Pro Medicus (ASX:PME) has posted another strong full-year result, with reported net profit more than doubling as the medical imaging technology company grew revenue, expanded margins and built a substantial contracted revenue pipeline.

The company reported net profit after tax of $265.3 million for FY26, up 130.3% from $155.2 million a year earlier and ahead of the $250.7 million Visible Alpha consensus.

Revenue rose 22.9% to $261.7 million, while underlying EBIT increased 24.4% to $196.1 million and underlying NPAT climbed 24.1% to $144.7 million.

The result was accompanied by a fully franked final dividend of 37 cents, taking the full-year payout to 69 cents per share.

Forward contract book up 41.3%

One of the most closely watched numbers for investors was the forward contract book, which increased 41.3% to $1.34 billion, up from $948 million a year earlier and $624 million two years ago. The backlog provides substantial visibility over future revenue and reflects the longer sales cycles and multi-year implementation timelines common in enterprise healthcare software, where contract wins can take time to flow through to delivery and revenue.

Pro Medicus signed 10 new contracts worth at least $407 million during FY26, while six existing contracts worth $141 million were renewed for five-year terms with higher transaction fees.

Among the major wins were a 10-year, $170 million contract with UCHealth Colorado and a $90 million, seven-year agreement with Beth Israel Lahey Health. Both were full-stack contracts covering the company's viewer, open archive and workflow products.

Margins extend expansion streak

Margins remained a defining feature of the result. Underlying EBIT margin reached 74.9%, marking a fifth consecutive year of margin expansion, while underlying EBITDA margin came in at 78%.

Growth is also extending beyond the company's core diagnostic imaging offering. Pro Medicus is progressing its cardiology expansion alongside digital pathology and AI-optimised reporting products, while its breast cancer detection algorithm remains subject to FDA clearance.

The Trinity Health rollout, described as one of the world's largest CloudPACS implementations, was 87% complete, with the final cohorts expected by October 2026.

Management said the pipeline remains strong, with increasing inbound interest from major US healthcare institutions, and that cardiology represents an additional avenue for growth. For investors tracking the stock, the combination of a rapidly expanding forward book, rising margins, higher-value contracts and strong cash generation helps explain why contract conversion and implementation progress remain key near-term markers of execution, even as the business continues to broaden beyond its core imaging software base.

With $1.34 billion of contracted future revenue, the FY26 result provides a base heading into FY27. The next catalysts will be the conversion of the company's pipeline, further cardiology adoption and regulatory progress for its breast cancer detection technology.