concentration of direct labor as a percentage of the total work performed on the BARDA Project BioShield (PBS) Contract from the prior year;
• General & Administrative expenses were $4.0 million, down 2% from $4.1 million on overall cost reductions partially offset by an increase in public company infrastructure costs;
• Net interest expense was $258,000 compared to $20,000, with the increase related to the Avenue Capital financing and insurance policy financing;
• Other expense of $1.2 million was attributable to a change in fair value of warrants and the amortization of the discount on the Avenue notes payable;
• Income tax benefit was $10,000 vs. an expense of $71,000;
• Net loss was $3.4 million or $0.11 per share vs net income of $2.9 million and $0.15 per share.

As of March 31^st, 2026, cash totaled $11.7 million. This amount compares to the $15.4 million cash balance held at the end of 2025. Cash burn in the quarter was $3.7 million, and cash flow from financing was insignificant.

Addition of New CFO

David McGuire steps into the CFO role at Spectral following the elevation of Vincent Capone to CEO. A press release issued on April 8^th, 2026, announced David’s appointment. Mr. McGuire has 20 years of experience in finance and accounting roles. Prior to joining Spectral AI, he served as the Chief Accounting Officer of Solo Brands, a publicly traded consumer products company, where he was responsible for overseeing the accounting, financial reporting, internal controls, and tax functions, while also supporting broader finance and operational initiatives to scale its public company infrastructure.

He also served as Deputy CFO and Chief Accounting Officer of EZCORP, a multi-national, publicly traded provider of consumer retail transactions and consumer financial services, where he was responsible for financial operations and played a key role in capital markets activities and broader strategic initiatives. Mr. McGuire was a Managing Director at a professional services company where he built the firm’s Texas practice and advised growing companies on finance and accounting transformation. He began his career at Ernst & Young, where he assumed positions of increasing responsibility over a 14-year career. He holds a Bachelor of Business Administration and a Master’s in Professional Accounting from The University of Texas at Austin and is a Certified Public Accountant.

American Burn Association Annual Meeting

Spectral AI and its representatives attended the American Burn Association (ABA) Annual Meeting held in Orlando, Florida, from April 14^th to 17^th, 2026. This event brings together many of the most important leaders and stakeholders in the burn care education, research, and practice from around the world. Spectral brought along its DeepView System to display to attendees. Dr. Christopher Lewis, the lead investigator and author on evaluations of the device, also joined the conference. He provided a review of DeepView and real-world observations of its use in emergency practice. Spectral engaged with prospectively interested parties, including the military, during the conference. As a follow-up to this event, CEO Vince Capone noted that he would be attending the Institute of Strategic Research conference next month, which is heavily attended by Department of Defense representatives. This should provide another opportunity to share the DeepView device with interested parties.

As part of the meeting, Spectral offered several podium and poster presentations, which we list below:

Podium Presentations

• Evaluation of Triage Patterns of Burn-Injured Patients Using the BEACON Model (Dr. Taryn Travis).
• The First Reader Study of Burn Wounds with Predictive Artificial Intelligence Analysis (Dr. Alisa Savetamal)
• Artificial Intelligence - Enhanced Multispectral Imaging for Burn Wound Assessment: Pilot Evaluation of Complex Anatomical Sites (Dr. Shreyas Supparamaniam)
• Advancements in Burn Size Assessment: A Systematic Review of Emerging Technologies (Dr. Amy Woods)

Poster Presentations

• Exploring Patient Experiences of Decision-Making Around Skin Graft Surgery Using an AI Burn Assessment Tool (Dr. Zoe Gotts)
• Artificial Intelligence-Enhanced Multispectral Imaging for Burn Wound Assessment: A Multi-Centre UK Evaluation update (Dr. Leslie Tan)
• Usability of an Artificial Intelligence-Enhanced Multispectral Imaging Tool for Burn Assessment: A Retrospective Heuristic Evaluation (Dr. Hajar Abdulla)

Product Update

During the first quarter conference call, CEO Vince Capone guided towards a mid-year response from the FDA. In the meantime, the team will be focused on pre-commercialization activities. Despite the departure of the company’s Chief Commercial Officer earlier this year, Spectral is conducting a search to identify a new one. We think that an appointment could be announced in the near term.

In parallel, the company will engage Deloitte Consulting to help with the strategic plan for commercialization and expects sales inside and outside of the BARDA universe this year. Spectral plans to structure the implementations as multi-year contracts that provide for software upgrades, product licensing, and device maintenance. Spectral will receive help from the BARDA contract, which will fund device deployment.

SnapShot, a handheld version of DeepView, is undergoing additional testing for durability on the battlefield for the Department of Defense. The device offers civilian applications, and Spectral management is in discussions with authorities for its use in public settings such as ambulances. Management expects that regulatory clearance for SnapShot will follow the faster 510(k) pathway, relying on the DeepView device as a predicate. Spectral achieved a near-term milestone for SnapShot and delivered a fully functioning prototype of the handheld device in early May. The Medical Technology Enterprise Consortium (MTEC) will consider the device and application, and could grant another award by year end. For DeepView, further research and development work is expected, including a label expansion to image and diagnose burns on the head, hands, and feet. Spectral may also pursue a new indication, which may be in critical limb ischemia or amputations. Partnerships could also be developed for work in wound care.

Despite federal funding uncertainties, Spectral announced $31.7 million of BARDA funding that will accelerate the development of DeepView. The company will augment this funding with another $9.7 million to support additional features for the device.

Spectral AI CEO Podcast

Spectral AI CEO Vincent Capone discusses the key factors driving the value of the company. The conversation touches on the $32 million BARDA award, 2026 revenue guidance, the handheld device, and expectations for unit deployments assuming approval occurs in the next weeks. Follow the embedded link for the full episode.

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