iCAD (ICAD) 10-K 29 Mar 19 2018 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2018	Mar. 25, 2019	Jun. 30, 2018
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2018
Document Fiscal Year Focus	2018
Document Fiscal Period Focus	FY
Trading Symbol	ICAD
Entity Registrant Name	ICAD INC
Entity Central Index Key	0000749660
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		17,235,267
Entity Public Float			$ 42,671,764

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 12,185	$ 9,387
Trade accounts receivable, net of allowance for doubtful accounts of $177 in 2018 and $107 in 2017	6,403	8,599
Inventory, net	1,587	2,123
Prepaid expenses and other current assets	1,045	1,100
Total current assets	21,220	21,209
Property and equipment:
Equipment	6,020	5,722
Leasehold improvements	62	62
Furniture and fixtures	308	305
Marketing assets	376	376
Total property and equipment	6,766	6,465
Less accumulated depreciation and amortization	6,214	5,889
Net property and equipment	552	576
Other assets:
Other assets	53	53
Intangible assets, net of accumulated amortization of $7,809 in 2018 and $7,433 in 2017	1,550	1,931
Goodwill	8,362	8,362
Total other assets	9,965	10,346
Total assets	31,737	32,131
Current liabilities:
Accounts payable	1,154	1,362
Accrued expenses	5,060	4,475
Notes payable - current portion	1,851	817
Capital lease payable, short-term portion	15	12
Deferred revenue	5,165	5,404
Total current liabilities	13,245	12,070
Other long-term liabilities	27	119
Deferred revenue, long-term portion	331	506
Notes payable, long-term portion	4,254	5,119
Convertible debentures payable to non-related parties, at fair value	6,300
Convertible debentures payable to related parties, at fair value	670
Capital lease - long-term portion	11	27
Deferred tax	3	14
Total liabilities	24,841	17,855
Commitments and contingencies (Note 9)
Stockholders' equity:
Preferred stock, $ .01 par value: authorized 1,000,000 shares; none issued.
Common stock, $ .01 par value: authorized 30,000,000 shares; issued 17,066,510 in 2018 and 16,711,512 in 2017; outstanding 16,880,679 in 2018 and 16,525,681 in 2017	171	167
Additional paid-in capital	218,914	217,389
Accumulated deficit	(210,774)	(201,865)
Treasury stock at cost, 185,831 shares in 2018 and 2017	(1,415)	(1,415)
Total stockholders' equity	6,896	14,276
Total liabilities and stockholders' equity	$ 31,737	$ 32,131

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Allowance for doubtful accounts on trade accounts receivable	$ 177	$ 107
Intangible assets, accumulated amortization	$ 7,809	$ 7,433
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, shares issued	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	30,000,000	30,000,000
Common stock, shares issued	17,066,510	16,711,512
Common stock, shares outstanding	16,880,679	16,525,681
Treasury stock, shares	185,831	185,831

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenue:
Total Revenue	$ 25,621	$ 28,102	$ 26,338
Cost of Revenue:
Amortization and depreciation	403	1,037	1,189
Total cost of revenue	6,191	9,926	7,820
Gross profit	19,430	18,176	18,518
Operating expenses:
Engineering and product development	9,445	9,327	9,518
Marketing and sales	8,693	10,503	10,179
General and administrative	9,117	7,877	7,675
Amortization and depreciation	305	452	1,116
Gain on sale of MRI assets		(2,508)
Goodwill and long-lived asset impairment		6,693
Total operating expenses	27,560	32,344	28,488
Loss from operations	(8,130)	(14,168)	(9,970)
Other expense
Interest expense	(504)	(124)	(63)
Interest income	110	18	10
Financing costs	(451)
Other expense, net	(845)	(106)	(53)
Loss before income tax	(8,975)	(14,274)	(10,023)
Income tax (benefit) expense	42	(18)	76
Net loss and comprehensive loss	$ (9,017)	$ (14,256)	$ (10,099)
Net loss per share:
Basic	$ (0.54)	$ (0.87)	$ (0.63)
Diluted	$ (0.54)	$ (0.87)	$ (0.63)
Weighted average number of shares used in computing loss per share:
Basic	16,685	16,343	15,932
Diluted	16,685	16,343	15,932
Product [Member]
Revenue:
Total Revenue	$ 13,111	$ 13,554	$ 10,471
Cost of Revenue:
Total cost of revenue	2,161	2,660	918
Service [Member]
Revenue:
Total Revenue	12,510	14,548	15,867
Cost of Revenue:
Total cost of revenue	$ 3,627	$ 6,229	$ 5,713

Consolidated Statements of Shar

Consolidated Statements of Shareholders' Equity - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Deficit [Member]	Treasury Stock [Member]
Beginning Balance at Dec. 31, 2015	$ 32,746	$ 159	$ 211,512	$ (177,510)	$ (1,415)
Beginning Balance, shares at Dec. 31, 2015		15,923,349
Issuance of common stock relative to vesting of restricted stock, net of 27,299, 55,115 and 56,946 shares forfeited for tax obligations in 2016, 2017 and 2018 respectively	(114)	$ 3	(117)
Issuance of common stock relative to vesting of restricted stock, net of 27,299, 55,115 and 56,946 shares forfeited for tax obligations in 2016, 2017 and 2018 respectively, shares		261,731
Issuance of common stock pursuant to stock option plans	$ 198	$ 1	197
Issuance of common stock pursuant to stock option plans, shares	75,583	75,583
Stock-based compensation	$ 2,307		2,307
Net loss	(10,099)			(10,099)
Ending Balance at Dec. 31, 2016	25,038	$ 163	213,899	(187,609)	(1,415)
Ending Balance, shares at Dec. 31, 2016		16,260,663
Issuance of common stock relative to vesting of restricted stock, net of 27,299, 55,115 and 56,946 shares forfeited for tax obligations in 2016, 2017 and 2018 respectively	(241)	$ 4	(245)
Issuance of common stock relative to vesting of restricted stock, net of 27,299, 55,115 and 56,946 shares forfeited for tax obligations in 2016, 2017 and 2018 respectively, shares		414,319
Issuance of common stock pursuant to stock option plans	$ 79		79
Issuance of common stock pursuant to stock option plans, shares	36,530	36,530
Stock-based compensation	$ 3,656		3,656
Net loss	(14,256)			(14,256)
Ending Balance at Dec. 31, 2017	14,276	$ 167	217,389	(201,865)	(1,415)
Ending Balance, shares at Dec. 31, 2017		16,711,512
Issuance of common stock relative to vesting of restricted stock, net of 27,299, 55,115 and 56,946 shares forfeited for tax obligations in 2016, 2017 and 2018 respectively	(180)	$ 3	(183)
Issuance of common stock relative to vesting of restricted stock, net of 27,299, 55,115 and 56,946 shares forfeited for tax obligations in 2016, 2017 and 2018 respectively, shares		265,442
Issuance of common stock pursuant to stock option plans	$ 204	$ 1	203
Issuance of common stock pursuant to stock option plans, shares	139,556	89,556
Stock-based compensation	$ 1,505		1,505
Net loss	(9,017)			(9,017)
Ending Balance at Dec. 31, 2018	6,896	$ 171	$ 218,914	(210,774)	$ (1,415)
Ending Balance, shares at Dec. 31, 2018		17,066,510
Cumulative impact from the adoption of ASC 606 (see Note 1)	$ 108			$ 108

Consolidated Statements of Sh_2

Consolidated Statements of Shareholders' Equity (Parenthetical) - shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Shares forfeited for tax obligations	56,946	55,115	27,299
Common Stock [Member]
Shares forfeited for tax obligations	56,946	55,115	27,299
Additional Paid-in Capital [Member]
Shares forfeited for tax obligations	56,946	55,115	27,299

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash flow from operating activities:
Net loss	$ (9,017)	$ (14,256)	$ (10,099)
Adjustments to reconcile net loss to net cash used for operating activities:
Amortization	383	494	983
Depreciation	325	995	1,322
Bad debt provision	225	45	177
Inventory obsolesence reserve		1,052	114
Stock-based compensation expense	1,505	3,656	2,307
Amortization of debt discount and debt costs	170		(23)
Gain from acquisition settlement			(249)
Goodwill and long-lived asset impairment		6,693
Interest on settlement obligations		26	82
Deferred tax	(12)	8	7
Loss on disposal of assets	12	52	10
Gain on sale of MRI assets		(2,158)
Changes in operating assets and liabilities, net of acquisition:
Accounts receivable	2,003	(3,474)	2,201
Inventory	536	554	482
Prepaid and other assets	172	29	(504)
Accounts payable	(209)	(215)	(16)
Accrued expenses	494	(505)	309
Deferred revenue	(454)	(333)	(2,581)
Total adjustments	5,150	6,919	4,621
Net cash used for operating activities	(3,867)	(7,337)	(5,478)
Cash flow from investing activities:
Additions to patents, technology and other	(15)	(5)	(12)
Additions to property and equipment	(301)	(390)	(337)
Acquisition of VuComp M-Vu CAD			(6)
Sale of MRI assets		2,850
Net cash provided by (used for) investing activities	(316)	2,455	(355)
Cash flow from financing activities:
Issuance of common stock for cash, net	0	0	0
Stock option exercises	204	79	198
Taxes paid related to restricted stock issuance	(180)	(241)	(114)
Debt issuance costs		(74)
Principal payments of capital lease obligations	(13)	(80)	(946)
Proceeds from debt financing		6,000
Proceeds from convertible debentures	6,970
Net cash provided by (used for) financing activities	6,981	5,684	(862)
Increase (decrease) in cash and equivalents	2,798	802	(6,695)
Cash and equivalents, beginning of year	9,387	8,585	15,280
Cash and equivalents, end of year	12,185	9,387	8,585
Supplemental disclosure of cash flow information:
Interest paid	294	79	70
Taxes paid	$ 51	60	$ 67
Escrow due from MRI asset sale		350
Equipment purchased under capital lease		$ 42

