Akumin Inc (AKU) 2023 Q1 法說會逐字稿

Good morning. My name is Laura, and I will be your conference operator today. At this time, I would like to welcome everyone to Akumin Inc.'s 2023 first-quarter results research analyst call. (Operator Instructions) Mr. Zine, you may begin your conference.

早上好。我叫勞拉，今天我將擔任你們的會議操作員。此時，我歡迎大家參加 Akumin Inc. 2023 年第一季度業績研究分析師電話會議。 （操作員指示） Zine 先生，您可以開始會議了。

Thank you. Good morning, everyone, and thank you for joining us for today's presentation. My name is Riadh Zine, and I'm the Chairman and CEO of Akumin. I'm joined today by David Kretschmer, our Chief Financial Officer. I want to thank all of you for taking the time to join us on this call.

謝謝。大家早上好，感謝您參加我們今天的演講。我叫 Riadh Zine，是 Akumin 的董事長兼首席執行官。今天我們的首席財務官 David Kretschmer 也加入了我的行列。我要感謝大家抽出時間參加我們的這次電話會議。

In today's call, I will provide an overview of Akumin's Q1 results and discuss some of the factors that impacted our results in the first quarter. I will also review our recent progress regarding our key transformation and growth initiatives. David will go over some of our key operating and financial metrics. I will then conclude the presentation and then we'll proceed to Q&A. There's a slide deck that is meant to go along with our presentation today. A copy of it is available for download from the investor relations section of our website at akumin.com under events presentations.

在今天的電話會議中，我將概述 Akumin 第一季度的業績，並討論影響我們第一季度業績的一些因素。我還將回顧我們最近在關鍵轉型和增長舉措方面取得的進展。大衛將回顧我們的一些關鍵運營和財務指標。然後我將結束演示，然後我們將進行問答。有一個幻燈片是為了配合我們今天的演示而設計的。您可以從我們網站 akumin.com 的投資者關係部分的活動演示下下載該文件的副本。

Before we begin, let me remind you that certain matters discussed in today's conference call or answers that may be given to questions asked could constitute forward-looking statements or information that are subject to risks or uncertainties relating to Akumin's future financial and business performance. Actual results could differ materially from those anticipated in these forward-looking statements. Please refer to the disclaimer at slide 2 of our presentation as well as the full forward-looking statements section of our earnings press release.

在我們開始之前，讓我提醒您，今天電話會議中討論的某些事項或可能對提出的問題作出的回答可能構成前瞻性陳述或信息，這些陳述或信息受到與 Akumin 未來財務和業務業績相關的風險或不確定性的影響。實際結果可能與這些前瞻性陳述中的預期存在重大差異。請參閱我們演示文稿第 2 幻燈片中的免責聲明以及我們收益新聞稿的完整前瞻性陳述部分。

The risk factors that may affect results and these forward-looking statements are detailed Akumin's periodic results and public disclosure. These documents can be accessed under our public disclosure at sec.gov and sedar.com. You may also refer to certain non-GAAP measures during this conference call, such as EBITDA, adjusted EBITDA, and adjusted EBITDA margin. You can find information regarding these non-GAAP measures, including definitions again, on slide 2 of our presentation, as well as the non-GAAP measures section of our earnings release. A reconciliation of EBITDA and adjusted EBITDA to net loss, the most comparable GAAP measure, is included in the presentation as an appendix.

可能影響結果和這些前瞻性陳述的風險因素詳細介紹了 Akumin 的定期結果和公開披露。這些文件可通過我們在 sec.gov 和 sedar.com 上公開披露的內容獲取。您還可以在本次電話會議期間參考某些非 GAAP 指標，例如 EBITDA、調整後 EBITDA 和調整後 EBITDA 利潤率。您可以在我們演示文稿的幻燈片 2 以及我們收益發布的非 GAAP 衡量標準部分找到有關這些非 GAAP 衡量標準的信息，包括再次定義。 EBITDA 和調整後 EBITDA 與淨虧損（最具可比性的 GAAP 衡量標準）的調節表作為附錄包含在演示文稿中。

We have not provided a reconciliation for any forward-looking non-GAAP measure referred to in this presentation as we would not be able to produce such a reconciliation without unreasonable efforts.

我們尚未提供本演示文稿中提到的任何前瞻性非公認會計原則措施的調節表，因為如果沒有不合理的努力，我們將無法進行此類調節。

Turning to our Q1 results. On slide 3, you can see the same-store consolidated volume growth in our key radiology services and our patient starts in our oncology segment versus our results in Q1 on 2022. Specifically, our MRI volumes were up 4%, which reflected strong demand for MRI procedures and alleviation of some of the clinical staff shortages that persisted in prior quarters.

轉向我們第一季度的業績。在幻燈片 3 上，您可以看到我們的主要放射學服務的同店綜合銷量增長，以及我們的患者開始進入我們的腫瘤學領域，與 2022 年第一季度的結果相比。具體來說，我們的 MRI 銷量增長了 4%，這反映出對MRI 程序並緩解了前幾個季度持續存在的一些臨床人員短缺問題。

Our PET/CT volumes were up an impressive 16.1%, a strong demand, particularly from our hospital partners, continued for that modality. Total oncology patient starts were up 7.6% as momentum continues to build in this segment after repositioning efforts in 2022. Q1 revenue of $187.6 million was up 0.7% from $186.3 million in the first quarter of last year.

我們的 PET/CT 數量增長了 16.1%，令人印象深刻，這種需求持續強勁，尤其是來自我們的醫院合作夥伴。隨著 2022 年重新定位後該領域的勢頭繼續增強，腫瘤患者的總起始人數增長了 7.6%。第一季度收入為 1.876 億美元，比去年第一季度的 1.863 億美元增長了 0.7%。

Adjusted EBITDA of $33.1 million was up $1.1 million, a 3.4% increase from $32 million in the first quarter of last year. Adjusted EBITDA margin of 17.7% is also up 0.5% from the first quarter of 2022 levels. Recall that Q1 is our seasonally slowest quarter. And given our high operating leverage, lower volumes in the first quarter typically put downward pressure on margins in that period.

調整後 EBITDA 為 3,310 萬美元，較去年第一季度的 3,200 萬美元增加 110 萬美元，增幅為 3.4%。調整後 EBITDA 利潤率為 17.7%，也較 2022 年第一季度的水平增長 0.5%。回想一下，第一季度是我們季節性最慢的季度。鑑於我們的運營槓桿較高，第一季度銷量下降通常會給該時期的利潤率帶來下行壓力。

On a consolidated basis, accounts receivable at quarter end were $114.7 million versus $114.2 million at the end of Q4 2022. This equates to 56 days of sales outstanding near record low levels.