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	(1) Summary of Significant Accounting Policies (a) Nature of Operations and Use of Estimates iCAD, Inc. and subsidiaries (the “Company” or “iCAD”) is a provider of advanced image analysis, workflow solutions and radiation therapy for the early identification and treatment of cancer. The Company has grown primarily through acquisitions to become a broad player in the oncology market. Its solutions include advanced image analysis and workflow solutions that enable healthcare professionals to better serve patients by identifying pathologies and pinpointing the most prevalent cancers earlier, a comprehensive range of high-performance, upgradeable Computer-Aided Detection (CAD) systems and workflow solutions for mammography, MRI and CT, and the Xoft System which is an isotope-free cancer treatment platform technology. CAD is reimbursable in the U.S. under federal and most third-party insurance programs. The Company intends to continue the extension of its image analysis and clinical decision support solutions for mammography, MRI and CT imaging. iCAD believes that advances in digital imaging techniques should bolster its efforts to develop additional commercially viable CAD/advanced image analysis and workflow products. The Company’s management believes that early detection in combination with earlier targeted intervention will provide patients and care providers with the best tools available to achieve better clinical outcomes resulting in a market demand that will drive top line growth. The Company’s headquarters are located in Nashua, New Hampshire, with manufacturing and contract manufacturing facilities in New Hampshire and Massachusetts, and an operations, research, development, manufacturing and warehousing facility in San Jose, California. The Company operates in two segments: Cancer Detection (“Detection”) and Cancer Therapy (“Therapy”). The Detection segment consists of advanced image analysis and workflow products, and the Therapy segment consists of radiation therapy products. The Company sells its products throughout the world through its direct sales organization as well as through various OEM partners, distributors and resellers. See Note 8 for segment, major customer and geographical information. In January 2018, the Company adopted a plan to discontinue offering radiation therapy professional services to practices that provide the Company’s electronic brachytherapy solution for the treatment of non-melanoma The preparation of financial statements in conformity with generally accepted accounting principles in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. Actual results could differ from those estimates. It is reasonably possible that changes may occur in the near term that would affect management’s estimates with respect to assets and liabilities. (b) Principles of Consolidation The consolidated financial statements include the accounts of the Company and its wholly owned subsidiaries: Xoft, Inc. and Xoft Solutions, LLC. All material inter-company transactions and balances have been eliminated in consolidation. (c) Cash and cash equivalents The Company defines cash and cash equivalents as all bank accounts, money market funds, deposits and other money market instruments with original maturities of 90 days or less, which are unrestricted as to withdrawal. Cash and cash equivalents are maintained at financial institutions and, at times, balances may exceed federally insured limits. The Company has never experienced any losses related to these balances. Insurance coverage is $250,000 per depositor at each financial institution, and the Company’s non-interest (d) Financial instruments Financial instruments consist of cash and cash equivalents, accounts receivable, accounts payable, notes payable and convertible debentures. Due to their short term nature and market rates of interest, the carrying amounts of the financial instruments, except the convertible debentures, approximated fair value as of December 31, 2018 and 2017. The Company has elected to record the convertible debentures at fair value at each reporting date in accordance with the fair value option election. See Note 4(b) for further details. (e) Accounts Receivable and Allowance for Doubtful Accounts Accounts receivable are customer obligations due under normal trade terms. Credit limits are established through a process of reviewing the financial history and stability of each customer. The Company performs continuing credit evaluations of its customers’ financial condition and generally does not require collateral. The Company’s policy is to maintain allowances for estimated losses from the inability of its customers to make required payments. The Company’s senior management reviews accounts receivable on a periodic basis to determine if any receivables may potentially be uncollectible. The Company includes any accounts receivable balances that it determines may likely be uncollectible, along with a general reserve for estimated probable losses based on historical experience, in its overall allowance for doubtful accounts. An amount would be written off against the allowance after all attempts to collect the receivable had failed. Based on the information available, the Company believes the allowance for doubtful accounts as of December 31, 2018 and 2017 is adequate. The following table summarizes the allowance for doubtful accounts for the three years ended December 31, 2018 (in thousands): 2018 2017 2016 Balance at beginning of period $ 107 $ 172 $ 236 Additions charged to costs and expenses 225 45 177 Reductions (155 ) (110 ) (241 ) Balance at end of period $ 177 $ 107 $ 172 (f) Inventory Inventory is valued at the lower of cost or net realizable value, with cost determined by the first-in, first-out As of December 31, 2018 2017 Raw materials $ 606 $ 992 Work in process 67 63 Finished Goods 914 1,068 Inventory $ 1,587 $ 2,123 (g) Property and Equipment Property and equipment are stated at cost and depreciated using the straight-line method over the estimated useful lives of the assets or the remaining lease term, if shorter, for leasehold improvements (see below). Estimated life Equipment 3-5 years Leasehold improvements 3-5 Furniture and fixtures 3-5 Marketing assets 3-5 (h) Goodwill In accordance with FASB Accounting Standards Codification (“ASC”) Topic 350-20, “Intangibles - Goodwill and Other” 350-20”), Factors the Company considers important, which could trigger an impairment of such asset, include the following: • significant underperformance relative to historical or projected future operating results; • significant changes in the manner or use of the assets or the strategy for the Company’s overall business; • significant negative industry or economic trends; • significant decline in the Company’s stock price for a sustained period; and • a decline in the Company’s market capitalization below net book value. The Company records an impairment charge when such assessment indicates that the fair value of a reporting unit was less than the carrying value. In evaluating potential impairments outside of the annual measurement date, judgment is required in determining whether an event has occurred that may impair the value of goodwill or intangible assets. The Company utilizes either discounted cash flow models or other valuation models, such as comparative transactions and market multiples, to determine the fair value of reporting units. The Company makes assumptions about future cash flows, future operating plans, discount rates, comparable companies, market multiples, purchase price premiums and other factors in those models. Different assumptions and judgment determinations could yield different conclusions that would result in an impairment charge to income in the period that such change or determination was made. In January 2018, the Company adopted a plan to discontinue offering radiation therapy professional services to practices that provide the Company’s electronic brachytherapy solution for the treatment of non-melanoma The Company elected to early adopt ASU 2017-04, 2017-04”) 2017-04 As a result of the underperformance of the Therapy reporting unit as compared to expected future results, the Company determined there was a triggering event in the third quarter of 2017. As a result, the Company completed an interim impairment assessment. The interim test resulted in the fair value of the Therapy reporting unit being less than the carrying value of the reporting unit. The fair value of the Therapy reporting unit was $3.5 million and the carrying value was $7.5 million. The deficiency of $4.0 million was recorded as an impairment charge in the third quarter of the year ended December 31, 2017. The Company did not identify a triggering event within the Detection reporting unit and accordingly did not perform an interim test. The Company determines the fair value of reporting units based on the present value of estimated future cash flows, discounted at an appropriate risk adjusted rate. This approach was selected as it measures the income producing assets, primarily technology and customer relationships. This method estimates the fair value based upon the ability to generate future cash flows, which is particularly applicable when future profit margins and growth are expected to vary significantly from historical operating results. The Company uses internal forecasts to estimate future cash flows and includes an estimate of long-term future growth rates based on the most recent views of the long-term forecast for the reporting unit. Accordingly, actual results can differ from those assumed in the forecasts. Discount rates are derived from a capital asset pricing model and analyzing published rates for industries relevant to the reporting unit to estimate the cost of equity financing. The Company uses discount rates that are commensurate with the risks and uncertainty inherent in the respective businesses and in the internally developed forecasts. Other significant assumptions include terminal value margin rates, future capital expenditures, and changes in future working capital requirements. While there are inherent uncertainties related to the assumptions used and to the application of these assumptions to this analysis, the income approach provides a reasonable estimate of the fair value of the Therapy reporting unit. The Company performed the annual impairment assessment at October 1, 2018 and compared the fair value of each reporting unit to its carrying value as of this date. The fair value exceeded the carrying value for the Detection reporting unit as of the date of this impairment assessment. Goodwill for the Therapy reporting unit was fully impaired as of December 31, 2017. As such, the Company did not record any impairment charges for the year ended December 31, 2018. The carrying values of the reporting units were determined based on an allocation of our assets and liabilities through specific allocation of certain assets and liabilities, to the reporting units and an apportionment of the remaining net assets based on the relative size of the reporting units’ revenues and operating expenses compared to the Company as a whole. The determination of reporting units also requires management judgment. The Company determines the fair values for each reporting unit using a weighting of the income approach and the market approach. For purposes of the income approach, fair value is determined based on the present value of estimated future cash flows, discounted at an appropriate risk adjusted rate. The Company uses internal forecasts to estimate future cash flows and includes estimates of long-term future growth rates based on our most recent views of the long-term forecast for each segment. Accordingly, actual results can differ from those assumed in our forecasts. Discount rates are derived from a capital asset pricing model and by analyzing published rates for industries relevant to our reporting units to estimate the cost of equity financing. The Company uses discount rates that are commensurate with the risks and uncertainty inherent in the respective businesses and in our internally developed forecasts. In the market approach, the Company uses a valuation technique in which values are derived based on market prices of publicly traded companies with similar operating characteristics and industries. A market approach allows for comparison to actual market transactions and multiples. It can be somewhat limited in its application because the population of potential comparable publicly-traded companies can be limited due to differing characteristics of the comparative business and ours, as well as market data may not be available for divisions within larger conglomerates or non-public The Company corroborates the total fair values of the reporting units using a market capitalization approach; however, this approach cannot be used to determine the fair value of each reporting unit value. The blend of the income approach and market approach is more closely aligned to the business profile of the Company, including markets served and products available. In addition, required rates of return, along with uncertainties inherent in the forecast of future cash flows, are reflected in the selection of the discount rate. In addition, under the blended approach, reasonably likely scenarios and associated sensitivities can be developed for alternative future states that may not be reflected in an observable market price. The Company will assess each valuation methodology based upon the relevance and availability of the data at the time the valuation is performed and weights the methodologies appropriately. A rollforward of goodwill activity by reportable segment is as follows (in thousands): Detection Therapy Total Accumulated Goodwill $ — $ — $ 47,937 Accumulated impairment — — (26,828 ) Fair value allocation 7,663 13,446 — Acquisition of DermEbx and Radion — 6,154 6,154 Acquisition measurement period adjustments — 116 116 Acquisition of VuComp 1,093 — 1,093 Sale of MRI assets (394 ) — (394 ) Impairment — (13,981 ) (13,981 ) Balance at December 31, 2016 8,362 5,735 14,097 Impairment — (5,735 ) (5,735 ) Balance at December 31, 2017 8,362 — 8,362 — — — Balance at December 31, 2018 $ 8,362 $ — $ 8,362 Accumulated Goodwill 699 6,270 49,171 Fair value allocation 7,663 13,446 — Accumulated impairment — (19,716 ) (40,809 ) Balance at December 31, 2018 $ 8,362 $ — $ 8,362 (i) Long Lived Assets In accordance with FASB ASC Topic 360, “Property, Plant and Equipment”, (“ASC 360”), the Company assesses long-lived assets for impairment if events and circumstances indicate it is more likely than not that the fair value of the asset group is less than the carrying value of the asset group. ASC 360-10-35 360-10-35-21, • A significant decrease in the market price of a long-lived asset (asset group); • A significant adverse change in the extent or manner in which a long-lived asset (asset group) is being used or in its physical condition; • A significant adverse change in legal factors or in the business climate that could affect the value of a long-lived asset (asset group), including an adverse action or assessment by a regulator; • An accumulation of costs significantly in excess of the amount originally expected for the acquisition or construction of a long-lived asset (asset group); • A current period operating or cash flow loss combined with a history of operating or cash flow losses or a projection or forecast that demonstrates continuing losses associated with the use of a long-lived asset (asset group). In accordance with ASC 360-10-35-17, The Company completed an interim goodwill impairment assessment for the Therapy reporting unit in the third quarter of 2017 and noted that there was an impairment of goodwill. As a result, the Company determined this was a triggering event to review long-lived assets for impairment. The Company determined the “Asset Group” to be the assets of the Therapy segment, which the Company considered to be the lowest level for which the identifiable cash flows were largely independent of the cash flows of other assets and liabilities. Accordingly, the Company completed an analysis pursuant to ASC 360-10-35-17 The Company also completed a goodwill assessment in the fourth quarter of 2017, and in connection with that assessment, the Company completed an analysis pursuant to ASC 360-10-35-17 The Company did not record any impairment charges for the years ended December 31, 2018 or 2016. A considerable amount of judgment and assumptions are required in performing the impairment tests, principally in determining the fair value of the asset group. While the Company believes the judgments and assumptions are reasonable, different assumptions could change the estimated fair values, and, therefore additional impairment charges could be required. Significant negative industry or economic trends, disruptions to the Company’s business, loss of significant customers, inability to effectively integrate acquired businesses, unexpected significant changes or planned changes in use of the assets may adversely impact the assumptions used in the fair value estimates and ultimately result in future impairment charges. Intangible assets subject to amortization consist primarily of patents, technology, customer relationships and trade names purchased in the Company’s previous acquisitions. These assets, which include assets from the acquisition of the assets of VuComp, DermEbx and Radion and the acquisition of Xoft, Inc., are amortized on a straight-line basis consistent with the pattern of economic benefit over their estimated useful lives of 5 to 15 years. A summary of intangible assets for 2018 and 2017 are as follows (in thousands): 2018 2017 Weighted Gross Carrying Amount Patents and licenses $ 571 $ 556 5 years Technology 8,257 8,257 10 years Customer relationships 272 292 7 years Tradename 259 259 10 years Total amortizable intangible assets 9,359 9,364 Accumulated Amortization Patents and licenses $ 511 $ 503 Technology 6,958 6,610 Customer relationships 81 61 Tradename 259 259 Total accumulated amortization 7,809 7,433 Total amortizable intangible assets, net $ 1,550 $ 1,931 Amortization expense related to intangible assets was approximately $383,000, $494,000 and $983,000 for the years ended December 31, 2018, 2017, and 2016, respectively. Estimated remaining amortization of the Company’s intangible assets is as follows (in thousands): For the years ended December 31: Estimated 2019 $ 422 2020 304 2021 226 2022 297 2023 100 Thereafter 201 $ 1,550 (j) Revenue Recognition Revenue Recognition Upon Adoption of ASC 606 On January 1, 2018, the Company adopted FASB ASC Topic 606, “Revenue from Contracts with Customers” and all the related amendments (“Topic 606”), using the modified retrospective method for all contracts not completed as of the date of adoption. For contracts that were modified before the effective date, the Company reflected the aggregate effect of all modifications when identifying performance obligations and allocating transaction price in accordance with practical expedient ASC 606-10-65-1-(f)-4, We recorded a net increase to opening retained earnings of $0.1 million as of January 1, 2018 due to the cumulative impact of adopting Topic 606, with the impact primarily related to the deferral of commissions on our long-term service arrangements and warranty periods greater than one year, which previously were expensed as incurred but, under the amendments to ASC 340-40, The cumulative effect of the changes made to the Company’s consolidated balance sheet for the adoption of Topic 606 were as follows (in thousands): Selected Balance Sheet Balance at Adjustments Due to ASU 2014-09 Balance at Assets Prepaid expenses and other current assets $ 1,100 $ 147 $ 1,247 Liabilities Deferred revenue — 408 408 Contract liabilities 5,910 (369 ) 5,541 Stockholders’ equity Accumulated deficit (201,865 ) 108 (201,973 ) In accordance with the requirements of the new standard, the disclosure of the impact of the adoption on our consolidated balance sheet and statement of operations was as follows (in thousands): As of December 31, 2018 Selected Balance Sheet As Reported Balances without Effect of Change Assets Prepaid expenses and other current assets $ 1,045 $ 763 $ (282 ) Liabilities Accrued expenses 5,060 5,060 — Deferred revenue 287 287 — Contract liabilities 5,209 5,209 — Deferred tax 3 2 (1 ) Stockholders’ equity Accumulated deficit (210,774 ) (211,056 ) (282 ) The impact to revenues as a result of applying Topic 606 for the year ended December 31, 2018 was an increase of $116,000 (table in thousands). Year ended December 31, 2018 Selected Statement of Operations As Reported Balances without Effect of Change Revenue Products $ 13,111 $ 12,944 $ 167 Service and supplies 12,510 12,561 (51 ) Cost of revenue Products 2,161 2,161 — Service and supplies 3,627 3,627 — Operating expenses Marketing and sales 8,693 8,975 (282 ) Interest expense (504 ) (504 ) — Other income 110 110 — Tax benefit (expense) 42 42 — Net loss (9,017 ) (9,415 ) (398 ) In accordance with ASC 606, revenue is recognized when a customer obtains control of promised goods or services. The amount of revenue recognized reflects the consideration to which the Company expects to be entitled to receive in exchange for these goods or services and excludes any sales incentives or taxes collected from customers which are subsequently remitted to government authorities. To achieve this core principle, the Company applies the following five steps: 1) Identify the contract(s) with a customer 2) Identify the performance obligations in the contract 3) Determine the transaction price 4) Allocate the transaction price to the performance obligations in the contract 5) Recognize revenue when (or as) the Company satisfies a performance obligation The Company recognizes revenue from its contracts with customers primarily from the sale of products and from the sale of services and supplies. Under Topic 606, revenue is recognized when control of the promised goods or services is transferred to a customer, in an amount that reflects the consideration we expect to be entitled to in exchange for those goods or services. For product revenue, control has transferred upon shipment provided title and risk of loss have passed to the customer. Services and supplies are considered to be transferred as the services are performed or over the term of the service or supply agreement. The Company enters into contracts that can include various combinations of products and services, which are generally capable of being distinct and accounted for as separate performance obligations. The Company’s hardware is generally highly dependent on, and interrelated with, the underlying software and the software is considered essential to the functionality of the product. In these cases, the hardware and software license are accounted for as a single performance obligation and revenue is recognized at the point in time when ownership is transferred to the customer. Taxes assessed by a governmental authority that are both imposed on and concurrent with a specific revenue-producing transaction, that are collected by the Company from a customer, are excluded from revenue. Shipping and handling costs associated with outbound freight after control of a product has transferred to a customer are accounted for as fulfillment costs and are included in cost of revenue. The Company continues to provide for estimated warranty costs on original product warranties at the time of sale. Disaggregation of Revenue The following tables presents our revenues disaggregated by major good or service line, timing of revenue recognition and sales channel, reconciled to our reportable segments (in thousands). Year ended December 31, 2018 Reportable Segments Detection Therapy Total Major Goods/Service Lines Products $ 10,783 $ 4,393 $ 15,176 Service contracts 5,311 1,450 6,761 Supply and source usage agreements — 2,261 2,261 Professional services — 264 264 Other 229 389 618 $ 16,323 $ 8,757 $ 25,080 Timing of Revenue Recognition Goods transferred at a point in time $ 10,835 $ 4,676 $ 15,511 Services transferred over time 5,488 4,081 9,569 $ 16,323 $ 8,757 $ 25,080 Sales Channels Direct sales force $ 8,335 $ 7,554 $ 15,889 OEM partners 7,988 — 7,988 Channel partners — 1,203 1,203 $ 16,323 $ 8,757 $ 25,080 Total Revenue Revenue from contracts with customers $ 16,323 $ 8,757 $ 25,080 Revenue from lease components 541 — 541 $ 16,864 $ 8,757 $ 25,621 Year ended December 31, 2017(1) Reportable Segments Detection Therapy Total Major Goods/Service Lines Products $ 11,650 $ 4,763 $ 16,413 Service contracts 5,687 1,482 7,169 Supply and source usage agreements — 1,956 1,956 Professional services — 254 254 Other 388 1,337 1,725 $ 17,725 $ 9,792 $ 27,517 Timing of Revenue Recognition Goods transferred at a point in time 11,684 5,266 $ 16,814 Services transferred over time 6,041 4,526 10,703 $ 17,725 $ 9,792 $ 27,517 Sales Channels Direct sales force $ 7,787 $ 8,354 $ 16,141 OEM partners 9,938 — 9,938 Channel partners — 1,438 1,438 $ 17,725 $ 9,792 $ 27,517 Total Revenue Revenue from contracts with customers $ 17,725 $ 9,792 $ 27,517 Revenue from lease components 585 — 585 $ 18,310 $ 9,792 $ 28,102 (1) As noted above, prior period amounts have not been adjusted under the modified retrospective method. Products Service Contracts non-lease Supply and Source Usage Agreements Professional Services Other Significant Judgments The Company’s contracts with customers may include promises to transfer multiple products and services to a customer. Determining whether products and services are considered distinct performance obligations that should be accounted for separately versus together may require significant judgment. For arrangements with multiple performance obligations, the Company allocates revenue to each performance obligation based on its relative standalone selling price. Judgment is required to determine the standalone selling price for each distinct performance obligation. The Company generally determines standalone selling prices based on the prices charged to customers and uses a range of amounts to estimate standalone selling prices when we sell each of the products and services separately and need to determine whether there is a discount that needs to be allocated based on the relative standalone selling prices of the various products and services. The Company typically has more than one range of standalone selling prices for individual products and services due to the stratification of those products and services by customers and circumstances. In these instances, the Company may use information such as the type of customer and geographic region in determining the range of standalone selling prices. The Company may provide credits or incentives to customers, which are accounted for as variable consideration when estimating the transaction price of the contract and amounts of revenue to recognize. The amount of variable consideration to include in the transaction price is estimated at contract inception using either the estimated value method or the most likely amount method based on the nature of the variable consideration. These estimates are updated at the end of each reporting period as additional information becomes available and revenue is recognized only to the extent that it is probable that a significant reversal of any amounts of variable consideration included in the transaction price will not occur. The Company provides for estimated warranty costs on original product warranties at the time of sale. Contract Balances Contract liabilities are a component of deferred revenue, and contract assets are a component of prepaid and other current assets. The following table provides information about receivables, contract assets, and contract liabilities from contracts with customers (in thousands). Balance at Receivables, which are included in ‘Trade accounts receivable’ $ 6,252 Contract assets, which are included in “Prepaid and other current assets” 19 Contract liabilities, which are included in “Deferred revenue” 5,209 Timing of revenue recognition may differ from timing of invoicing to customers. The Company records a receivable when revenue is recognized prior to receipt of cash payments and the Company has the unconditional right to such consideration, or unearned revenue when cash payments are received or due in advance of performance. For multi-year agreements, the Company generally invoices customers annually at the beginning of each annual service period. The opening balance of accounts receivable from contracts with customers, net of allowance for doubtful accounts, was $8.5 million as of January 1, 2018. As of December 31, 2018, accounts receivable, net of allowance for doubtful accounts, was $6.3 million. The Company records a contract asset for unbilled revenue when the Company’s performance is in excess of amounts billed or billable. The Company has classified the contract asset balance as a component of prepaid expenses and other current assets as of January 1, 2018 and December 31, 2018. The opening balance of contract assets was $166,000 as of January 1, 2018. As of December 31, 2018, the contract asset balance was $19,000. Deferred revenue from contracts with customers is primarily composed of fees related to long-term service arrangements, which are generally billed in advance. Deferred revenue also includes payments for installation and training that has not yet been completed and other offerings for which we have been paid in advance and earn the revenue when we transfer control of the product or service. Deferred revenue from contracts with customers is included in deferred revenue in the consolidated balance sheets. Deferred revenue on the consolidated balance sheet also includes $369,000 and $287,000 at December 31, 2017 and December 31, 2018, respectively of amounts associated with service contracts accounted for under Topic 840. The balance of deferred revenue at December 31, 2017 and December 31, 2018 is as follows (in thousands): December 31, 2017 Contract Lease revenue Total Short term $ 5,044 $ 360 $ 5,404 Long term 497 9 506 Total $ 5,541 $ 369 $ 5,910 December 31, 2018 Contract Lease revenue Total Short term $ 4,885 $ 280 $ 5,165 Long term 324 7 331 Total $ 5,209 $ 287 $ 5,496 Changes in deferred revenue from contracts with customers were as follows (in thousands): Year Ended Balance at beginning of period $ 5,541 Adoption adjustment 39 Deferral of revenue 9,993 Recognition of deferred revenue (10,364 ) Balance at end of period $ 5,209 We expect to recognize approximately $4.9 million of the deferred amount in 2019, $0.2 million in 2020, and $0.1 million thereafter. Assets Recognized from the Costs to Obtain a Contract with a Customer We recognize an asset for the incremental costs of obtaining a contract with a customer if we expect the benefit of those costs to be longer than one year. We have determined that certain commissions programs meet the requirements to be capitalized. The opening balance of capitalized costs to obtain a contract was $117,000 as of January 1, 2018. As of December 31, 2018, the balance of capitalized costs to obtain a contract was $282,000. The Company has classified the capitalized costs to obtain a contract as a component of prepaid expenses and other current assets as of January 1, 2018 and December 31, 2018. Changes in the balance of capitalized costs to obtain a contract were as follows (in thousands): Year Ended Balance at beginning of period $ 117 Deferral of costs to obtain a contract 368 Recognition of costs to obtain a contract (203 ) Balance at end of period $ 282 Practical Expedients and Exemptions The Company has elected to make the following accounting policy elections through the adoption of the following practical expedients: Right to Invoice Where applicable, the Company will recognize revenue from a contract with a customer in an amount that corresponds directly with the value to the customer of the Company’s performance completed to date and the amount to which the entity has a right to invoice. Sales and Other Similar Taxes The Company will exclude sales taxes and similar taxes from the measurement of transaction price and will en

Acquisitions

Acquisitions	12 Months Ended
	Dec. 31, 2018
Business Combinations [Abstract]
Acquisitions	(2) Acquisitions Acquisition of VuComp Cancer detection portfolio On January 13, 2016, the Company completed the acquisition of the VuCOMP cancer detection portfolio, including the M-Vu As noted below, the Company acquired VuComp’s M-Vu Amount (000’s) Cash $ 6 Acquisition litigation settlement 249 Purchase price $ 255 The amount allocated to the acquired assets was estimated primarily through the use of discounted cash flow valuation techniques. Appraisal assumptions utilized under this method include a forecast of estimated future net cash flows, as well as discounting the future net cash flows to their present value. The following is a summary of the allocation of the total purchase price based on the estimated fair values as of the date of the acquisition and the amortizable life: Amount (000’s) Estimated Current assets $ 84 Property and equipment 65 3 Years Identifiable intangible assets 699 1-10 Years Goodwill 293 Current liabilities (280 ) Long-term liabilities (606 ) Purchase price $ 255 The assets obtained in the acquisition of VuComp’s M-Vu M-Vu Acquisition of VuComp M-Vu On April 29, 2015, pursuant to the terms of the Asset Purchase Agreement with VuComp, the Company purchased VuComp’s M-Vu Business Combinations The amount allocated to the acquired assets was estimated primarily through the use of discounted cash flow valuation techniques. Appraisal assumptions utilized under this method include a forecast of estimated future net cash flows, as well as discounting the future net cash flows to their present value. The acquired technology is being amortized over the estimated useful life of approximately eight years and nine months from the closing of the transaction. The following is a summary of the allocation of the total purchase price based on the estimated fair values as of the date of the acquisition and the amortizable life (in thousands): Amount Estimated Developed Technology $ 900 8 years 9 months Goodwill 800 Purchase price $ 1,700 The assets obtained in the acquisition of VuComp’s M-Vu

Sale of MRI Assets

Sale of MRI Assets	12 Months Ended
	Dec. 31, 2018
Discontinued Operations and Disposal Groups [Abstract]
Sale of MRI Assets	(3) Sale of MRI Assets In December 2016, the Company entered into an Asset Purchase Agreement with Invivo Corporation. In accordance with the agreement, the Company sold to Invivo all right, title and interest to certain intellectual property relating to the Company’s VersaVue Software and DynaCAD product and related assets for $3.2 million. The Company closed the transaction on January 30, 2017 less a holdback reserve of $350,000 for a net of approximately $2.9 million. The holdback reserve of $350,000 has been recorded as an asset in other assets and will be paid to the Company within eighteen months from the closing date, less any amounts, if any, due and payable or reserved under the indemnification provisions in the Asset Purchase agreement. See Note 9(g) Litigation The Company determined the sale constituted the sale of a business in accordance with ASC 805. The Company performed an evaluation to determine if the sale constituted discontinued operations and concluded that the sale did not represent a major strategic shift, and accordingly it was not considered to be discontinued operations. In connection with the transaction, the Company allocated $394,000 of goodwill which was a component of the gain on the sale. The allocation was based on the fair value of the assets sold relative to the fair value of the Detection reporting unit as of the date of the agreement, based on the guidance from ASC 350-20-40-3. The value of the net assets sold is as follows (in thousands): Assets Accounts Receivable $ 116 Intangible assets 810 Allocated Goodwill 394 Total Assets $ 1,320 Liabilities Deferred Revenue $ 746 Total Liabilities $ 746 Net Assets Sold $ 574 In connection with the sale the Company agreed to provide certain transition services to Invivo. The fair value of the transition services were determined based on the cost to provide plus a reasonable profit margin and have been recognized as revenue over the term of approximately ninety days from the closing date. The Company recorded a gain of $2.5 million as of January 30, 2017. The components of the gain on the sale are as follows (in thousands): Gain on Sale Cash received $ 2,850 Holdback reserve 350 Fair value of transition services (118 ) Net Assets sold (574 ) Total $ 2,508