綜合來看，季度末的應收賬款為 1.147 億美元，而 2022 年第四季度末的應收賬款為 1.142 億美元。這相當於有 56 天的未清銷售額接近歷史最低水平。

Turning to slide 4, we were pleased to see renewed growth in volumes within our radiology segment. We experienced a return to normal growth in our MRI volume because of reduced impact from the constraints we faced in the second half of 2022. More specifically, clinical labor shortages were less impactful as the labor market pressures are moderating and our initiatives to address them begun to pay off.

轉向幻燈片 4，我們很高興看到放射學領域的銷量再次增長。由於 2022 年下半年我們面臨的限制的影響減少，我們的 MRI 數量恢復了正常增長。更具體地說，隨著勞動力市場壓力緩和，並且我們開始採取解決這些問題的舉措，臨床勞動力短缺的影響較小付清。

Our PET/CT volumes continue to demonstrate very robust growth as demand for that modality remains strong, particularly from our hospital partners. This impressive growth in our PET/CT volume is driven by an expansion of clinical applications and the development of new tracers. However, in the first quarter, this organic growth in our radiology segment was negatively impacted by a revenue loss from certain Florida facilities closed for renovations in the period.

我們的 PET/CT 數量繼續表現出非常強勁的增長，因為對該模式的需求仍然強勁，特別是來自我們的醫院合作夥伴。我們的 PET/CT 數量令人印象深刻的增長是由臨床應用的擴展和新示踪劑的開發推動的。然而，在第一季度，我們放射學部門的有機增長受到了佛羅里達州某些設施在此期間關閉進行翻修的收入損失的負面影響。

In our oncology segment, our focus is now firmly on organic growth following the repositioning efforts we undertook in 2022. We were pleased to see growth continues in patient starts.

在我們的腫瘤學領域，繼 2022 年進行重新定位努力之後，我們現在的重點堅定地放在有機增長上。我們很高興看到患者開始數量持續增長。

As you also know, we embarked on a significant organizational transformation in 2022 to align and streamline all areas of our business. These initiatives resulted in the realization of approximately $23 million in synergies. Although last year, they were somewhat offset by inflationary pressures and other cost increases during the year.

如您所知，我們於 2022 年開始進行重大組織轉型，以調整和簡化我們業務的所有領域。這些舉措實現了約 2300 萬美元的協同效應。儘管去年，它們在一定程度上被年內通脹壓力和其他成本增加所抵消。

We continue to implement initiatives related to rationalizing business processes, consolidating systems, and optimizing our procurement by leveraging our enhanced scale. As we indicated in our Q4 call, we expect to realize an additional $25 million in synergies from these efforts on a run-rate basis by the end of 2023.

我們繼續實施與業務流程合理化、系統整合以及利用規模擴大的優勢優化採購相關的舉措。正如我們在第四季度電話會議中指出的那樣，我們預計到 2023 年底，這些努力將在運行率基礎上額外實現 2500 萬美元的協同效應。

As we have highlighted in the past, there is significant operating leverage in Akumin's business model. As such, we are very focused on increasing our capacity utilization and drive additional volumes through existing sites. On that front, we continue to focus on improving scans and treatments per labor hour, especially in an environment where clinical labor shortage is an important consideration.

正如我們過去強調的那樣，Akumin 的商業模式具有巨大的運營槓桿。因此，我們非常注重提高產能利用率並通過現有站點增加產量。在這方面，我們繼續專注於改善每工時的掃描和治療，特別是在臨床勞動力短缺是一個重要考慮因素的環境下。

We have also enhanced our scheduling and call center capabilities, and we are starting to see the benefits of these measures in reduced abandoned rates and improved utilization. We also continue to evaluate our fixed site footprint to identify opportunities for further operational improvements related to underperforming sites. As you know, another key element of Akumin's strategy is to digitize the business to streamline operations in order to enhance patient care and the patient experience. The investments we've made in the patient journey and our remote technologist capabilities are examples of the initiatives we have underway.

我們還增強了調度和呼叫中心能力，我們開始看到這些措施在降低放棄率和提高利用率方面的好處。我們還繼續評估我們的固定站點足跡，以確定與表現不佳的站點相關的進一步運營改進的機會。如您所知，Akumin 戰略的另一個關鍵要素是業務數字化以簡化運營，從而增強患者護理和患者體驗。我們在患者旅程中所做的投資和我們的遠程技術專家能力就是我們正在進行的舉措的例子。

Part of the strategic rationale for the Alliance acquisition in 2021 was to better position Akumin to service hospitals and health systems partners in their ever-growing needs for out-patient service delivery functionality and capability. With the extensive suite of services and facilities we have in place, including network density in key markets, we are an attractive out-patient partner for hospitals and health systems. While these relationships will take time to formalize, we continue to explore potential opportunities to leverage our capabilities for the mutual benefit of Akumin's hospital partners.

2021 年聯盟收購的部分戰略理由是為了更好地定位 Akumin，為醫院和衛生系統合作夥伴提供服務，滿足他們對門診服務提供功能和能力不斷增長的需求。憑藉我們擁有的廣泛的服務和設施，包括主要市場的網絡密度，我們是醫院和衛生系統有吸引力的門診合作夥伴。雖然這些關係需要時間才能正式確立，但我們將繼續探索潛在機會，利用我們的能力來實現 Akumin 醫院合作夥伴的共同利益。

I will now turn the presentation over to David, who will walk us through some of our key operating and financial metrics.

我現在將演講交給 David，他將引導我們了解一些關鍵的運營和財務指標。

Thank you, Riadh, and good morning, everyone. As Riadh mentioned at the outside, I will review some key operating and financial metrics of our business for the first quarter.

謝謝你，里亞德，大家早上好。正如 Riadh 在外部提到的，我將回顧第一季度我們業務的一些關鍵運營和財務指標。

Starting with slide 6, we illustrate that while Akumin's platform offers a diverse suite of services, we are very focused on areas of high growth and high value-added modalities. As you can see, 54% of our radiology revenues derived from MRI procedures making MRI volumes a key driver of that segment. Akumin is also a significant player in cancer diagnosis and treatment with 26% of our radiology revenues from PET/CT and 16% of our total revenues coming from our oncology division. These modalities are critical to delivery of quality patient care and are utilized by a variety of physician specialties across the care continuum from screening to diagnosis to treatment.

從幻燈片 6 開始，我們說明雖然 Akumin 的平台提供多樣化的服務，但我們非常關注高增長和高附加值模式的領域。正如您所看到的，我們 54% 的放射學收入來自 MRI 程序，這使得 MRI 銷量成為該領域的關鍵驅動力。 Akumin 也是癌症診斷和治療領域的重要參與者，我們的放射學收入的 26% 來自 PET/CT，總收入的 16% 來自腫瘤部門。這些模式對於提供高質量的患者護理至關重要，並且被各種專業醫師在從篩查到診斷到治療的整個護理過程中使用。

As we have highlighted previously, we undertook an initiative in 2022 to consolidate our fixed-site radiology footprint to eliminate underperforming sites. We now operate 100 radiology fixed sites and continue to evaluate all sites to identify opportunities to optimize our fixed site footprint and improve operations.