Financing Arrangements

Financing Arrangements	12 Months Ended
	Dec. 31, 2018
Debt Disclosure [Abstract]
Financing Arrangements	(4) Financing Arrangements (a) Loan and Security Agreement On August 7, 2017, the Company entered into a Loan and Security Agreement, which has been modified by the First Loan Modification Agreement dated as of March 22, 2018, the Second Loan Modification Agreement dated as of August 13, 2018, and the Third Loan Modification Agreement dated as of December 20, 2018 (collectively, the “Loan Agreement”) with Silicon Valley Bank (the “Bank”) that provided an initial term loan facility (amounts borrowed thereunder, the “Initial Term Loan”) of $6.0 million and a $4.0 million revolving line of credit (amounts borrowed thereunder, the “Revolving Loans”). The Company also has the option to borrow an additional $3.0 million term loan under the Loan Agreement (amounts borrowed thereunder, the “Subsequent Term Loan” and together with the Initial Term Loan, the “Term Loan”), subject to meeting a Detection revenue minimum of at least $21.5 million for a trailing twelve month period ending on or prior to June 30, 2019. The Company began repayment of the Initial Term Loan on March 1, 2019, with 30 equal monthly installments of principal, based on the amended terms of the Loan Agreement. The maturity date of the Initial Term Loan is August 1, 2021. The Company will be required to begin repayment of the Subsequent Term Loan, if drawn, on October 1, 2019 and make 23 equal monthly installments of principal, as determined by the Third Loan Modification Agreement. The maturity date of the Subsequent Term Loan is August 1, 2021. The maturity date of the Revolving Loans is March 1, 2022. However, the maturity date will become April 30, 2020 or April 30, 2021 if (after the Fourth Loan Modification Agreement, see Note 1(t) Subsequent Events The outstanding Revolving Loans will accrue interest at a floating per annum rate equal to 1.50% above the prime rate for periods when the ratio of the Company’s unrestricted cash to the Company’s outstanding liabilities to the Bank, plus the amount of the Company’s total liabilities that mature within one year is at least 1.25 to 1.0. At all other times, the interest rate shall be 0.50% above the prime rate. The outstanding Term Loans will accrue interest at a floating per annum rate equal to the prime rate. If the Revolving Loans are paid in full and the Loan Agreement is terminated prior to the maturity date, then the Company will pay to the Bank a termination fee in an amount equal to two percent (2.0%) of the maximum revolving line of credit. If the Company prepays the Term Loans prior to the maturity date, then the Company will pay to the Bank an amount equal to 1.0% to 3.0% of the Term Loans, depending on when such Term Loans are repaid. In addition, the Loan Agreement requires the Company to pay a final payment of 8.5% of the Term Loans (which was increased by the Second Loan Modification Agreement from 8.0%) upon the earliest of the repayment of the Term Loans, the termination of the Loan Agreement and the maturity date. The Company is accruing such payment as additional interest expense. As of December 31, 2018, the accrued final payment is approximately $162,000 and is a component of the outstanding loan balance. The Loan Agreement, as amended, required the Company to maintain minimum Detection revenues during the trailing six month period ending on December 31, 2018 of $8.75 million, and adjusted EBITDA during the trailing six month period ending on December 31, 2018 of $1.00. On December 21, 2018, the Bank agreed to waive the covenants for the six month trailing period ended December 31, 2018. Although the Bank has agreed to revise the covenants in prior periods, there is no guarantee that the Bank would be willing to revise the covenants in future periods. Obligations to the Bank under the Loan Agreement or otherwise are secured by a first priority security interest in substantially all of the assets, including intellectual property, accounts receivable, equipment, general intangibles, inventory and investment property, and all of the proceeds and products of the foregoing, of each of the Company and Xoft, Inc. and Xoft Solutions LLC, wholly-owned subsidiaries of the Company. In connection with the Loan Agreement, the Company incurred approximately $74,000 of closing costs. In accordance with ASC Topic 835, “Interest,” the closing costs have been deducted from the carrying value of the debt and will be amortized through August 1, 2021, the maturity date of the Initial Term Loan. The Company has evaluated the accounting impact of each of the modifications noted above, and as all have occurred within a 12 month period, each successive modification has been combined and compared to the terms of the original Loan Agreement. The Company has determined that modifications occurring at each modification date above are modifications of the Loan Agreement for accounting purposes. As such, the Company has capitalized any closing costs paid to the Bank as part of the modifications and has expensed any third party costs incurred. The additional closing costs and the unamortized initial closing costs are being amortized over the remaining term of the modified Initial Term Loan. The current repayment schedule for the Initial Term Loan is based on repayment beginning on March 1, 2019. The carrying value of the Term Loans (net of debt issuance costs) as of December 31, 2018 and 2017 is as follows (in thousands): December 31, 2018 December 31, 2017 Principal Amount of Term Loan $ 6,000 $ 6,000 Unamortized closing costs (58 ) (64 ) Accrued final payment 163 — Carrying amount of Term Loan 6,105 5,936 Less current portion of Term Loan (1,851 ) (817 ) Notes payable long-term portion $ 4,254 $ 5,119 (b) Convertible Debentures On December 20, 2018, the Company entered into a Securities Purchase Agreement (the “SPA”) with certain institutional and accredited investors, including, but not limited to, all directors and executive officers of the Company (the “Investors”), pursuant to which the Investors agreed to purchase unsecured subordinated convertible debentures (the “Convertible Debentures” or the “Notes”) with an aggregate principal amount of approximately $7.0 million in a private placement. The Company will pay interest to the Investors on the outstanding principal amount of the Convertible Debentures at the rate of 5.0% per annum, payable semi-annually on December 21st and June 21st, beginning on June 21, 2019, as well as on each conversion date (as to that principal amount then being converted) and on the maturity date. The Convertible Debentures mature on December 21, 2021. At any time prior to the maturity date, the Convertible Debentures are convertible into shares of the Company’s common stock at a conversion price of $4.00 per share, at the Investor’s option, subject to certain anti-dilution adjustments. The Convertible Debentures contain a cap of shares to be issued upon the conversion of the Convertible Debentures at 19.99% of the issued and outstanding shares of the Company’s Common Stock on December 21, 2018, unless shareholder approval of such issuance has been obtained. Upon the satisfaction of certain conditions, the Company has the right to cause the Investors to convert all or part of the then outstanding principal amount of the Convertible Debentures (a “Forced Conversion”). In connection with such Forced Conversion, the Company will be required to pay accrued but unpaid interest, an interest make whole amount determined based on the timing of the Forced Conversion and interest payments made to that date, liquidated damages and other amounts owing to the Investors under the Convertible Debentures. The conversion price in both the optional conversion and Forced Conversion provisions is subject to adjustment due to certain ‘down-round’ dilutive issuances as well for typical anti-dilutive actions, such as stock splits and stock dividends. The Investors also have the right to require the Company to repurchase the Convertible Debentures, at a repurchase price that would be at least 115% of the then outstanding principal, plus any accrued but unpaid interest, upon the occurrence of an event of default, as defined in the SPA. The Convertible Debentures will also accrue interest upon an event of default at a rate of the lesser of 10.0% or the maximum permitted by law. The Convertible Debentures also include certain liquidate damages provisions, whereby the Company will be required to compensate the Investors for certain contingent events, such as the failure to timely deliver conversion shares of common stock, failure to timely pay any accrued interest when due and failure to timely report public information. The Convertible Debentures are unsecured and structurally subordinated to the Company’s existing indebtedness. In connection with the issuance of the Convertible Debentures, all of the Company’s subsidiaries entered into a Subsidiary Guarantee, dated as of December 20, 2018, for the benefit of the Investors, pursuant to which all the subsidiaries guaranteed the Company’s payments under the Convertible Debentures. In connection with the issuance, on December 20, 2018, the Company entered into a registration rights agreement (the “Registration Rights Agreement”) with the Investors, pursuant to which the Company agreed to file a registration statement with the Securities and Exchange Commission (“SEC”) to register the resale of shares of common stock underlying the Convertible Debentures on or prior to January 31, 2019. The Company filed the Registration Rights Agreement with the SEC on January 31, 2019. Certain Investors in the Convertible Debentures include directors and employees of the Company. These related parties purchased approximately 10% of the principal value of the Convertible Debentures, or $670,000. The Convertible Debentures issued to the related parties have substantially the same rights and provisions as the unrelated third party investors, with the exception of certain terms where the related parties received less favorable terms than the unrelated third parties (such as with determination of the make whole conversion rate, as defined in the SPA; or limits on the impact of potential ‘down-round’ adjustments to the conversion price). In connection with the issuance of the Convertible Debentures, the Company incurred approximately $503,000 in issuance costs related to placement agent fees and third party legal fees. The Company initially evaluated the required accounting for the Convertible Debentures under ASC Topic 470, “ Debt Distinguishing Liabilities from Equity Derivatives and Hedging one-time, Financial Instruments In accordance the Company’s election of the fair value option, the Company expensed the approximately $503,000 in issuance costs incurred related to the Convertible Debentures during the year ended December 31, 2018. Fair Value Measurements Related to the Convertible Debentures The Company utilized a Monte Carlo simulation model to estimate the fair value of the Convertible Debentures as of their issuance date and as of December 31, 2018. The simulation model is designed to capture the potential settlement features of the Convertible Debentures (the embedded features described above), in conjunction with simulated changes in the Company’s stock price and the probability of certain events occurring. The simulation utilizes 100,000 trials or simulations to determine the estimated fair value. The simulation utilizes the assumptions that if the Company is able to exercise its Forced Conversion right (if the requirements to do so are met), that it will do so in 100% of such scenarios. Additionally, if an event of default occurs during the simulated trial (based on the Company’s probability of default), the Investors will opt to redeem the Convertible Debentures in 100% of such scenarios. If neither event occurs during a simulated trial, the simulation assumes that the Investor will hold the Convertible Debentures until the maturity date. The value of the cash flows associated with each potential settlement are discounted to present value in each trial based on either the risk free rate (for an equity settlement) or the effective discount rate (for a redemption or cash settlement). The Company notes that the key inputs to the simulation model that were utilized to estimate the fair value of the Convertible Debentures included: Input December 21, 2018 December 31, 2018 Company’s stock price $ 3.68 $ 3.70 Conversion price $ 4.00 $ 4.00 Remaining term (years) 3.00 2.97 Equity volatility 54.00 % 54.00 % Risk free rate 2.58 % 2.46 % Probability of default event 0.75 % 0.81 % Utilization of Forced Conversion (if available) 100.00 % 100.00 % Exercise of Default Redemption (if available) 100.00 % 100.00 % Effective discount rate 21.90 % 21.90 % The Company’s stock price is based on the closing stock price on the valuation date. The conversion price is based on the contractual conversion price included in the SPA. The remaining term was determined based on the remaining time period to maturity of the Convertible Debentures. The Company’s equity volatility estimate was based on the Company’s historical equity volatility, the Company’s implied and observed volatility of option pricing, and the historical equity and observed volatility of option pricing for a selection of comparable guideline public companies. The risk free rate was determined based on U.S. Treasury securities with similar terms. The probability of the occurrence of a default event was based on Bloomberg’s 1 year estimate of default risk for the Company (extrapolated over the remaining term). The utilization of the forced conversion right and the default redemption right is based on management’s best estimate of both features being exercised upon the occurrence of the related contingent events. The effective discount rate utilized at December 21, 2018 and December 31, 2018 was solved for utilizing the simulation model based on the principal value of the Convertible Debentures, as the transaction was determined to represent an ‘arm’s length’ transaction. The effective discount was corroborated against market yield data which implied the Company’s credit rating, and this implied credit rating will be utilized to determine the changes in the effective discount rate at future valuation dates. As of the issuance date of the Convertible Debentures (December 21, 2018) and December 31, 2018, the fair value and principal value of the Convertible Debentures was: Convertible Debentures December 21, 2018 December 31, 2018 Fair value, in accordance with fair value option $ 6,970 $ 6,970 Principal value outstanding $ 6,970 $ 6,970 The Company did not record any gains or losses from the change in fair value of the Convertible Debentures between their issuance date and December 31, 2018. See also additional fair value disclosures related to the Convertible Debentures in Note 1(r) above. (c) Principal and Interest Payments Related to Financing Arrangements Future principal and interest payments related to the Loan Agreement and Convertible Debentures are as follows (in thousands): Fiscal Year Amount Due 2019 $ 2,624 2020 2,895 2021 9,454 Total $ 14,972 The following amounts are included in interest expense in our consolidated statement of operations for the years ended December 31, 2018, 2017 and 2016 (in thousands): December 31, 2018 December 31, 2017 December 31, 2016 Cash interest expense, notes payable $ 299 $ 98 $ — Cash interest expense, convertible debentures 9 — — Amortization of debt costs 29 9 — Accrual of notes payable final payment 163 — — Amortization of settlement obligations — 26 82 Interest expense capital lease 4 1 70 Capital lease - fair value amortization — (10 ) (89 ) Total interest expense $ 504 $ 124 $ 63 Cash interest expense, notes payable, represents the cash interest paid monthly on the term loan. Cash interest expense, convertible debentures represents cash interest accrued in connection with the convertible debt closed in December 2018. Interest payments are due to the holders in June and December of each year. The amortization of debt costs represents the closing costs incurred with the Loan Agreement, which have been capitalized and expensed using the effective interest method. The amortization of the settlement obligations represents the interest associated with the settlement agreement for Zeiss. See Note 9(f) to our Consolidated Financial Statements.

Accrued Expenses

Accrued Expenses	12 Months Ended
	Dec. 31, 2018
Payables and Accruals [Abstract]
Accrued Expenses	(5) Accrued Expenses Accrued expenses consist of the following at December 31 (in thousands): 2018 2017 Accrued salary and related expenses $ 1,811 $ 1,388 Accrued accounts payable 2,329 2,523 Accrued professional fees 737 418 Other accrued expenses 91 70 Deferred rent 92 76 $ 5,060 $ 4,475

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2018
Federal Home Loan Banks [Abstract]
Stockholders' Equity	(6) Stockholders’ Equity (a) Stock Options The Company has six stock option or stock incentive plans, which are described as follows: The 2002 Stock Option Plan (the “2002 Plan”). The 2002 Plan was adopted by the Company’s stockholders in June 2002. The 2002 Plan provides for the granting of non-qualifying Non-qualifying The 2004 Stock Incentive Plan (the “2004 Plan”). The 2004 Plan was adopted by the Company’s stockholders in June 2004. The 2004 Plan provides for the grant of any or all of the following types of awards: (a) stock options, (b) restricted stock, (c) deferred stock and (d) other stock-based awards. The 2004 Plan provides for the granting of non-qualifying Non-qualifying The 2005 Stock Incentive Plan (the “2005 Plan”). The 2005 Plan was adopted by the Company’s stockholders in June 2005. The 2005 Plan provides for the grant of any or all of the following types of awards: (a) stock options, (b) restricted stock, (c) deferred stock and (d) other stock-based awards. The 2005 Plan provides for the granting of non-qualifying Non-qualifying The 2007 Stock Incentive Plan (the “2007 Plan”). The 2007 Plan was adopted by the Company’s stockholders in July 2007 and amended in June 2009. The 2007 Plan provides for the grant of any or all of the following types of awards: (a) stock options, (b) restricted stock, (c) deferred stock and (d) other stock-based awards. Awards may be granted singly, in combination, or in tandem. Subject to anti-dilution adjustments as provided in the 2007 Plan, (i) the 2007 Plan provides for a total of 1,050,000 shares of the Company’s common stock to be available for distribution pursuant to the 2007 Plan, and (ii) the maximum number of shares of the Company’s common stock with respect to which stock options, restricted stock, deferred stock, or other stock-based awards may be granted to any participant under the 2007 Plan during any calendar year or part of a year may not exceed 160,000 shares. The 2007 Plan provides that it will be administered by the Company’s Board of Directors or a committee of two or more directors appointed by the Board of Directors. The administrator will generally have the authority to administer the 2007 Plan, determine participants who will be granted awards under the 2007 Plan, the size and types of awards, the terms and conditions of awards and the form and content of the award agreements representing awards. Awards under the 2007 Plan may be granted to employees, directors, consultants and advisors of the Company and its subsidiaries. However, only employees of the Company and its subsidiaries will be eligible to receive options that are designated as incentive stock options. With respect to options granted under the 2007 Plan, the exercise price must be at least 100% (110% in the case of an incentive stock option granted to a 10% stockholder) of the fair market value of the common stock subject to the award, determined as of the date of grant. Restricted stock awards are shares of common stock that are awarded subject to the satisfaction of the terms and conditions established by the administrator. In general, awards that do not require exercise may be made in exchange for such lawful consideration, including services, as determined by the administrator. At December 31, 2018, there are no further shares available for grant under the 2007 Plan. The 2012 Stock Incentive Plan (the “2012 Plan”). The 2012 Plan was adopted by the Company’s stockholders in May 2012 and amended in May 2014. The 2012 Plan, as amended, provides for the grant of any or all of the following types of awards: (a) stock options, (b) restricted stock, (c) deferred stock and (d) other stock-based awards. Awards may be granted singly, in combination, or in tandem. Subject to anti-dilution adjustments as provided in the amended 2012 Plan, (i) the amended 2012 Plan provides for a total of 1,600,000 shares of the Company’s common stock to be available for distribution pursuant to the amended 2012 Plan, and (ii) the maximum number of shares of the Company’s common stock with respect to which stock options, restricted stock, deferred stock, or other stock-based awards may be granted to any participant under the amended 2012 Plan during any calendar year or part of a year may not exceed 250,000 shares. The 2012 Plan provides that it will be administered by the Company’s Board of Directors or a committee of two or more directors appointed by the Board of Directors. The administrator will generally have the authority to administer the 2012 Plan, determine participants who will be granted awards under the 2012 Plan, the size and types of awards, the terms and conditions of awards and the form and content of the award agreements representing awards. Awards under the 2012 Plan may be granted to employees, directors, consultants and advisors of the Company and its subsidiaries. However, only employees of the Company and its subsidiaries will be eligible to receive options that are designated as incentive stock options. With respect to options granted under the 2012 Plan, the exercise price must be at least 100% (110% in the case of an incentive stock option granted to a 10% stockholder) of the fair market value of the common stock subject to the award, determined as of the date of grant. Restricted stock awards are shares of common stock that are awarded subject to the satisfaction of the terms and conditions established by the administrator. In general, awards that do not require exercise may be made in exchange for such lawful consideration, including services, as determined by the administrator. At December 31, 2018, there were 99,215 shares available for issuance under the 2012 Plan. The 2016 Stock Incentive Plan (the “2016 Plan”). The 2016 Plan was adopted by the Company’s stockholders in May 2016 and amended in November 2018. The 2016 Plan provides for the grant of any or all of the following types of awards: (a) non-qualified Subject to anti-dilution adjustments as provided in the 2016 Plan, (i) the amended 2016 Plan provides for a total of 2,600,000 shares of the Company’s common stock to be available for distribution pursuant to the 2016 Plan, and (ii) the maximum number of shares of the Company’s common stock with respect to which stock options or stock appreciation rights may be granted to any one individual under the 2016 Plan during any one calendar year period may not exceed 1,000,000 shares. No more than 1,000,000 shares of common stock may be issued in the form of incentive stock options and no more than 120,000 shares of stock may be issued pursuant to awards to non-employee The 2016 Plan provides that it will be administered by the Company’s Compensation Committee. The Compensation Committee has the authority to administer the 2016 Plan, determine participants, from among the individuals eligible for awards, who will be granted awards under the 2016 Plan, make any combination of awards to participants and determine the specific terms and conditions of awards subject to the 2016 Plan. Awards under the 2016 Plan may be granted to full or part-time officers, employees, non-employee With respect to stock options granted under the 2016 Plan, the exercise price will be determined by the Compensation Committee but may not be less than 100% of the fair market value of the common stock subject to the award, determined as of the date of grant. Regarding incentive stock options, including that the aggregate grant date fair market value of the shares of stock with respect to which incentive stock options granted under the 2016 Plan and any other plan of the Company or its parent and subsidiary corporations become exercisable for the first time by an optionee during any calendar year shall not exceed $100,000. To the extent that any incentive stock option exceeds this limit, it shall constitute a non-qualified A summary of stock option activity for all stock option plans is as follows: Number of Weighted Average Weighted Average Outstanding, January 1, 2016 1,571,998 $ 5.05 Granted 127,500 $ 5.46 Exercised (75,583 ) $ 2.62 Forfeited (198,567 ) $ 6.19 Outstanding, December 31, 2016 1,425,348 $ 5.05 Granted 200,813 $ 4.14 Exercised (36,530 ) $ 2.18 Forfeited (124,516 ) $ 4.71 Outstanding, December 31, 2017 1,465,115 $ 5.03 Granted 888,263 $ 2.95 Exercised (139,556 ) $ 2.27 Forfeited (230,345 ) $ 5.41 Outstanding, December 31, 2018 1,983,477 $ 4.25 4.4 years Exercisable at December 31, 2016 1,054,211 $ 4.71 Exercisable at December 31, 2017 1,301,651 $ 4.95 Exercisable at December 31, 2018 1,296,439 $ 4.90 4.1 years There were 965,719 shares available for future grants from all plans at December 31, 2018. The Company’s stock-based compensation expense, including options and restricted stock by category is as follows (amounts in thousands): Years Ended December 31, 2018 2017 2016 Cost of revenue $ 4 $ 5 $ 6 Engineering and product development 399 715 329 Marketing and sales 190 1,003 677 General and administrative expense 912 1,933 1,295 $ 1,505 $ 3,656 $ 2,307 As of December 31, 2018, there was $1.8 million of total unrecognized compensation costs related to unvested options and restricted stock. That cost is expected to be recognized over a weighted average period of 1.0 years. Options granted under the stock incentive plans were valued utilizing the Black-Scholes model using the following assumptions and had the following fair values: Years Ended December 31, 2018 2017 2016 Average risk-free interest rate 2.65% 1.61% 0.98% Expected dividend yield None None None Expected life 3.5 years 3.5 years 3.5 years Expected volatility 50.4% to 61.6% 64.2% to 72.0% 68.5% to 75.3% Weighted average exercise price $2.96 $4.14 $5.46 Weighted average fair value $1.23 $1.99 $2.66 The Company’s 2018, 2017 and 2016 average expected volatility and average expected life is based on the average of the Company’s historical information. The risk-free rate is based on the rate of U.S. Treasury zero-coupon Intrinsic values of options (in thousands) and the closing market price used to determine the intrinsic values are as follows: Years Ended December 31, 2018 2017 2016 Outstanding $ 1,021 $ 449 $ 409 Exercisable 499 442 409 Exercised 224 79 201 Company’s stock price at December 31 $ 3.70 $ 3.44 $ 3.24 (b) Restricted Stock The Company’s restricted stock awards typically vest in either one year or three equal annual installments with the first installment vesting one year from grant date. The Company granted a total of 162,500 shares of performance based restricted stock during 2016 with performance measured on meeting a revenue target based on growth for fiscal year 2017 and vesting in three equal installments with the first installment vesting upon measurement of the goal. In addition, a maximum of 108,333 additional shares are available to be earned based on exceeding the revenue goal. The revenue target was partially exceeded and 189,583 shares were granted with initial vesting of 63,194 at the grant date in April 2018, and 63,194 vesting on the second and third anniversary of the initial vesting. The Company granted an additional 144,500 shares with time based vesting and 45,356 shares with immediate vesting in the year ended December 31, 2018. A summary of restricted stock activity for all equity incentive plans is as follows: Years Ended December 31, 2018 2017 2016 Beginning outstanding balance 415,147 511,398 516,396 Granted 379,439 394,599 345,778 Vested (322,388 ) (469,434 ) (289,030 ) Forfeited (48,996 ) (21,416 ) (61,746 ) Ending outstanding balance 423,202 415,147 511,398 Intrinsic values of restricted stock (in thousands) and the closing market price used to determine the intrinsic values are as follows: Years Ended December 31, 2018 2017 2016 Outstanding $ 1,566 $ 1,428 $ 1,657 Vested 1,193 1,615 936 Company’s stock price at December 31 $ 3.70 $ 3.44 $ 3.24

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Income Taxes	(7) Income Taxes The components of income tax expense for the years ended December 31, 2018, 2017 and 2016 are as follows (in thousands): 2018 2017 2016 Current provision (benefit): Federal $ — $ — $ — State 54 (26 ) 69 $ 54 $ (26 ) $ 69 Deferred provision: Federal $ (10 ) $ 7 $ 6 State (2 ) 1 1 $ (12 ) $ 8 $ 7 Total $ 42 $ (18 ) $ 76 A summary of the differences between the Company’s effective income tax rate and the Federal statutory income tax rate for the years ended December 31, 2018, 2017 and 2016 is as follows: 2018 2017 2016 Federal statutory rate 21.0 % 34.0 % 34.0 % State income taxes, net of federal benefit 3.6 % 1.4 % 2.8 % Net state impact of deferred rate change 0.6 % (0.3 %) 0.2 % Stock compensation expense (1.1 %) (1.9 %) (3.2 %) Tax amortization on goodwill 0.1 % (0.1 %) (0.1 %) Goodwill impairment 0.0 % (13.7 %) 0.0 % Other permanent differences (0.5 %) (0.4 %) (0.4 %) Change in valuation allowance (27.6 %) 97.4 % (37.3 %) Tax credits 3.1 % 1.5 % 3.2 % Federal Rate Change 0.0 % (133.5 %) 0.0 % Accrual to TR 0.3 % (0.7 %) 0.0 % Increase Xoft NOLs under 382 Study 0.0 % 16.2 % 0.0 % Effective income tax (0.5 %) (0.1 %) (0.8 %) Deferred tax assets and liabilities are recognized for the expected future tax consequences of net operating loss carryforwards, tax credit carryforwards and temporary differences between the financial statement carrying amounts and the income tax basis of assets and liabilities. A valuation allowance is applied against any net deferred tax asset if, based on the available evidence, it is more likely than not that the deferred tax assets will not be realized. Deferred income taxes reflect the impact of “temporary differences” between the amount of assets and liabilities for financial reporting purposes and such amounts as measured by tax laws and regulations. The Company has fully reserved the net deferred tax assets, as it is more likely than not that the deferred tax assets will not be utilized. Deferred tax assets (liabilities) are composed of the following at December 31 (in thousands): 2018 2017 Inventory (Section 263A) $ 239 $ 287 Inventory reserves 270 305 Receivable reserves 45 27 Other accruals 88 224 Deferred revenue 85 129 Accumulated depreciation/amortization 138 320 Stock options 1,879 1,901 Developed technology 2,031 2,201 Tax credits 3,364 3,130 NOL carryforward 32,074 31,113 Net deferred tax assets 40,213 39,637 Valuation allowance (40,213 ) (39,637 ) Goodwill tax amortization (3 ) (14 ) Deferred tax liability $ (3 ) $ (14 ) The increase in the net deferred tax assets and corresponding valuation allowance during the year ended December 31, 2018 is primarily attributable to additional net operating losses and additional research and development credits. The decrease in the net deferred tax assets and corresponding valuation allowance during the year ended December 31, 2017 is related primarily to the decrease in corporate tax rate from 34% to 21% starting on January 1, 2018. The Company completed an asset acquisition in January 2016 which resulted in $293,307 of goodwill. For book purposes, the goodwill was classified as an indefinite lived asset and tested for impairment each year. For tax, the Company is allowed amortization expense over a 15-year As of December 31, 2018, Company has federal net operating loss carryforwards totaling approximately $134.9 million. The federal net operating loss carryforwards of $127.7 million will expire at various dates from 2019 to 2037. Approximately $7.2 million of the federal net operating losses can be carried forward indefinitely. A portion of the total net operating loss carryforwards amounting to approximately $56.7 million relate to the acquisition of Xoft, Inc. As of December 31, 2018, the Company has provided a valuation allowance for its net operating loss carryforwards due to the uncertainty of the Company’s ability to generate sufficient taxable income in future years to obtain the benefit from the utilization of the net operating loss carryforwards. In the event of a deemed change in control, an annual limitation imposed on the utilization of the net operating losses may result in the expiration of all or a portion of the net operating loss carryforwards. There were no net operating losses utilized for the years ended December 31, 2018 or 2017. The Company currently has approximately $7.9 million in net operating losses that are subject to limitations related to Xoft. Approximately $656,000 can be used annually through 2029. The Company has available tax credit carryforwards (adjusted to reflect provisions of the Tax Reform Act of 1986) to offset future income tax liabilities totaling approximately $3.4 million. The tax credits related to Xoft have been fully reserved for and as a result no deferred tax asset has been recorded. The credits expire in various years through 2038. ASC 740-10 de-recognition, As of December 31, 2018 and 2017, the Company had no unrecognized tax benefits and no adjustments to liabilities or operations were required under ASC 740-10. The Company does not anticipate that it is reasonably possible that unrecognized tax benefits as of December 31, 2018 will significantly change within the next 12 months. On December 22, 2017, the President of the United States signed into law the Tax Cuts and Jobs Act (“TCJA”) tax reform legislation. This legislation makes significant change in U.S. tax law including a reduction in the corporate tax rates, changes to net operating loss carryforwards and carrybacks, and a repeal of the corporate alternative minimum tax. The legislation reduced the U.S. corporate tax rate from the current rate of 34% down to 21% starting on January 1, 2018. As a result of the enacted law, the Company was required to revalue deferred tax assets and liabilities at the 21%. This revaluation resulted in a provision of $19.1 million to income tax expense in continuing operations and a corresponding reduction in the valuation allowance. As a result, there was no impact to the Company’s income statement as a result of reduction in tax rates. The other provisions of the TCJA did not have a material impact on our consolidated financial statements. In December 2017, the SEC staff issued SAB 118 to address the application of GAAP in situations when a registrant does not have the necessary information available, prepared, or analyzed (including computations) in reasonable detail to complete the accounting for certain income tax effects of TCJA. The Company did not record any adjustments in the year ended December 31, 2018 to provisional amounts that were material to its financial statements. As of December 31, 2018, the Company’s accounting treatment is complete.

Segment Reporting, Geographical

Segment Reporting, Geographical Information and Major Customers	12 Months Ended
	Dec. 31, 2018
Segment Reporting [Abstract]
Segment Reporting, Geographical Information and Major Customers	(8) Segment Reporting, Geographical Information and Major Customers (a) Segment Reporting In accordance with FASB Topic ASC 280, Segments, operating segments are defined as components of an enterprise that engage in business activities for which discrete financial information is available and regularly reviewed by the chief operating decision maker (“CODM”) in deciding how to allocate resources and assess performance. The Company’s CODM is the Chief Executive Officer (“CEO”). Each reportable segment generates revenue from the sale of medical equipment and related services and/or sale of supplies. The Company has determined there are two segments: Cancer Detection (“Detection”) and Cancer Therapy (“Therapy”). The Detection segment consists of our advanced image analysis and workflow products, and the Therapy segment consists of our radiation therapy (“Axxent”) products, and related services. The primary factors used by our CODM to allocate resources are based on revenues, gross profit, operating income or loss, and earnings or loss before interest, taxes, depreciation, amortization, and other specific and non-recurring We do not track our assets by operating segment and our CODM does not use asset information by segment to allocate resources or make operating decisions. Segment revenues, gross profit, segment operating income or loss, and a reconciliation of segment operating income or loss to GAAP loss before income tax is as follows (in thousands, including prior periods which have been presented for consistency): Year Ended December 31, 2018 2017 2016 Segment revenues: Detection $ 16,864 $ 18,310 $ 17,133 Therapy 8,757 9,792 9,205 Total Revenue $ 25,621 $ 28,102 $ 26,338 Segment gross profit: Detection $ 14,709 $ 16,218 $ 15,113 Therapy 4,721 1,958 3,405 Segment gross profit $ 19,430 $ 18,176 $ 18,518 Segment operating income (loss): Detection $ 3,412 $ 6,401 $ 5,694 Therapy (2,373 ) (15,102 ) (7,752 ) Segment operating income (loss) $ 1,039 $ (8,701 ) $ (2,058 ) General, administrative, depreciation and amortization expense $ (9,169 ) $ (7,975 ) $ (7,912 ) Interest expense (504 ) (124 ) (63 ) Financing costs (451 ) — — Gain on sale of MRI assets — 2,508 — Other income 110 18 10 Loss on debt extinguishment — — — Loss before income tax $ (8,975 ) $ (14,274 ) $ (10,023 ) Segment depreciation and amortization included in segment operating income (loss) is as follows (in thousands): Year Ended December 31, 2018 2017 2016 Detection depreciation and amortization Depreciation $ 106 $ 172 $ 223 Amortization 248 246 696 Therapy depreciation and amortization Depreciation $ 177 $ 768 $ 970 Amortization 129 222 252 (b) Geographic Information The Company’s sales are made to customers, distributors and dealers of mammography, electronic brachytherapy equipment and other medical equipment, and to foreign distributors of mammography and electronic brachytherapy equipment. Export sales to a single country did not exceed 10% of total revenue in any year. Total export sales were approximately $3.2 million or 12% of total revenue in 2018, $3.9 million or 14% of total revenue in 2017 and $2.3 million or 9% of total revenue in 2016. As of December 31, 2018 and 2017, the Company had outstanding receivables of $1.1 million and $2.1 million, respectively, from distributors and customers of its products who are located outside of the U.S. (c) Major Customers The Company had one major customer, GE Healthcare, with revenues of approximately $6.1 million in 2018, $7.1 million in 2017, and $3.9 million in 2016 or 24%, 25%, and 15% of total revenue, respectively. Cancer detection products are also sold through OEM partners, including GE Healthcare, Fuji Medical Systems, Siemens Medical and Vital Images and Invivo. For the year ended December 31, 2018, these five OEM partners composed approximately 50% of Detection revenues and 33% of revenue overall. OEM partners composed 55% of Detection revenues and 39% of revenue overall for the year ended December 31, 2017 and 47% of Detection revenues and 30% of revenue overall for the year ended December 31, 2016. OEM partners represented $2.5 million or 37% of outstanding receivables as of December 31, 2018, with GE Healthcare accounting for $1.6 million or 25% of this amount. The three largest Cancer Therapy customers composed $0.8 million or 12% of outstanding receivables as of December 31, 2018. These eight customers in total represented $3.3 million or 50% of outstanding receivables as of December 31, 2018.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2018
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	(9) Commitments and Contingencies (a) Lease Obligations As of December 31, 2018, the Company had three lease obligations related to its facilities. The Company’s executive offices are leased pursuant to a five-year operating lease (the “Lease”) that commenced on December 15, 2006, with renewals in January 2012 and August 2016, of office space located at 98 Spit Brook Road, Suite 100 in Nashua, New Hampshire (the “Premises”). The August 2016 renewal provides for an annual base rent of $184,518 for the period from March 2017 to February 2020. Additionally, the Company is required to pay its proportionate share of the building and real estate tax expenses and obtain insurance for the Premises. The Company leases a facility in San Jose, California under a non-cancelable In addition to the foregoing leases relating to its principal properties, the Company also has an operating lease for an additional facility in Nashua, New Hampshire used for product repairs, manufacturing and warehousing. Rent expense for all leases for the years ended December 31, 2018, 2017 and 2016 was $896,000, $899,000 and $745,000, respectively. Future minimum rental payments due under these agreements as of December 31, 2018 are as follows (in thousands): Fiscal Year Operating Leases 2019 $ 781 2020 183 $ 964 (b) Capital lease obligations In August, 2017, the Company assumed an equipment lease obligation with payments totaling $50,000. The leases were determined to be capital leases and accordingly the equipment was capitalized and a liability of $42,000 was recorded. The equipment will be depreciated over the expected life of 3 years. The remaining minimum lease payments are as follows (in thousands): Fiscal Year Capital Lease 2019 $ 17 2020 13 subtotal minimum lease obligation 30 less interest (4 ) Total, net 26 less current portion 11 long term portion $ 15 (c) Other Commitments The Company has non-cancelable (d) Employment Agreements The Company has entered into employment agreements with certain key executives. The employment agreements provide for minimum annual salaries and performance-based annual bonus compensation as defined in their respective agreements. In addition, the employment agreements provide that if employment is terminated without cause, the executive will receive an amount equal to their respective base salary then in effect for the greater of the remainder of the original term of employment or, for Mr. Ferry, a period of two years from the date of termination, for Mr. Christopher and Ms. Stevens, a period of eighteen months from the date of termination, in each case, plus the pro rata portion of any annual bonus earned in any employment year through the date of termination. On November 8, 2018, Mr. Ferry retired as Chief Executive Officer of the Company and from his position as Chairman of the Board of Directors. Mr. Ferry and the Company entered into a Separation Agreement on that date, to which Mr. Ferry will generally receive the payments that would have been payable had he been terminated by the Company without cause. The Company accrued $1,009,000 representing 24 months of severance and 18 months of health benefits as of November 2018 upon Mr. Ferry’s agreeing to the Separation Agreement, which will be paid monthly beginning in May 2019. On December 27, 2018, the Company announced that Mr. Christopher would be resigning from his position as Chief Financial Officer of the Company, effective January 11, 2019. There were no termination benefits associated with Mr. Christopher’s resignation. (e) Foreign Tax Claim In July 2007, a dissolved former Canadian subsidiary of the Company, CADx Medical Systems Inc. (“CADx Medical”), received a tax re-assessment re-assessment re-assessment (f) Royalty Obligations In connection with prior litigation, the Company received a nonexclusive, irrevocable, perpetual, worldwide license, including the right to sublicense certain Hologic patents, and a non-compete non-compete (g) Litigation The Company may be a party to various legal proceedings and claims arising out of the ordinary course of its business. Although the final results of all such matters and claims cannot be predicted with certainty, the Company currently believes that there are no current proceedings or claims pending against it of which the ultimate resolution would have a material adverse effect on its financial condition or results of operations. However, should we fail to prevail in any legal matter or should several legal matters be resolved against us in the same reporting period, such matters could have a material adverse effect on our operating results and cash flows for that particular period. In all cases, at each reporting period, the Company evaluates whether or not a potential loss amount or a potential range of loss is probable and reasonably estimable under ASC 450, Contingencies. Legal costs are expensed as incurred. In December 2016, the Company entered into an Asset Purchase Agreement, referred to in this Section as the Agreement, with Invivo Corporation, referred to in this Section as Invivo. In accordance with the Agreement, the Company sold to Invivo all right, title and interest to certain intellectual property relating to the Company’s VersaVue software and DynaCAD product and related assets for $3.2 million. The Company closed the transaction on January 30, 2017, less a holdback reserve of $350,000 for a net of approximately $2.9 million. On September 5, 2018, third-party Yeda Research and Development Company Ltd., referred to in this Section as Yeda, filed a complaint against the Company and Invivo in the United States District Court for the Southern District of New York, captioned Yeda Research and Development Company Ltd. v. iCAD, Inc. and Invivo Corporation, Case No. 1:18-cv-08083-GBD, related to the Company’s sale of the VersaVue software and DynaCAD product under the Agreement. In the Complaint, Yeda asserts claims for: (i) copyright infringement and misappropriation of trade secrets against both the Company and Invivo; (ii) breach of contract against the Company only; and (iii) tortious interference with existing business relationships and unjust enrichment against Invivo only. The Company and Invivo filed Motions to Dismiss the Complaint on December 21, 2018. On January 18, 2019, Yeda filed Oppositions to the Motions to Dismiss. The Company and Invivo submitted responses to the Opposition to the Motion to Dismiss on February 8, 2019. The Court held oral argument on the Motions to Dismiss on March 27, 2019. The Company is awaiting a decision from the Court. To the extent that the Complaint is not dismissed in its entirety, the Company will vigorously defend against the claims asserted by Yeda. The amount of the loss, if any, cannot be reasonably estimated at this time. Any amounts owed by the Company in connection with its indemnification obligations to Invivo related to this action may reduce the $350,000 holdback under the Asset Purchase Agreement.