正如我們之前強調的，我們在 2022 年採取了一項舉措，以鞏固我們的固定站點放射學足跡，以消除表現不佳的站點。我們現在運營著 100 個放射科固定站點，並繼續評估所有站點，以確定優化我們固定站點佔地面積和改進運營的機會。

As you know, Akumin is clearly well-positioned to benefit from the ongoing shift to out-patient service delivery as we partner with hospitals and hospital systems to transition care to lower cost sites of delivery. We continue to generate over 95% of our revenues from out-patient procedures as you can see on slide 7. We have a balanced revenue mix between third-party payers for out-patient services and hospitals with no one customer representing more than 4% of our consolidated pro forma revenues.

如您所知，Akumin 顯然處於有利位置，可以從持續向門診服務提供的轉變中受益，因為我們與醫院和醫院系統合作，將護理轉移到成本較低的交付地點。正如您在幻燈片 7 中看到的那樣，我們 95% 以上的收入仍然來自門診手術。我們在門診服務的第三方付款人和醫院之間保持著平衡的收入結構，沒有一個客戶的收入比例超過 4%我們的合併預計收入。

As preferred out-patient solution provided to hospitals, half of our revenues come from our hospital customers. Balance of revenues or reimbursement for patient procedures paid by third party and government payers. We expect the revenue share of hospitals to continue to grow as both existing and new hospital customers and partners search for out-patient solutions in both radiology and oncology.

作為向醫院提供的首選門診解決方案，我們一半的收入來自醫院客戶。由第三方和政府付款人支付的患者手術的收入或報銷餘額。我們預計，隨著現有和新的醫院客戶和合作夥伴尋求放射學和腫瘤學方面的門診解決方案，醫院的收入份額將繼續增長。

Our financial performance is primarily driven by procedure volumes. Given that the current mix of our business includes both hospitals and independent sites, we track actual scans by modality across our radiology platform. Previously noted MRI and PET/CT scan procedure volumes are the biggest contributors to the performance in our radiology segment. These volumes, together with the radiology procedures as a percent of revenues as illustrated on slide 6, are the key metrics we use to track our operating and financial performance in radiology.

我們的財務業績主要由程序量驅動。鑑於我們目前的業務組合包括醫院和獨立站點，我們通過放射學平台按模式跟踪實際掃描。之前提到的 MRI 和 PET/CT 掃描程序量是我們放射學領域業績的最大貢獻者。這些數量，以及幻燈片 6 所示的放射學程序佔收入的百分比，是我們用來跟踪放射學業務和財務績效的關鍵指標。

In slide 8, you can see the MRI, PET/CT procedure volumes over the last four quarters in 2022 and the percentage same-store changes in those periods.

在幻燈片 8 中，您可以看到 2022 年最後四個季度的 MRI、PET/CT 手術量以及這些時期的同店變化百分比。

As we noted in our last call, growth in MRI volumes in the second half of 2022 were negatively impacted by labor constraints, particularly in shortage of clinical staff. We took measures in late 2022 to mitigate these pressures and have started to see some benefits augmenting our ability to perform more MRI procedures. It's important to note that as the market leader in PET/CT, we have seen strong growth in that modality in recent years as pharmaceutical industry continues to develop improved tracers, which can allow for earlier detection of diseases.

正如我們在上次電話會議中指出的那樣，2022 年下半年 MRI 數量的增長受到勞動力限制的負面影響，特別是臨床人員短缺。我們在 2022 年底採取了措施來減輕這些壓力，並開始看到一些好處，增強了我們執行更多 MRI 程序的能力。值得注意的是，作為 PET/CT 的市場領導者，近年來，隨著製藥行業不斷開發改進的示踪劑，可以更早地發現疾病，我們看到這種模式的強勁增長。

As we previously mentioned, labor constraints are less of a factor in PET/CT, given the highly specialized skill sets of clinical personnel for this modality, and we are better able to capitalize on the strong demand for these services.

正如我們之前提到的，考慮到 PET/CT 臨床人員具備高度專業化的技能，勞動力限制在 PET/CT 中不再是一個因素，我們能夠更好地利用對這些服務的強勁需求。

In oncology segment, we track activity level by patient starts volume. As you can see, patient starts grew in Q4 as we completed the review and repositioning that business in Q2 and Q3 of last year. We expect our oncology division to continue this improving growth trajectory over time, given the compelling value proposition of radiation therapy we bring to our hospital partners in this modality, including our mobile fleet, which keeps programs treating patients while replacing equipment and our significant experience with Varian's Halcyon, new treatment platform which provide faster and more cost-effective treatments.

在腫瘤學領域，我們通過患者開始量來跟踪活動水平。正如您所看到的，隨著我們在去年第二季度和第三季度完成了對該業務的審查和重新定位，第四季度的患者啟動量有所增長。我們預計我們的腫瘤科將隨著時間的推移繼續保持這種不斷改善的增長軌跡，因為我們以這種方式向我們的醫院合作夥伴提供了令人信服的放射治療價值主張，包括我們的移動車隊，該車隊在更換設備的同時保持對患者進行治療的計劃，以及我們在放射治療方面的豐富經驗。瓦里安的 Halcyon 是一種新的治療平台，可提供更快、更具成本效益的治療。

On slide 9, we present quarterly revenue and adjusted EBITDA trends for radiology and oncology segments. As you can see, the contribution from our radiology and oncology segments have been consistent over the past five quarters, with radiology ranging between 83% and 84% of total revenues and oncology making up the balance of the 16% to 17%.

在幻燈片 9 上，我們展示了放射學和腫瘤學領域的季度收入和調整後 EBITDA 趨勢。正如您所看到的，我們的放射科和腫瘤科部門的貢獻在過去五個季度中保持一致，放射科佔總收入的 83% 至 84%，腫瘤科佔其餘的 16% 至 17%。

For radiology segment, our first quarter adjusted EBITDA margin was 19.3% before allocation of corporate services. Our oncology segment is higher margin with an adjusted EBITDA margin of 32.6% for the allocation of those corporate services. Note, as we had already mentioned, that first quarter is typically our seasonally weakest quarter as annual benefit plans rollover and winter weather in some regions results in lower volumes.

對於放射學部門，在分配企業服務之前，我們第一季度調整後的 EBITDA 利潤率為 19.3%。我們的腫瘤學部門的利潤率較高，這些企業服務的分配調整後 EBITDA 利潤率為 32.6%。請注意，正如我們已經提到的，第一季度通常是我們季節性最弱的季度，因為年度福利計劃展期和某些地區的冬季天氣導致銷量下降。

As you can see on the chart on the left, the seasonality impact was less pronounced in 2022 part because of the impact of Hurricane Ian in Q3 and the clinical labor shortage we discussed in our radiology segment, which impacted us negatively in the second half of 2022. In addition, our oncology segment revenues were essentially flat in 2022 as we undertook the repositioning of that business. As we have previously stated, our oncology segment is typically a high growth activity and we expect to see stronger growth in this segment in future years as business development efforts are now our renewed focus.

正如您在左側圖表中所看到的，由於第三季度伊恩颶風的影響以及我們在放射科部分討論的臨床勞動力短缺，2022 年的季節性影響不太明顯，這對我們下半年產生了負面影響2022 年。此外，由於我們對該業務進行了重新定位，2022 年我們的腫瘤業務收入基本持平。正如我們之前所說，我們的腫瘤學領域通常是一個高增長的活動，我們預計未來幾年該領域將出現更強勁的增長，因為業務發展工作現在成為我們新的重點。

The chart on the right illustrates the quarterly adjusted EBITDA and EBITDA margin over the past five quarters. The impact of seasonality in our business can be seen more clearly in this chart. Given the high operating leverage in our business, the segment volumes in Q1 with higher labor costs put a bit of downward pressure on margins for the period. That noted, we did see some modest year-over-year growth in both revenue and adjusted EBITDA in Q1 2023, and we believe we have established a solid foundation in which to build.

右圖顯示了過去五個季度的季度調整後 EBITDA 和 EBITDA 利潤率。在此圖表中可以更清楚地看到季節性對我們業務的影響。鑑於我們業務的運營槓桿較高，第一季度勞動力成本較高的業務量給該期間的利潤率帶來了一定的下行壓力。值得注意的是，我們確實看到 2023 年第一季度的收入和調整後 EBITDA 同比略有增長，我們相信我們已經奠定了堅實的基礎。

Turning to slide 10, you see the annual last trailing 12-months financial performance in our radiology and oncology segments and the consolidated adjusted EBITDA. Note that the 2021 results and pro forma results, assuming the legacy Akumin Alliance businesses with the combination of which was completed in September 2021 were combined for the entire period as well as the adjusted for the fourth quarter 2021 divestiture of Alliance Oncology of Arizona.

轉向幻燈片 10，您可以看到我們放射學和腫瘤學部門最近 12 個月的年度財務業績以及合併調整後 EBITDA。請注意，2021 年業績和預計業績假設在整個期間合併了 Akumin Alliance 遺留業務，並於 2021 年 9 月完成合併，並根據 2021 年第四季度亞利桑那州腫瘤聯盟剝離進行了調整。

As you see in the chart on the left, the radiology segment contributed $627 million of revenue for the trailing 12-month period, while representing approximately 83% of total revenues; and oncology segment contributed $124 million of revenue or approximately 17% of the total.

如左圖所示，放射科在過去 12 個月期間貢獻了 6.27 億美元的收入，約佔總收入的 83%；腫瘤學部門貢獻了 1.24 億美元的收入，約佔總收入的 17%。

As we have mentioned on prior calls, growth in consolidated adjusted EBITDA as reviewed in recent periods, we have focused on internal integration and transformation initiatives and address labor constraints in 2022.

正如我們在之前的電話會議中提到的，根據近期審查的綜合調整後 EBITDA 的增長，我們重點關注內部整合和轉型舉措，並在 2022 年解決勞動力限制問題。

Going forward, we are confident that we'll see volume growth driving revenue and EBITDA, given the demand for our services and the operational improvements we have made in improving labor market conditions.

展望未來，鑑於對我們服務的需求以及我們在改善勞動力市場條件方面所取得的運營改進，我們有信心看到銷量增長推動收入和 EBITDA。

Slide 11 is a bridge from our adjusted EBITDA to our free cash flow in the first quarter. As you can see from the slide, our cash position decreased by approximately $14 million in the quarter. When you look at our balance sheet, you'll note that our accounts payable fell by $11 million as we accelerated payments at the end of the quarter in anticipation of our migration to a single general ledger platform on April 1. Business is the largest driver of the change in working capital. And in past quarters in that service, finance lease payments continue to have meaningful impact on free cash flow.

幻燈片 11 是從我們調整後的 EBITDA 到第一季度自由現金流的橋樑。正如您從幻燈片中看到的，本季度我們的現金頭寸減少了約 1400 萬美元。當您查看我們的資產負債表時，您會注意到，我們的應付賬款減少了 1100 萬美元，因為我們預計將於 4 月 1 日遷移到單一總賬平台，因此在季度末加快了付款速度。業務是最大的推動力營運資金的變化。在該服務的過去幾個季度中，融資租賃付款繼續對自由現金流產生重大影響。

And as you know, cash minority interest primarily relates to oncology joint ventures with hospital partners and as a function of performance of these centers is not a fixed obligation as these partnerships become more profitable and generate more cash for cash distributions to our minority partners increase as well. It should be noted that we incurred over $7.1 million of cash costs in Q1, which were related to site repairs in our Port Charlotte facility, which was particularly hard hit by Hurricane Ian, as well as our ongoing restructuring efforts. We have receive partial reimbursement on the Port Charlotte repairs and will be recovering more.

如您所知，現金少數股東權益主要與與醫院合作夥伴的腫瘤學合資企業有關，並且作為這些中心績效的函數，並不是固定義務，因為這些合作夥伴關係變得更加有利可圖，並產生更多現金，用於向我們少數合作夥伴的現金分配增加出色地。應該指出的是，我們在第一季度產生了超過 710 萬美元的現金成本，這些成本與我們夏洛特港工廠的現場維修（該工廠受到伊恩颶風的打擊尤為嚴重）以及我們正在進行的重組工作有關。我們已收到夏洛特港維修的部分補償，並將恢復更多。

In 2023, we continue to expect to reduce burden of restructuring charges together with the additional synergy capture we had discussed earlier, which will benefit our free cash flow. This will be offset somewhat by additional cash interest payments related to the Stonepeak subordinated notes, which will cash pay in the later part of the year.

到 2023 年，我們繼續預計將減輕重組費用的負擔以及我們之前討論過的額外協同效應，這將有利於我們的自由現金流。這將在一定程度上被與 Stonepeak 次級票據相關的額外現金利息支付所抵消，這些利息將在今年下半年以現金支付。

Turning to slide 12, we present an overview of our 2023 guidance announced in the Q4 call. As a reminder, for 2023, we expect consolidated revenues to be in the range of $765 million to $775 million and adjusted EBITDA to be in the range $150 million to $160 million. Our 2023 guidance reflects the fact that some ongoing labor constraints and cost inflation persists in some markets, although we have seen some improvement on these fronts thus far this year.

轉向幻燈片 12，我們概述了第四季度電話會議中宣布的 2023 年指導方針。提醒一下，我們預計 2023 年合併收入將在 7.65 億至 7.75 億美元之間，調整後 EBITDA 將在 1.5 億至 1.6 億美元之間。我們的 2023 年指導反映了一些市場持續存在的勞動力限制和成本通脹的事實，儘管今年迄今為止我們在這些方面已經看到了一些改善。

Turning to CapEx, as we did in 2022, we continue to refine our capital expenditure plans to ensure the most efficient deployment of equipment better aligned with our strategic priorities. We continuously evaluate our markets and prioritize those based on our criteria that have the greatest near-term potential for growth. We continue to expect total CapEx to be in the range of $55 million to $65 million, with approximately 50% allocated to growth CapEx for new customers and new sites and the balance for maintenance CapEx.