Quarterly Financial Data

Quarterly Financial Data	12 Months Ended
	Dec. 31, 2018
Quarterly Financial Information Disclosure [Abstract]
Quarterly Financial Data	(10) Quarterly Financial Data 2018 Net sales Gross profit Net loss Income (loss) Weighted average First quarter $ 6,313 $ 4,498 $ (3,281 ) ($ 0.20 ) 16,583 Second quarter 6,162 4,784 $ (1,027 ) ($ 0.06 ) 16,664 Third quarter 6,192 4,738 $ (1,365 ) ($ 0.08 ) 16,700 Fourth quarter 6,954 5,410 $ (3,344 ) ($ 0.20 ) 16,774 2017 First quarter $ 6,791 $ 4,689 $ (457 ) ($ 0.03 ) 16,135 Second quarter 6,409 4,503 $ (2,631 ) ($ 0.16 ) 16,310 Third quarter 7,000 4,643 $ (6,933 ) ($ 0.42 ) 16,424 Fourth quarter 7,902 4,341 $ (4,235 ) ($ 0.26 ) 16,501

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Nature of Operations and Use of Estimates	(a) Nature of Operations and Use of Estimates iCAD, Inc. and subsidiaries (the “Company” or “iCAD”) is a provider of advanced image analysis, workflow solutions and radiation therapy for the early identification and treatment of cancer. The Company has grown primarily through acquisitions to become a broad player in the oncology market. Its solutions include advanced image analysis and workflow solutions that enable healthcare professionals to better serve patients by identifying pathologies and pinpointing the most prevalent cancers earlier, a comprehensive range of high-performance, upgradeable Computer-Aided Detection (CAD) systems and workflow solutions for mammography, MRI and CT, and the Xoft System which is an isotope-free cancer treatment platform technology. CAD is reimbursable in the U.S. under federal and most third-party insurance programs. The Company intends to continue the extension of its image analysis and clinical decision support solutions for mammography, MRI and CT imaging. iCAD believes that advances in digital imaging techniques should bolster its efforts to develop additional commercially viable CAD/advanced image analysis and workflow products. The Company’s management believes that early detection in combination with earlier targeted intervention will provide patients and care providers with the best tools available to achieve better clinical outcomes resulting in a market demand that will drive top line growth. The Company’s headquarters are located in Nashua, New Hampshire, with manufacturing and contract manufacturing facilities in New Hampshire and Massachusetts, and an operations, research, development, manufacturing and warehousing facility in San Jose, California. The Company operates in two segments: Cancer Detection (“Detection”) and Cancer Therapy (“Therapy”). The Detection segment consists of advanced image analysis and workflow products, and the Therapy segment consists of radiation therapy products. The Company sells its products throughout the world through its direct sales organization as well as through various OEM partners, distributors and resellers. See Note 8 for segment, major customer and geographical information. In January 2018, the Company adopted a plan to discontinue offering radiation therapy professional services to practices that provide the Company’s electronic brachytherapy solution for the treatment of non-melanoma The preparation of financial statements in conformity with generally accepted accounting principles in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. Actual results could differ from those estimates. It is reasonably possible that changes may occur in the near term that would affect management’s estimates with respect to assets and liabilities.
Principles of Consolidation	(b) Principles of Consolidation The consolidated financial statements include the accounts of the Company and its wholly owned subsidiaries: Xoft, Inc. and Xoft Solutions, LLC. All material inter-company transactions and balances have been eliminated in consolidation.
Cash and cash equivalents	(c) Cash and cash equivalents The Company defines cash and cash equivalents as all bank accounts, money market funds, deposits and other money market instruments with original maturities of 90 days or less, which are unrestricted as to withdrawal. Cash and cash equivalents are maintained at financial institutions and, at times, balances may exceed federally insured limits. The Company has never experienced any losses related to these balances. Insurance coverage is $250,000 per depositor at each financial institution, and the Company’s non-interest
Financial instruments	(d) Financial instruments Financial instruments consist of cash and cash equivalents, accounts receivable, accounts payable, notes payable and convertible debentures. Due to their short term nature and market rates of interest, the carrying amounts of the financial instruments, except the convertible debentures, approximated fair value as of December 31, 2018 and 2017. The Company has elected to record the convertible debentures at fair value at each reporting date in accordance with the fair value option election. See Note 4(b) for further details.
Accounts Receivable and Allowance for Doubtful Accounts	(e) Accounts Receivable and Allowance for Doubtful Accounts Accounts receivable are customer obligations due under normal trade terms. Credit limits are established through a process of reviewing the financial history and stability of each customer. The Company performs continuing credit evaluations of its customers’ financial condition and generally does not require collateral. The Company’s policy is to maintain allowances for estimated losses from the inability of its customers to make required payments. The Company’s senior management reviews accounts receivable on a periodic basis to determine if any receivables may potentially be uncollectible. The Company includes any accounts receivable balances that it determines may likely be uncollectible, along with a general reserve for estimated probable losses based on historical experience, in its overall allowance for doubtful accounts. An amount would be written off against the allowance after all attempts to collect the receivable had failed. Based on the information available, the Company believes the allowance for doubtful accounts as of December 31, 2018 and 2017 is adequate. The following table summarizes the allowance for doubtful accounts for the three years ended December 31, 2018 (in thousands): 2018 2017 2016 Balance at beginning of period $ 107 $ 172 $ 236 Additions charged to costs and expenses 225 45 177 Reductions (155 ) (110 ) (241 ) Balance at end of period $ 177 $ 107 $ 172
Inventory	(f) Inventory Inventory is valued at the lower of cost or net realizable value, with cost determined by the first-in, first-out As of December 31, 2018 2017 Raw materials $ 606 $ 992 Work in process 67 63 Finished Goods 914 1,068 Inventory $ 1,587 $ 2,123
Property and Equipment	(g) Property and Equipment Property and equipment are stated at cost and depreciated using the straight-line method over the estimated useful lives of the assets or the remaining lease term, if shorter, for leasehold improvements (see below). Estimated life Equipment 3-5 years Leasehold improvements 3-5 Furniture and fixtures 3-5 Marketing assets 3-5
Goodwill	(h) Goodwill In accordance with FASB Accounting Standards Codification (“ASC”) Topic 350-20, “Intangibles - Goodwill and Other” 350-20”), Factors the Company considers important, which could trigger an impairment of such asset, include the following: • significant underperformance relative to historical or projected future operating results; • significant changes in the manner or use of the assets or the strategy for the Company’s overall business; • significant negative industry or economic trends; • significant decline in the Company’s stock price for a sustained period; and • a decline in the Company’s market capitalization below net book value. The Company records an impairment charge when such assessment indicates that the fair value of a reporting unit was less than the carrying value. In evaluating potential impairments outside of the annual measurement date, judgment is required in determining whether an event has occurred that may impair the value of goodwill or intangible assets. The Company utilizes either discounted cash flow models or other valuation models, such as comparative transactions and market multiples, to determine the fair value of reporting units. The Company makes assumptions about future cash flows, future operating plans, discount rates, comparable companies, market multiples, purchase price premiums and other factors in those models. Different assumptions and judgment determinations could yield different conclusions that would result in an impairment charge to income in the period that such change or determination was made. In January 2018, the Company adopted a plan to discontinue offering radiation therapy professional services to practices that provide the Company’s electronic brachytherapy solution for the treatment of non-melanoma The Company elected to early adopt ASU 2017-04, 2017-04”) 2017-04 As a result of the underperformance of the Therapy reporting unit as compared to expected future results, the Company determined there was a triggering event in the third quarter of 2017. As a result, the Company completed an interim impairment assessment. The interim test resulted in the fair value of the Therapy reporting unit being less than the carrying value of the reporting unit. The fair value of the Therapy reporting unit was $3.5 million and the carrying value was $7.5 million. The deficiency of $4.0 million was recorded as an impairment charge in the third quarter of the year ended December 31, 2017. The Company did not identify a triggering event within the Detection reporting unit and accordingly did not perform an interim test. The Company determines the fair value of reporting units based on the present value of estimated future cash flows, discounted at an appropriate risk adjusted rate. This approach was selected as it measures the income producing assets, primarily technology and customer relationships. This method estimates the fair value based upon the ability to generate future cash flows, which is particularly applicable when future profit margins and growth are expected to vary significantly from historical operating results. The Company uses internal forecasts to estimate future cash flows and includes an estimate of long-term future growth rates based on the most recent views of the long-term forecast for the reporting unit. Accordingly, actual results can differ from those assumed in the forecasts. Discount rates are derived from a capital asset pricing model and analyzing published rates for industries relevant to the reporting unit to estimate the cost of equity financing. The Company uses discount rates that are commensurate with the risks and uncertainty inherent in the respective businesses and in the internally developed forecasts. Other significant assumptions include terminal value margin rates, future capital expenditures, and changes in future working capital requirements. While there are inherent uncertainties related to the assumptions used and to the application of these assumptions to this analysis, the income approach provides a reasonable estimate of the fair value of the Therapy reporting unit. The Company performed the annual impairment assessment at October 1, 2018 and compared the fair value of each reporting unit to its carrying value as of this date. The fair value exceeded the carrying value for the Detection reporting unit as of the date of this impairment assessment. Goodwill for the Therapy reporting unit was fully impaired as of December 31, 2017. As such, the Company did not record any impairment charges for the year ended December 31, 2018. The carrying values of the reporting units were determined based on an allocation of our assets and liabilities through specific allocation of certain assets and liabilities, to the reporting units and an apportionment of the remaining net assets based on the relative size of the reporting units’ revenues and operating expenses compared to the Company as a whole. The determination of reporting units also requires management judgment. The Company determines the fair values for each reporting unit using a weighting of the income approach and the market approach. For purposes of the income approach, fair value is determined based on the present value of estimated future cash flows, discounted at an appropriate risk adjusted rate. The Company uses internal forecasts to estimate future cash flows and includes estimates of long-term future growth rates based on our most recent views of the long-term forecast for each segment. Accordingly, actual results can differ from those assumed in our forecasts. Discount rates are derived from a capital asset pricing model and by analyzing published rates for industries relevant to our reporting units to estimate the cost of equity financing. The Company uses discount rates that are commensurate with the risks and uncertainty inherent in the respective businesses and in our internally developed forecasts. In the market approach, the Company uses a valuation technique in which values are derived based on market prices of publicly traded companies with similar operating characteristics and industries. A market approach allows for comparison to actual market transactions and multiples. It can be somewhat limited in its application because the population of potential comparable publicly-traded companies can be limited due to differing characteristics of the comparative business and ours, as well as market data may not be available for divisions within larger conglomerates or non-public The Company corroborates the total fair values of the reporting units using a market capitalization approach; however, this approach cannot be used to determine the fair value of each reporting unit value. The blend of the income approach and market approach is more closely aligned to the business profile of the Company, including markets served and products available. In addition, required rates of return, along with uncertainties inherent in the forecast of future cash flows, are reflected in the selection of the discount rate. In addition, under the blended approach, reasonably likely scenarios and associated sensitivities can be developed for alternative future states that may not be reflected in an observable market price. The Company will assess each valuation methodology based upon the relevance and availability of the data at the time the valuation is performed and weights the methodologies appropriately. A rollforward of goodwill activity by reportable segment is as follows (in thousands): Detection Therapy Total Accumulated Goodwill $ — $ — $ 47,937 Accumulated impairment — — (26,828 ) Fair value allocation 7,663 13,446 — Acquisition of DermEbx and Radion — 6,154 6,154 Acquisition measurement period adjustments — 116 116 Acquisition of VuComp 1,093 — 1,093 Sale of MRI assets (394 ) — (394 ) Impairment — (13,981 ) (13,981 ) Balance at December 31, 2016 8,362 5,735 14,097 Impairment — (5,735 ) (5,735 ) Balance at December 31, 2017 8,362 — 8,362 — — — Balance at December 31, 2018 $ 8,362 $ — $ 8,362 Accumulated Goodwill 699 6,270 49,171 Fair value allocation 7,663 13,446 — Accumulated impairment — (19,716 ) (40,809 ) Balance at December 31, 2018 $ 8,362 $ — $ 8,362
Long Lived Assets	(i) Long Lived Assets In accordance with FASB ASC Topic 360, “Property, Plant and Equipment”, (“ASC 360”), the Company assesses long-lived assets for impairment if events and circumstances indicate it is more likely than not that the fair value of the asset group is less than the carrying value of the asset group. ASC 360-10-35 360-10-35-21, • A significant decrease in the market price of a long-lived asset (asset group); • A significant adverse change in the extent or manner in which a long-lived asset (asset group) is being used or in its physical condition; • A significant adverse change in legal factors or in the business climate that could affect the value of a long-lived asset (asset group), including an adverse action or assessment by a regulator; • An accumulation of costs significantly in excess of the amount originally expected for the acquisition or construction of a long-lived asset (asset group); • A current period operating or cash flow loss combined with a history of operating or cash flow losses or a projection or forecast that demonstrates continuing losses associated with the use of a long-lived asset (asset group). In accordance with ASC 360-10-35-17, The Company completed an interim goodwill impairment assessment for the Therapy reporting unit in the third quarter of 2017 and noted that there was an impairment of goodwill. As a result, the Company determined this was a triggering event to review long-lived assets for impairment. The Company determined the “Asset Group” to be the assets of the Therapy segment, which the Company considered to be the lowest level for which the identifiable cash flows were largely independent of the cash flows of other assets and liabilities. Accordingly, the Company completed an analysis pursuant to ASC 360-10-35-17 The Company also completed a goodwill assessment in the fourth quarter of 2017, and in connection with that assessment, the Company completed an analysis pursuant to ASC 360-10-35-17 The Company did not record any impairment charges for the years ended December 31, 2018 or 2016. A considerable amount of judgment and assumptions are required in performing the impairment tests, principally in determining the fair value of the asset group. While the Company believes the judgments and assumptions are reasonable, different assumptions could change the estimated fair values, and, therefore additional impairment charges could be required. Significant negative industry or economic trends, disruptions to the Company’s business, loss of significant customers, inability to effectively integrate acquired businesses, unexpected significant changes or planned changes in use of the assets may adversely impact the assumptions used in the fair value estimates and ultimately result in future impairment charges. Intangible assets subject to amortization consist primarily of patents, technology, customer relationships and trade names purchased in the Company’s previous acquisitions. These assets, which include assets from the acquisition of the assets of VuComp, DermEbx and Radion and the acquisition of Xoft, Inc., are amortized on a straight-line basis consistent with the pattern of economic benefit over their estimated useful lives of 5 to 15 years. A summary of intangible assets for 2018 and 2017 are as follows (in thousands): 2018 2017 Weighted Gross Carrying Amount Patents and licenses $ 571 $ 556 5 years Technology 8,257 8,257 10 years Customer relationships 272 292 7 years Tradename 259 259 10 years Total amortizable intangible assets 9,359 9,364 Accumulated Amortization Patents and licenses $ 511 $ 503 Technology 6,958 6,610 Customer relationships 81 61 Tradename 259 259 Total accumulated amortization 7,809 7,433 Total amortizable intangible assets, net $ 1,550 $ 1,931 Amortization expense related to intangible assets was approximately $383,000, $494,000 and $983,000 for the years ended December 31, 2018, 2017, and 2016, respectively. Estimated remaining amortization of the Company’s intangible assets is as follows (in thousands): For the years ended December 31: Estimated 2019 $ 422 2020 304 2021 226 2022 297 2023 100 Thereafter 201 $ 1,550
Revenue Recognition	(j) Revenue Recognition Revenue Recognition Upon Adoption of ASC 606 On January 1, 2018, the Company adopted FASB ASC Topic 606, “Revenue from Contracts with Customers” and all the related amendments (“Topic 606”), using the modified retrospective method for all contracts not completed as of the date of adoption. For contracts that were modified before the effective date, the Company reflected the aggregate effect of all modifications when identifying performance obligations and allocating transaction price in accordance with practical expedient ASC 606-10-65-1-(f)-4, We recorded a net increase to opening retained earnings of $0.1 million as of January 1, 2018 due to the cumulative impact of adopting Topic 606, with the impact primarily related to the deferral of commissions on our long-term service arrangements and warranty periods greater than one year, which previously were expensed as incurred but, under the amendments to ASC 340-40, The cumulative effect of the changes made to the Company’s consolidated balance sheet for the adoption of Topic 606 were as follows (in thousands): Selected Balance Sheet Balance at Adjustments Due to ASU 2014-09 Balance at Assets Prepaid expenses and other current assets $ 1,100 $ 147 $ 1,247 Liabilities Deferred revenue — 408 408 Contract liabilities 5,910 (369 ) 5,541 Stockholders’ equity Accumulated deficit (201,865 ) 108 (201,973 ) In accordance with the requirements of the new standard, the disclosure of the impact of the adoption on our consolidated balance sheet and statement of operations was as follows (in thousands): As of December 31, 2018 Selected Balance Sheet As Reported Balances without Effect of Change Assets Prepaid expenses and other current assets $ 1,045 $ 763 $ (282 ) Liabilities Accrued expenses 5,060 5,060 — Deferred revenue 287 287 — Contract liabilities 5,209 5,209 — Deferred tax 3 2 (1 ) Stockholders’ equity Accumulated deficit (210,774 ) (211,056 ) (282 ) The impact to revenues as a result of applying Topic 606 for the year ended December 31, 2018 was an increase of $116,000 (table in thousands). Year ended December 31, 2018 Selected Statement of Operations As Reported Balances without Effect of Change Revenue Products $ 13,111 $ 12,944 $ 167 Service and supplies 12,510 12,561 (51 ) Cost of revenue Products 2,161 2,161 — Service and supplies 3,627 3,627 — Operating expenses Marketing and sales 8,693 8,975 (282 ) Interest expense (504 ) (504 ) — Other income 110 110 — Tax benefit (expense) 42 42 — Net loss (9,017 ) (9,415 ) (398 ) In accordance with ASC 606, revenue is recognized when a customer obtains control of promised goods or services. The amount of revenue recognized reflects the consideration to which the Company expects to be entitled to receive in exchange for these goods or services and excludes any sales incentives or taxes collected from customers which are subsequently remitted to government authorities. To achieve this core principle, the Company applies the following five steps: 1) Identify the contract(s) with a customer 2) Identify the performance obligations in the contract 3) Determine the transaction price 4) Allocate the transaction price to the performance obligations in the contract 5) Recognize revenue when (or as) the Company satisfies a performance obligation The Company recognizes revenue from its contracts with customers primarily from the sale of products and from the sale of services and supplies. Under Topic 606, revenue is recognized when control of the promised goods or services is transferred to a customer, in an amount that reflects the consideration we expect to be entitled to in exchange for those goods or services. For product revenue, control has transferred upon shipment provided title and risk of loss have passed to the customer. Services and supplies are considered to be transferred as the services are performed or over the term of the service or supply agreement. The Company enters into contracts that can include various combinations of products and services, which are generally capable of being distinct and accounted for as separate performance obligations. The Company’s hardware is generally highly dependent on, and interrelated with, the underlying software and the software is considered essential to the functionality of the product. In these cases, the hardware and software license are accounted for as a single performance obligation and revenue is recognized at the point in time when ownership is transferred to the customer. Taxes assessed by a governmental authority that are both imposed on and concurrent with a specific revenue-producing transaction, that are collected by the Company from a customer, are excluded from revenue. Shipping and handling costs associated with outbound freight after control of a product has transferred to a customer are accounted for as fulfillment costs and are included in cost of revenue. The Company continues to provide for estimated warranty costs on original product warranties at the time of sale. Disaggregation of Revenue The following tables presents our revenues disaggregated by major good or service line, timing of revenue recognition and sales channel, reconciled to our reportable segments (in thousands). Year ended December 31, 2018 Reportable Segments Detection Therapy Total Major Goods/Service Lines Products $ 10,783 $ 4,393 $ 15,176 Service contracts 5,311 1,450 6,761 Supply and source usage agreements — 2,261 2,261 Professional services — 264 264 Other 229 389 618 $ 16,323 $ 8,757 $ 25,080 Timing of Revenue Recognition Goods transferred at a point in time $ 10,835 $ 4,676 $ 15,511 Services transferred over time 5,488 4,081 9,569 $ 16,323 $ 8,757 $ 25,080 Sales Channels Direct sales force $ 8,335 $ 7,554 $ 15,889 OEM partners 7,988 — 7,988 Channel partners — 1,203 1,203 $ 16,323 $ 8,757 $ 25,080 Total Revenue Revenue from contracts with customers $ 16,323 $ 8,757 $ 25,080 Revenue from lease components 541 — 541 $ 16,864 $ 8,757 $ 25,621 Year ended December 31, 2017(1) Reportable Segments Detection Therapy Total Major Goods/Service Lines Products $ 11,650 $ 4,763 $ 16,413 Service contracts 5,687 1,482 7,169 Supply and source usage agreements — 1,956 1,956 Professional services — 254 254 Other 388 1,337 1,725 $ 17,725 $ 9,792 $ 27,517 Timing of Revenue Recognition Goods transferred at a point in time 11,684 5,130 $ 16,814 Services transferred over time 6,041 4,662 10,703 $ 17,725 $ 9,792 $ 27,517 Sales Channels Direct sales force $ 7,787 $ 8,354 $ 16,141 OEM partners 9,938 — 9,938 Channel partners — 1,438 1,438 $ 17,725 $ 9,792 $ 27,517 Total Revenue Revenue from contracts with customers $ 17,725 $ 9,792 $ 27,517 Revenue from lease components 585 — 585 $ 18,310 $ 9,792 $ 28,102 (1) As noted above, prior period amounts have not been adjusted under the modified retrospective method. Products Service Contracts non-lease Supply and Source Usage Agreements Professional Services Other Significant Judgments The Company’s contracts with customers may include promises to transfer multiple products and services to a customer. Determining whether products and services are considered distinct performance obligations that should be accounted for separately versus together may require significant judgment. For arrangements with multiple performance obligations, the Company allocates revenue to each performance obligation based on its relative standalone selling price. Judgment is required to determine the standalone selling price for each distinct performance obligation. The Company generally determines standalone selling prices based on the prices charged to customers and uses a range of amounts to estimate standalone selling prices when we sell each of the products and services separately and need to determine whether there is a discount that needs to be allocated based on the relative standalone selling prices of the various products and services. The Company typically has more than one range of standalone selling prices for individual products and services due to the stratification of those products and services by customers and circumstances. In these instances, the Company may use information such as the type of customer and geographic region in determining the range of standalone selling prices. The Company may provide credits or incentives to customers, which are accounted for as variable consideration when estimating the transaction price of the contract and amounts of revenue to recognize. The amount of variable consideration to include in the transaction price is estimated at contract inception using either the estimated value method or the most likely amount method based on the nature of the variable consideration. These estimates are updated at the end of each reporting period as additional information becomes available and revenue is recognized only to the extent that it is probable that a significant reversal of any amounts of variable consideration included in the transaction price will not occur. The Company provides for estimated warranty costs on original product warranties at the time of sale. Contract Balances Contract liabilities are a component of deferred revenue, and contract assets are a component of prepaid and other current assets. The following table provides information about receivables, contract assets, and contract liabilities from contracts with customers (in thousands). Balance at Receivables, which are included in ‘Trade accounts receivable’ $ 6,252 Contract assets, which are included in “Prepaid and other current assets” 19 Contract liabilities, which are included in “Deferred revenue” 5,209 Timing of revenue recognition may differ from timing of invoicing to customers. The Company records a receivable when revenue is recognized prior to receipt of cash payments and the Company has the unconditional right to such consideration, or unearned revenue when cash payments are received or due in advance of performance. For multi-year agreements, the Company generally invoices customers annually at the beginning of each annual service period. The opening balance of accounts receivable from contracts with customers, net of allowance for doubtful accounts, was $8.5 million as of January 1, 2018. As of December 31, 2018, accounts receivable, net of allowance for doubtful accounts, was $6.3 million. The Company records a contract asset for unbilled revenue when the Company’s performance is in excess of amounts billed or billable. The Company has classified the contract asset balance as a component of prepaid expenses and other current assets as of January 1, 2018 and December 31, 2018. The opening balance of contract assets was $166,000 as of January 1, 2018. As of December 31, 2018, the contract asset balance was $19,000. Deferred revenue from contracts with customers is primarily composed of fees related to long-term service arrangements, which are generally billed in advance. Deferred revenue also includes payments for installation and training that has not yet been completed and other offerings for which we have been paid in advance and earn the revenue when we transfer control of the product or service. Deferred revenue from contracts with customers is included in deferred revenue in the consolidated balance sheets. Deferred revenue on the consolidated balance sheet also includes $369,000 and $287,000 at December 31, 2017 and December 31, 2018, respectively of amounts associated with service contracts accounted for under Topic 840. The balance of deferred revenue at December 31, 2017 and December 31, 2018 is as follows (in thousands): December 31, 2017 Contract Lease revenue Total Short term $ 5,044 $ 360 $ 5,404 Long term 497 9 506 Total $ 5,541 $ 369 $ 5,910 December 31, 2018 Contract Lease revenue Total Short term $ 4,885 $ 280 $ 5,165 Long term 324 7 331 Total $ 5,209 $ 287 $ 5,496 Changes in deferred revenue from contracts with customers were as follows (in thousands): Year Ended Balance at beginning of period $ 5,541 Adoption adjustment 39 Deferral of revenue 9,993 Recognition of deferred revenue (10,364 ) Balance at end of period $ 5,209 We expect to recognize approximately $4.9 million of the deferred amount in 2019, $0.2 million in 2020, and $0.1 million thereafter. Assets Recognized from the Costs to Obtain a Contract with a Customer We recognize an asset for the incremental costs of obtaining a contract with a customer if we expect the benefit of those costs to be longer than one year. We have determined that certain commissions programs meet the requirements to be capitalized. The opening balance of capitalized costs to obtain a contract was $117,000 as of January 1, 2018. As of December 31, 2018, the balance of capitalized costs to obtain a contract was $282,000. The Company has classified the capitalized costs to obtain a contract as a component of prepaid expenses and other current assets as of January 1, 2018 and December 31, 2018. Changes in the balance of capitalized costs to obtain a contract were as follows (in thousands): Year Ended Balance at beginning of period $ 117 Deferral of costs to obtain a contract 368 Recognition of costs to obtain a contract (203 ) Balance at end of period $ 282 Practical Expedients and Exemptions The Company has elected to make the following accounting policy elections through the adoption of the following practical expedients: Right to Invoice Where applicable, the Company will recognize revenue from a contract with a customer in an amount that corresponds directly with the value to the customer of the Company’s performance completed to date and the amount to which the entity has a right to invoice. Sales and Other Similar Taxes The Company will exclude sales taxes and similar taxes from the measurement of transaction price and will ensure that it complies with the disclosure requirements of ASC 235-10-50-1 50-6. Significant Financing Component The Company will not adjust the promised amount of consideration for the effects of a significant financing component if the Company expects, at contract inception, that the period between when the entity transfers a promised good or service to a customer and when the customer pays for that good or service will be one year or less. Cost to Obtain a Contract The Company will recognize the incremental costs of obtaining a contract as an expense when incurred if the amortization period of the asset that the Company otherwise would have recognized is one year or less and there are no renewal periods on which the Company does not pay commissions that are not commensurate with those originally paid. Promised Goods or Services that are Immaterial in the Context of a Contract The Company has elected to assess promised goods or services as performance obligations that are deemed to be immaterial in the context of a contract. As such, the Company will not aggregate and assess immaterial items at the entity level. That is, when determining whether a good or service is immaterial in the context of a contract, the assessment will be made based on the application of ASC 606 at the contract level. The Company does not disclose the value of unsatisfied performance obligations for (i) contracts with an original expected length of one year or less and (ii) contracts for which we recognize revenue at the amount to which we have the right to invoice for services performed. Revenue Recognition Prior to the Adoption of ASC 606 The Company’s reporting periods prior to the adoption of ASC 606 and the year ended December 31, 2018 are not adjusted and continue to be reported in accordance with our historic accounting under Topic 605. Under Topic 605, revenue was recognized when delivery occurred, persuasive evidence of an arrangement existed, fees were fixed or determinable and collectability of the related receivable was probable. For product revenue, delivery was considered to occur upon shipment provided title and risk of loss had passed to the customer. Services and supplies revenue was considered to be delivered as the services were performed or over the estimated life of the supply agreement. Revenue from the sale of certain CAD products was recognized in accordance with ASC 840, which continues to be the case under Topic 606. In addition, revenue from certain CAD products was recognized in accordance with ASC 985-605, The Company historically determined that iCAD’s digital and film based sales generally followed the guidance of ASC 605 as the software was considered essential to the functionality of the product per the guidance of ASU 2009-14. 2009-13. Revenue from certain CAD products was recognized in accordance with ASC 985-605. Sales 2009-13. 605-20,