談到資本支出，正如我們在 2022 年所做的那樣，我們繼續完善我們的資本支出計劃，以確保最有效的設備部署，更好地符合我們的戰略重點。我們不斷評估我們的市場，並根據我們的標準優先考慮近期最具增長潛力的市場。我們仍然預計資本支出總額將在 5500 萬美元至 6500 萬美元之間，其中約 50% 分配給新客戶和新站點的增長資本支出，其餘用於維護資本支出。

Recall that we define maintenance CapEx we spend for existing customers at existing sites for growth capEx is primarily oriented towards new hospital customer partner acquisition, as well as capacity expansion. Our investments in new customers and sites continue to the high return, typically with a four-year payback on the growth capital. Anticipate total CapEx to be funded by approximately 20% in cash and the balance to be financed by combination of OEMs, equipment, finance companies, and local banks. Higher financing cost may be a bit of a headwind in coming quarters.

回想一下，我們將維護資本支出定義為在現有站點為現有客戶支出的增長資本支出主要面向新醫院客戶合作夥伴的收購以及產能擴張。我們對新客戶和網站的投資持續獲得高回報，通常在四年內即可收回增長資本。預計總資本支出將由約 20% 的現金提供，其餘部分將由 OEM、設備、金融公司和當地銀行聯合提供資金。較高的融資成本可能會成為未來幾個季度的阻力。

Turning to slide 13, we depict our capital structure at the end of Q1 2023. As you can see, Akumin secured leverage of 5.6 times for unsecured leverage is now 2.8 times. As an organization, we are focused on reducing this leverage over time. Near term drivers deliver reduction will come from increasing EBITDA as a result of synergy capture, network rationalizations, technology-driven standardization, and the streamlining of service delivery, as we outlined in our Q4 call. Note that as very significant shareholders, we are highly incentivized to prudently optimized capital structure, and we'll continue to evaluate options to do so as the market conditions permit.

轉向幻燈片 13，我們描繪了 2023 年第一季度末的資本結構。如您所見，Akumin 的擔保槓桿率為 5.6 倍，無擔保槓桿現在為 2.8 倍。作為一個組織，我們致力於隨著時間的推移減少這種影響力。正如我們在第四季度電話會議中概述的那樣，近期驅動因素帶來的減少將來自於協同效應捕獲、網絡合理化、技術驅動的標準化以及服務交付的簡化帶來的 EBITDA 的增加。請注意，作為非常重要的股東，我們非常有動力謹慎優化資本結構，並且我們將在市場條件允許的情況下繼續評估這樣做的選擇。

And I'll turn it back over to Riadh to wrap up before we take questions.

在我們回答問題之前，我會將其轉回給 Riadh 進行總結。

Thanks, David. That concludes the prepared remarks portion of the presentation. I hope that we provided more color on the performance of the first quarter. We would now ask the operator to start the question-and-answer period.

謝謝，大衛。演講中準備好的評論部分就到此結束。我希望我們能為第一季度的表現提供更多的色彩。我們現在要求接線員開始問答時間。

(Operator Instructions) Noel Atkinson, Clarus Securities.

（操作員指示）Noel Atkinson，Clarus 證券公司。

Hi. Good morning, Riadh and David and well done in Q1. Thanks for taking our questions this morning. First off, I was wondering if you could provide, give us a sense of what the impact was in Q1 in terms of revenue and adjusted EBITDA if you can from those center closures that are ongoing in Florida and then when you think they might be back on line.

你好。早上好，Riadh 和​​ David，第一季度做得很好。感謝您今天早上提出我們的問題。首先，我想知道您是否可以讓我們了解第一季度對收入和調整後 EBITDA 的影響，如果您可以從佛羅里達州正在進行的那些中心關閉中獲得什麼影響，然後您認為它們可能會回來在線的。

Sure. Thanks. Good morning, Noel, and thanks for the question. We'll give you the impact on the top line. So in the first quarter of 2023, that would be a couple of millions just in the first quarter and I think you know the operating leverage in the business. So it will -- the impact that would have as well on EBITDA. One has already reopened in the second quarter of 2023 and others are later this year. And some of that was -- the reason for the closures, there were obviously other closures that we did, as you know, last year, but those are permanent closures where -- it was part of what David discussed, a rationalization of the network.

當然。謝謝。早上好，諾埃爾，謝謝你的提問。我們將為您提供對營收的影響。因此，在 2023 年第一季度，這一數字將達到數百萬美元，我想您知道該業務的運營槓桿。因此，這也會對 EBITDA 產生影響。其中一個已於 2023 年第二季度重新開放，其他則將於今年晚些時候重新開放。其中一些是——關閉的原因，正如你所知，去年我們顯然還進行了其他關閉，但這些都是永久性的關閉——這是大衛討論的一部分，網絡的合理化。

But these are actually closures that have nothing to do with rationalization, some are related to just a much bigger opportunity in the markets and we've upgraded the equipment and it was planned long time ago. Others were actually outside our control and it was related to the hurricane and the weather issues we had.

但這些實際上是與合理化無關的關閉，有些只是與市場上更大的機會有關，我們已經升級了設備，這是很久以前就計劃好的。其他的實際上是我們無法控制的，這與颶風和我們遇到的天氣問題有關。

I'll jump in real quick. The bulk of what we had mentioned in terms of the closures were the ones that are temporarily closed due to hurricane. Those sites that we proactively closed/consolidated really, as you can imagine, were closed because they weren't generating a lot of revenue and weren't generating a lot of EBITDA. So the good news is the bulk of what closed right now is coming back on line.

我會很快跳進去。我們提到的大部分關閉都是由於颶風而暫時關閉的。正如您可以想像的那樣，我們主動關閉/整合的那些網站確實被關閉，因為它們沒有產生大量收入，也沒有產生大量 EBITDA。因此，好消息是目前關閉的大部分內容都已恢復上線。

Okay, great. Then I guess can we talk a little bit about the PET/CT. So your same-store volume growth accelerated pretty sharply in Q1. Is this kind of level of growth rate? Is it sustainable over an extended period of time or do you start running into capacity utilization issues?

好的，太好了。那麼我想我們可以談談 PET/CT 嗎？因此，你們的同店銷量增長在第一季度大幅加速。這是這樣的增長速度嗎？它是否可以長期持續，或者您是否開始遇到容量利用率問題？

Again, another good question here. What we know -- obviously, this is a new trend as you've outlined, Noel. But what we know is there's no reason to believe that it will slow down. We're still experiencing that type of organic growth, but it's recent shift. So we're not going to sit here and say, this is going to keep going for the next five years. To be honest with you, we don't know yet. But what we know is it's not slowing down. And we know that the demand is not a pent-up demand. It's not a COVID-related. It's actually fundamental demand from growing applications and huge development of new tracers.

又是一個好問題。我們所知道的——顯然，正如你所概述的那樣，這是一個新趨勢，諾埃爾。但我們所知道的是，沒有理由相信它會放緩。我們仍在經歷這種有機增長，但這是最近的轉變。因此，我們不會坐在這裡說，這種情況將在未來五年內持續下去。老實說，我們還不知道。但我們知道它並沒有放緩。我們知道這種需求並不是被壓抑的需求。這與新冠病毒無關。這實際上是不斷增長的應用和新示踪劑的巨大發展的基本需求。

And in terms of utilization in markets with customers where the volume is picking up, we already have plan as part of normal CapEx upgrades in our PET/CT. And the new digital PET/CT equipment comes with much better throughput that is 2x to 3x, so we don't foresee utilization or capacity constraints, as you outlined. So we are excited about this fundamental shift. And as it continues and we got up higher share, it's a very high margin, very profitable business for us.

就客戶數量正在增加的市場的利用率而言，我們已經制定了計劃，作為 PET/CT 正常資本支出升級的一部分。新的數字 PET/CT 設備具有更好的吞吐量，為 2 倍到 3 倍，因此我們預計不會出現利用率或容量限制，正如您所概述的。因此，我們對這一根本性轉變感到興奮。隨著這種情況的持續發展，我們的市場份額不斷提高，這對我們來說是一項利潤率非常高、利潤非常豐厚的業務。

Okay. And then lastly, could you just maybe remind us again kind of what you're expecting for in this next round of cost savings? So you say that's now more than $25 million that you're hoping to get out of this sort of next couple of phases of cost savings and integration efforts. Can you remind us again how you see that rolling out over the next few quarters?

好的。最後，您能否再次提醒我們您對下一輪成本節約的期望是什麼？所以您說您現在希望從接下來幾個階段的成本節約和集成工作中獲得超過 2500 萬美元。您能否再次提醒我們您如何看待未來幾個季度的推出？

I'll give you just one example, and I'll let David build on that. But I just want to illustrate it. So the $23 million of last year was duplication of functions, as you know. And unfortunately, a significant portion was offset with the inflation that hit us in both labor and medical supplies. The $25 million that we're working on that is a run rate by the end of the year, it does require more work and there is significant overlap. So to give you an example of a business process, your HR delivery from recruiting all the way to the end. From the two legacy systems, the legacy systems that were around to do the whole workflow we had in excess of seven or eight different systems and applications.

我只給你舉一個例子，我會讓大衛在此基礎上進一步發展。但我只是想說明一下。所以，正如你所知，去年的 2300 萬美元是職能重複。不幸的是，很大一部分被勞動力和醫療用品方面的通貨膨脹所抵消。我們正在處理的 2500 萬美元是到年底的運行率，它確實需要更多的工作，而且存在很大的重疊。給你一個業務流程的例子，你的人力資源交付從招聘一直到最後。從這兩個遺留系統中，我們擁有超過七八個不同的系統和應用程序來完成整個工作流程。

So what we've done there is we went to an ERP platform that does it all from end to end. So it's a new business process,. It's more contained. But in the meantime, you're paying for all the legacy systems as you come out of those, and you're paying for the new one you brought in place, and you're paying for some consulting and third-party cost for implementation.

所以我們所做的就是使用一個 ERP 平台來完成這一切。所以這是一個新的業務流程。它更加包容。但與此同時，您需要為所有遺留系統付費，並且您需要為安裝的新系統付費，並且您需要支付一些諮詢和第三方實施成本。

So it does -- that's why it takes time for these. These are actually type of synergies to be in place. And that's why we said our goal is to get there by the end of the year. So just want to provide that example in what we mean by business process. Sounds like a fancy concept, but it's not really that fancy. I just gave you a real example of what we're doing.

確實如此——這就是為什麼這些需要時間。這些實際上是需要發揮的協同作用。這就是為什麼我們說我們的目標是在今年年底之前實現這一目標。所以只想提供這個例子來說明我們所說的業務流程。聽起來像是一個奇特的概念，但實際上並不是那麼奇特。我剛剛給你舉了一個我們正在做的事情的真實例子。

Okay, great. All right, I'll get back in the queue. Thanks very much.

好的，太好了。好吧，我會回到隊列中。非常感謝。

Endri Leno, National Bank.

恩德里·萊諾，國家銀行。

Hi, good morning. It's Andre Bodo sitting in for Endri. My first question is related to CapEx. Maybe some color on why it was lower on the quarter and how do you expect it to evolve over the year?

早上好。安德烈·博多 (Andre Bodo) 代替恩德里 (Endri)。我的第一個問題與資本支出有關。也許有一些關於為什麼本季度較低的原因以及您預計它在一年中會如何發展的一些信息？

Andre, thank you for your question. I think we started talking and discussing this little bit in Q3 last year in [ethic of work] about time to be -- I'll talk about more discipline, a more intention hold with how we deploy CapEx. And we did close a couple of facilities that does free up a little bit of equipment. We've put a focus and EBITDA generation in IRR in that and preserving revenues. So I think we made a bunch of examples in past years where that maintenance CapEx, which is the CapEx which we spend to maintain existing customers. May be some of that CapEx was generated maintaining customers that weren't all that profitable for us.

安德烈，謝謝你的問題。我認為我們在去年第三季度的[工作道德]中開始談論和討論這一點——我將談論更多的紀律，以及我們如何部署資本支出的更多意圖。我們確實關閉了一些設施，確實釋放了一些設備。我們將重點放在 IRR 和 EBITDA 生成上，並保持收入。因此，我認為我們在過去幾年中舉了很多維護資本支出的例子，即我們用於維護現有客戶的資本支出。可能其中一些資本支出是為了維護客戶而產生的，而這些客戶對我們來說並沒有那麼有利可圖。

So we kind of refocused and say well, let's just really focus on profitability, whether it's growth CapEx or maintenance CapEx or even thinking about de novos at some point. Let's just make draw it up, optimizing every power of we put out there, getting their appropriate at IRR in free cash flow. So towards that end, there's been a couple things that we may have anticipated and predicting the maintenance CapEx side that we anticipated to invest in some new equipment in the new site and upon evaluation, we thought, well, we're not really generating the return that we need to get on that.

因此，我們重新聚焦並說，好吧，讓我們真正關注盈利能力，無論是增長資本支出還是維護資本支出，甚至在某個時候考慮從頭開始。讓我們來製定一下，優化我們投入的每一個力量，在自由現金流中獲得適當的內部收益率。因此，為了實現這一目標，我們可能已經預料到了一些事情，並預測了維護資本支出方面，我們預計將在新站點投資一些新設備，經過評估，我們認為，好吧，我們並沒有真正產生返回我們需要解決的問題。

So that's why it looked perhaps a little bit muted in Q1. Also keep in mind that you pay for the equipment as you take delivery. So some things as [we outsourced types of] of the oncology side of the business. Well, we brought a new leader in that department, 2022. Well, you can imagine we appropriately put projects on hold because we wanted to give that new leader a chance to see whether he wanted to go forward or not with some of those projects.

這就是為什麼它在第一季度看起來可能有點低調。另請記住，您在提貨時支付設備費用。因此，腫瘤學方面的一些事情[我們外包了一些類型]。好吧，我們在 2022 年為該部門帶來了一位新領導。好吧，你可以想像我們適當地擱置了項目，因為我們想給這位新領導一個機會，看看他是否願意繼續推進其中一些項目。

Now as things get moving again, those projects which might have come on line in Q1, [or maybe] Q2, Q3. So cash throughout this part of the time, we take a quick delivery, not so much at the time with a partner. So I think we're still on track as we said for the target, but maybe just deferred to a little bit later in the year.

現在，隨著事情再次進展，那些可能在第一季度、[或者可能]第二季度、第三季度上線的項目。因此，在這段時間裡，我們會快速交付現金，而不是與合作夥伴一起交付。因此，我認為我們仍然按照我們所說的目標走上正軌，但可能只是推遲到今年晚些時候。

Okay, great. Thank you. NCI I was higher year on year. Maybe you could share some color on that and how do we look at that for the rest of 2023?

好的，太好了。謝謝。 NCI I 同比更高。也許您可以就此分享一些看法，以及我們如何看待 2023 年剩餘時間的情況？

I think if you can look at that as a positive. I know you see the negative side of it, though. The minority -- and payments going out to minority partners. But what that means is that the actual joint venture, I'm very proud. It's a little bit more than anticipated and therefore, you kind of pay out more to your minority partners.

我想如果你能將其視為積極的一面的話。不過，我知道你看到了它的消極一面。少數派——以及支付給少數派合作夥伴的款項。但這意味著，對於真正的合資企業，我感到非常自豪。這比預期的要多一點，因此，您向少數合夥人支付了更多費用。

So we had, particularly in oncology, signed a handful of partnerships, which has performed exceptionally well in Q1. And the good news is they performed exceptionally well. The flip side is we didn't have to pay out distributions to those minority part (technical difficulty) the continued performance, there's higher cash distribution, that doesn't mean there was more cash generation that the company has hold.

因此，我們（特別是在腫瘤學領域）簽署了一些合作夥伴關係，這些合作夥伴關係在第一季度的表現非常出色。好消息是他們的表現非常出色。另一方面是我們不必向那些少數部分（技術難度）持續的業績進行分配，有更高的現金分配，這並不意味著公司擁有更多的現金生成。

Riadh, I don't know if you like it. But like I said, it's not a fixed obligation --

Riadh，我不知道你是否喜歡。但就像我說的，這不是一項固定的義務——

Well said.

說得好。

Distributions.

分佈。

Totally agree, David.

完全同意，大衛。

Okay. And then for my last question on -- any updates on evaluating options for the take note?

好的。然後，對於我的最後一個問題——評估筆記選項的任何更新？

Yeah, I think it's the same we said before. Stonepeak has always been supportive. We're having a constructive dialogue in the quarter like we're obviously aware of September 1, and we will address accordingly. So it's the same update as last quarter.

是的，我想這和我們之前說的一樣。 Stonepeak 一直給予支持。我們在本季度進行了建設性對話，就像我們顯然知道 9 月 1 日一樣，我們將做出相應的處理。所以這與上季度的更新相同。

Okay. Thank you.

好的。謝謝。

(Operator Instructions) Rishi Parekh, J.P. Morgan.

（操作員指令）Rishi Parekh，J.P. Morgan。

Hi. Thanks for taking my questions. First, on the topline, so your volumes are pretty strong. MRI up 4%, PET scans of 16%; and obviously, your oncology starts at 7.6%. These are high-dollar RVUs, but your revenue is flattish year over year and just up slightly sequentially. So I'm just trying to reconcile, given the strong volumes and given the fact that it sounded to me that Florida was only a couple of million dollars in terms of impact. What drove this low where you're just getting paid less on the hospital side on a per RVU basis where you're seeing a squeeze on the commercial side -- what was driving that revenue number lower relative to the volumes that you're showing?

你好。感謝您回答我的問題。首先，在營收方面，你們的交易量非常強勁。 MRI 增加 4%，PET 掃描增加 16%；顯然，您的腫瘤學起始率為 7.6%。這些都是高價值的 RVU，但您的收入同比持平，僅比上年略有增長。所以我只是想調和一下，考慮到交易量強勁，而且在我看來，佛羅里達州的影響力只有幾百萬美元。是什麼導致瞭如此低的收入，您在醫院方面獲得的每個 RVU 的報酬較少，您看到商業方面的擠壓 - 是什麼導致收入數字相對於您所展示的數量較低？

I think -- and I'll let David also build on this and good morning again, Rishi. So on your question, there really three -- I mentioned it in my script, there are really three things that we're still working on. One, like you mentioned, couple of millions from sites that -- in the comparison, obviously, you don't see. The other thing is we're really not done with rationalization yet. Like we are still -- like I said in my script, we are still working on underperforming regions that have done somewhat better in the prior period and then we've made changes and we haven't seen the impact of the changes yet. And so there is some overlap.

我想——我會讓大衛也以此為基礎，再次早上好，Rishi。所以關於你的問題，實際上有三件事——我在我的劇本中提到過，我們實際上仍在研究三件事。一個，就像你提到的，來自網站的數百萬——在比較中，顯然，你沒有看到。另一件事是我們實際上還沒有完成合理化。就像我們仍然一樣，就像我在腳本中所說的那樣，我們仍在對錶現不佳的地區開展工作，這些地區在上一時期表現較好，然後我們做出了改變，但我們還沒有看到這些改變的影響。所以存在一些重疊。

And I think also, David, you mentioned in your comments like last year, last quarter of -- in the first quarter of 2022, it was not actually really a horrible quarter from a seasonality perspective relative to 2022. So I think missing some of that revenues from what we closed and from some turnaround that we're still working on would have made a much bigger impact in the same -- in the first quarter.

我還認為，大衛，你在評論中提到，比如去年的最後一個季度——2022 年第一季度，從季節性角度來看，相對於 2022 年，這實際上並不是一個可怕的季度。所以我認為錯過了一些我們關閉的業務以及我們仍在努力的一些周轉帶來的收入將在第一季度產生更大的影響。

And real quick reality, you're exactly right. Well put. The only thing is we tend to focus a little bit on the radiology side or they're kind of gets shut down. We also did have a pop of [portions], which we handed in our oncology partners, and that also impacts the revenues. [That's not] make as much the bottomline but it does impact the revenues as well.

很快的現實，你是完全正確的。說得好。唯一的問題是我們傾向於稍微關注放射學方面，否則它們就會被關閉。我們也確實有一些[部分]，我們將其交給了我們的腫瘤學合作夥伴，這也影響了收入。 [這並沒有]產生那麼多的底線，但它確實也會影響收入。

Just on that, can you just quantify what that impact was? And so it seems to me that your non-consolidated volumes were down pretty significantly, and that's what's probably driving the total revenue number lower. Is that -- and I just want to make sure that this is not a rate situation and that is it's these underperforming sites that are materially bringing down your total volumes.

就這一點，你能量化一下這種影響是什麼嗎？因此，在我看來，你們的非合併銷量大幅下降，這可能是導致總收入下降的原因。我只是想確保這不是費率情況，而是這些表現不佳的網站大幅降低了您的總交易量。

No. That's very well put. It's not --

不，說得很好。它不是 -

That's exactly -- well said, yeah.

這就是——說得好，是的。

Okay. And then on the cost side, I could see that it's come down. I apologize. I'm in between a few calls, but I know you've highlighted challenges around the medtech cost and bonuses that you had to pay out to drivers. Can you just update us on where you stand? What are rates today on medtechs? Are you fully staffed? What's your capacity utilization within your facilities as it relates to clearing out some of these MRIs?

好的。然後在成本方面，我可以看到它有所下降。我道歉。我正在打幾個電話，但我知道您強調了醫療技術成本和必須向司機支付的獎金方面的挑戰。您能向我們介紹一下您的最新情況嗎？今天醫療技術的費率是多少？你們人員配備齊全嗎？您的設施內與清理某些 MRI 相關的容量利用率是多少？

We're not fully staffed yet and we're definitely not back to normal. But I think like we said in our remarks, the pressure is moderating, which is why you start to see 4% in MRI. The cost is stable, but it's not back to where it was. But we're addressing it as the year goes on and we're bringing more and more labor full time versus contracted labor. So we're hoping as we go throughout the year. If the positive trend continues, we'll see more and more improvement on that front. But you have all what you've seen in Q1. It's some stability and and some relief. But it doesn't matter what measure you look at. Q1 is not a return-to-normal environment.

我們的人員還沒有配備齊全，而且肯定還沒有恢復正常。但我認為就像我們在講話中所說的那樣，壓力正在緩和，這就是為什麼你開始在 MRI 中看到 4% 的情況。成本穩定，但還沒有回到原來的水平。但隨著時間的推移，我們正在解決這個問題，我們帶來了越來越多的全職勞動力而不是合同工。所以我們希望全年都能順利進行。如果積極的趨勢持續下去，我們將看到這方面越來越多的改善。但你已經擁有了在第一季度看到的所有內容。這是一些穩定和一些緩解。但你看什麼衡量標準並不重要。 Q1 並不是恢復正常的環境。

And then just the last question I want to ask is in the future, if you can provide total volumes as well just so we could better understand or follow the trend especially as you may lap some of those challenges. And then just lastly, can you just provide us with your incremental secured debt capacity? And that's it for me. Thanks.

我想問的最後一個問題是在未來，您是否也可以提供總量，以便我們可以更好地理解或跟隨趨勢，特別是當您可能會克服其中一些挑戰時。最後，您能否向我們提供增量擔保債務能力？對我來說就是這樣。謝謝。

Yes, I'll talk about the total volume and let David talk about the second one. I think with the total volume, we drop it because actually its fluctuation has no impact on revenues. That's why we drop it because MRI and PET/CT really drives, as you know, 75%, 80% of our revenues. And the rest, we could have much higher volume, but really means nothing to revenues because it's x-rays that could make a big difference. And that's not a modality that we're going to grow in every single facility. It's the opposite. So that's why we really don't provide the total volume because it's not going to really help you does stand any trend. It's the opposite. It's just noise.

是的，我會談談總音量，讓大衛談談第二個。我認為就總量而言，我們放棄它是因為實際上它的波動對收入沒有影響。這就是我們放棄它的原因，因為如您所知，MRI 和 PET/CT 確實推動了我們 75%、80% 的收入。其餘的，我們可以有更高的產量，但對收入來說實際上沒有任何意義，因為 X 射線可以產生很大的影響。我們不會在每個設施中都採用這種模式。事實恰恰相反。這就是為什麼我們確實不提供總交易量，因為它不會真正幫助您抵禦任何趨勢。事實恰恰相反。這只是噪音。

Sorry, just to be clear what I was referring to was -- and I apologize for this. Not necessarily the non-same-store volumes or MRI and PET/CT.

抱歉，我想澄清一下我指的是——對此我深表歉意。不一定是非同一存儲卷或 MRI 和 PET/CT。

Okay. Got it. I thought you mentioned the volume of procedures. And David, maybe the second part of your question.

好的。知道了。我以為你提到了程序的數量。大衛，也許是你問題的第二部分。

Yes, real quick. We do have the $55 million line of credit, the revolver. And that is actually fully available to us. Not only have we not drawn upon it, but we could draw our -- with meaning all of our leverage constraints. We could draw the entire amount.

是的，真的很快。我們確實有 5500 萬美元的左輪信用額度。這實際上對我們來說是完全可用的。我們不僅沒有利用它，而且我們可以利用我們所有的槓桿限制。我們可以全額提取。

Thanks, David.

謝謝，大衛。

There are no further questions at this time. I'd now like to turn the call back over to Mr. Zine for any closing remarks.

目前沒有其他問題。我現在想將電話轉回 Zine 先生，請他發表結束語。

Thank you very much again. Thanks, everyone, for your participation today. Again, I hope we provided more color on the first quarter. And we want to again thank all of our stakeholders, thank all of our staff and team members for their continued effort and support in transforming Akumin. And hopefully, the platform that we're building will only see a return as we've witnessed in the first quarter to more organic growth, which will further position the company as we streamline our service delivery for more hospital partnerships, which we -- really is the ultimate goal is more partnerships on both radiology and oncology side.

再一次非常感謝你。謝謝大家今天的參與。再次，我希望我們在第一季度提供更多的色彩。我們要再次感謝所有利益相關者，感謝我們所有員工和團隊成員為 Akumin 轉型所做的持續努力和支持。希望我們正在構建的平台只會像我們在第一季度所見證的那樣看到更有機增長的回報，這將進一步定位公司，因為我們簡化了為更多醫院合作夥伴提供的服務，我們——實際上，最終目標是在放射學和腫瘤學方面建立更多的合作夥伴關係。

Thank you again and have a wonderful day.

再次感謝您，祝您有美好的一天。

Thank you, sir. Ladies and gentlemen, this concludes your conference call for today. We thank you for participating and ask that you please disconnect your line. Have a lovely day.

謝謝你，先生。女士們、先生們，今天的電話會議到此結束。我們感謝您的參與，並請您斷開線路。祝你愉快。