Cost of Revenue	(k) Cost of Revenue Cost of revenue consists of the costs of products purchased for resale, cost relating to service including costs of service contracts to maintain equipment after the warranty period, inbound freight and duty, manufacturing, warehousing, material movement, inspection, scrap, rework, depreciation and in-house
Warranty Costs	(l) Warranty Costs The Company provides for the estimated cost of standard product warranty against defects in material and workmanship based on historical warranty trends, including the cost of product returns during the warranty period. Warranty provisions and claims for the years ended December 31, 2018, 2017 and 2016, were as follows (in thousands): 2018 2017 2016 Beginning accrual balance $ 10 $ 11 $ 19 Warranty provision 19 49 47 Usage (17 ) (50 ) (55 ) Ending accrual balance $ 12 $ 10 $ 11
Engineering and Product Development Costs	(m) Engineering and Product Development Costs Engineering and product development costs relate to research and development efforts including Company sponsored clinical trials which are expensed as incurred.
Advertising Costs	(n) Advertising Costs The Company expenses advertising costs as incurred. Advertising expense for the years ended December 31, 2018, 2017 and 2016 was approximately $811,000, $990,000 and $955,000 respectively.
Net Loss per Common Share	(o) Net Loss per Common Share The Company follows FASB ASC 260-10, A summary of the Company’s calculation of net loss per share is as follows (in thousands, except per share amounts): 2018 2017 2016 Net loss available to common shareholders $ (9,017 ) $ (14,256 ) $ (10,099 ) Basic shares used in the calculation of earnings per share 16,685 16,343 15,932 Effect of dilutive securities: Stock options — — — Restricted stock — — — Diluted shares used in the calculation of earnings per share 16,685 16,343 15,932 Net loss per share : Basic $ (0.54 ) $ (0.87 ) $ (0.63 ) Diluted $ (0.54 ) $ (0.87 ) $ (0.63 ) The following table summarizes the number of shares of common stock for convertible securities, warrants and restricted stock that were not included in the calculation of diluted net loss per share because such shares are antidilutive: 2018 2017 2016 Common stock options 1,983,477 1,465,115 1,425,348 Restricted Stock 423,202 415,147 511,398 Convertible Debentures 1,742,500 — — 4,149,179 1,880,262 1,936,746 Restricted common stock can be issued to directors, executives or employees of the Company and are subject to time-based vesting. These potential shares were excluded from the computation of basic loss per share as these shares are not considered outstanding until vested.
Income Taxes	(p) Income Taxes The Company follows the liability method under ASC Topic 740, “Income Taxes”, (“ASC 740”). The primary objectives of accounting for taxes under ASC 740 are to (a) recognize the amount of tax payable for the current year and (b) recognize the amount of deferred tax liability or asset for the future tax consequences of events that have been reflected in the Company’s financial statements or tax returns. The Company has provided a full valuation allowance against its deferred tax assets at December 31, 2018 and 2017, as it is more likely than not that the deferred tax asset will not be realized. Any subsequent changes in the valuation allowance will be recorded through operations in the provision (benefit) for income taxes. ASC 740-10 740-10 de-recognition,
Stock-Based Compensation	(q) Stock-Based Compensation The Company maintains stock-based incentive plans, under which it provides stock incentives to employees, directors and contractors. The Company may grant to employees, directors and contractors, options to purchase common stock at an exercise price equal to the market value of the stock at the date of grant. The Company may grant restricted stock to employees and directors. The underlying shares of the restricted stock grant are not issued until the shares vest, and compensation expense is based on the stock price of the shares at the time of grant. The Company follows FASB ASC Topic 718, “ Compensation – Stock Compensation The Company uses the Black-Scholes option pricing model to value stock options which requires extensive use of accounting judgment and financial estimates, including estimates of the expected term participants will retain their vested stock options before exercising them, the estimated volatility of its common stock price over the expected term, the risk free rate, expected dividend yield, and the number of options that will be forfeited prior to the completion of their vesting requirements. The fair value of restricted stock is determined based on the stock price of the underlying option on the date of the grant. The Company granted performance based restricted stock during 2016 based on the achievement of certain revenue targets. Compensation cost for performance based restricted stock requires significant judgment regarding probability of achieving the performance objectives and compensation cost is adjusted for the probability of achieving these objectives. As a result, compensation cost could vary significantly during the performance measurement period. Application of alternative assumptions could produce significantly different estimates of the fair value of stock-based compensation and consequently, the related amounts recognized in the Consolidated Statements of Operations.
Fair Value Measurements	(r) Fair Value Measurements The Company follows the provisions of FASB ASC Topic 820, “ Fair Value Measurement and Disclosures • Level 1 - Quoted prices in active markets for identical assets or liabilities. • Level 2 - Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. • Level 3 - Unobservable inputs that are supported by little or no market activity and that are significant to the fair value A financial instrument’s level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. The Company’s assets and liabilities that are measured at fair value on a recurring basis include the Company’s money market accounts and convertible debentures. The money market funds are included in cash and cash equivalents in the accompanying balance sheet, and are considered a Level 1 measurement as they are valued at quoted market prices in active markets. The convertible debentures are recorded as a separate component of the Company’s consolidated balance sheets, and are considered a Level 3 measurement due to the utilization of significant unobservable inputs in their valuation. See Note 4(b) for a discussion of these fair value measurements. The following table sets forth the Company’s assets and liabilities which are measured at fair value on a recurring basis by level within the fair value hierarchy: Fair Value Measurements (000’s) as of December 31, 2018 Level 1 Level 2 Level 3 Total Assets Money market accounts $ 12,134 $ — $ — $ 12,134 Total Assets $ 12,134 $ — $ — $ 12,134 Liabilities Convertible debentures $ — $ — $ 6,970 $ 6,970 Total Liabilities $ — $ — $ 6,970 $ 6,970 Fair Value Measurements (000’s) as of December 31, 2017 Level 1 Level 2 Level 3 Total Assets Money market accounts $ 8,853 $ — $ — $ 8,853 Total Assets $ 8,853 $ — $ — $ 8,853 The following is a roll forward of the Company’s Level 3 instruments for the year ended December 31, 2018: Convertible Balance, December 20, 2018 $ — Issuances 6,970 Fair value adjustments — Balance, December 31, 2018 $ 6,970 Items Measured at Fair Value on a Nonrecurring Basis Certain assets, including long-lived assets and goodwill, are measured at fair value on a nonrecurring basis. These assets are recognized at fair value when they are deemed to be impaired. In 2017, the Company recorded a $6.7 million impairment consisting of $5.7 million related to goodwill and $1.0 million related to long-lived and other assets. The fair values of long-lived assets and goodwill were measured using Level 3 inputs. There were no items measured at fair value on a nonrecurring basis as of or during the year ended December 31, 2018.
Recently Issued and Recently Adopted Accounting Standards	(s) Recently Issued and Recently Adopted Accounting Standards Recently Adopted Accounting Standards On January 1, 2018, the Company adopted the new accounting standard ASC 606, “Revenue from Contracts with Customers” and all the related amendments (“Topic 606”) using the modified retrospective method for all contracts not completed as of the date of adoption. For contracts that were modified before the effective date, the Company reflected the aggregate effect of all modifications when identifying performance obligations and allocating transaction price in accordance with practical expedient ASC 606-10-65-1-(f)-4, On January 1, 2018, the Company adopted FASB issued ASU 2016-01, 825-10): 2016-01”), 2016-01 2016-01 On January 1, 2018, the Company adopted FASB ASU 2017-09, 2017-09”). 2017-09 On January 1, 2018, the Company adopted FASB ASU 2016-15, 2016-15”). 2016-15 On January 1, 2018, the Company adopted FASB ASU 2016-18, 2016-18”), non-restricted 2016-18 Recently Issued Accounting Standards Not Yet Adopted In February 2016, the FASB issued ASU 2016-02, right-of-use For public companies, Topic 842 is effective for annual reporting periods beginning after December 15, 2018, including interim periods within that reporting period. The effective date for us is January 1, 2019. An entity may adopt the guidance either (1) retrospectively to each prior reporting period presented in the financial statements with a cumulative-effect adjustment recognized at the beginning of the earliest comparative period presented or (2) retrospectively at the beginning of the period of adoption through a cumulative-effect adjustment. The Company will adopt the guidance retrospectively at the beginning of the period of adoption, January 1, 2019, through a cumulative-effect adjustment, and will not apply the new standard to comparative periods presented. The new standard provides a number of practical expedients. Upon adoption, the Company will elect the transition package of practical expedients permitted within the new standard, which among other things, allows the carryforward of the historical lease classification. Further, upon implementation of the new guidance, the Company will elect the practical expedients for lessees to combine lease and non-lease right-of-use right-of-use ASC 842 will impact the Company’s consolidated financial statements as the Company has operating lease arrangements for which it is the lessee. The Company has substantially identified a complete population of leases, including any embedded leases. Based on the Company’s portfolio of leases as of December 31, 2018, we estimate the impact of the adoption to be an increase in lease-related assets and liabilities of approximately $1.0 million on the Company’s consolidated balance sheet with no material impact on the results of operations, equity or cash flows. In addition, upon electing the practical expedient to combine lease and non-lease In July 2017, the FASB issued ASU 2017-11, 2017-11”). 2017-11 2017-11 2017-11
Subsequent Events	(t) Subsequent Events The Company considers events or transactions that occur after the balance sheet date but prior to the issuance of the consolidated financial statements to provide additional evidence relative to certain estimates or to identify matters that require additional disclosure. On March 15, 2019, the Company and Silicon Valley Bank entered into the Fourth Loan Modification Agreement related to the Company’s Loan and Security Agreement. The modification revises certain covenants such that the Company must maintain minimum consolidated revenues of $11.4 million, $11.6 million, $13.0 million and $14.5 million during the trailing six month periods ending on March 31, 2019, June 30, 2019, September 30, 2019 and December 31, 2019, respectively, as well as adjusted EBITDA levels of $(3.5 million), $(4.0 million), $(4.0 million) and $(2.0 million) during the trailing six month periods ending on March 31, 2019, June 30, 2019, September 30, 2019 and December 31, 2019, respectively. In addition, the Company and Silicon Valley Bank will be required to negotiate the covenants for the 2020 and 2021 fiscal years, with a failure to agree to such covenants by specified dates in the agreement leading to an acceleration of the Initial Term Loan maturity date to either April 30, 2020 or April 31, 2021, respectively.
Segment Reporting	(a) Segment Reporting In accordance with FASB Topic ASC 280, Segments, operating segments are defined as components of an enterprise that engage in business activities for which discrete financial information is available and regularly reviewed by the chief operating decision maker (“CODM”) in deciding how to allocate resources and assess performance.
Litigation	(g) Litigation The Company may be a party to various legal proceedings and claims arising out of the ordinary course of its business. Although the final results of all such matters and claims cannot be predicted with certainty, the Company currently believes that there are no current proceedings or claims pending against it of which the ultimate resolution would have a material adverse effect on its financial condition or results of operations. However, should we fail to prevail in any legal matter or should several legal matters be resolved against us in the same reporting period, such matters could have a material adverse effect on our operating results and cash flows for that particular period. In all cases, at each reporting period, the Company evaluates whether or not a potential loss amount or a potential range of loss is probable and reasonably estimable under ASC 450, Contingencies. Legal costs are expensed as incurred. In December 2016, the Company entered into an Asset Purchase Agreement, referred to in this Section as the Agreement, with Invivo Corporation, referred to in this Section as Invivo. In accordance with the Agreement, the Company sold to Invivo all right, title and interest to certain intellectual property relating to the Company’s VersaVue software and DynaCAD product and related assets for $3.2 million. The Company closed the transaction on January 30, 2017, less a holdback reserve of $350,000 for a net of approximately $2.9 million. On September 5, 2018, third-party Yeda Research and Development Company Ltd., referred to in this Section as Yeda, filed a complaint against the Company and Invivo in the United States District Court for the Southern District of New York, captioned Yeda Research and Development Company Ltd. v. iCAD, Inc. and Invivo Corporation, Case No. 1:18-cv-08083-GBD, related to the Company’s sale of the VersaVue software and DynaCAD product under the Agreement. In the Complaint, Yeda asserts claims for: (i) copyright infringement and misappropriation of trade secrets against both the Company and Invivo; (ii) breach of contract against the Company only; and (iii) tortious interference with existing business relationships and unjust enrichment against Invivo only. The Company and Invivo filed Motions to Dismiss the Complaint on December 21, 2018. On January 18, 2019, Yeda filed Oppositions to the Motions to Dismiss. The Company and Invivo submitted responses to the Opposition to the Motion to Dismiss on February 8, 2019. The Court held oral argument on the Motions to Dismiss on March 27, 2019. The Company is awaiting a decision from the Court. To the extent that the Complaint is not dismissed in its entirety, the Company will vigorously defend against the claims asserted by Yeda. The amount of the loss, if any, cannot be reasonably estimated at this time. Any amounts owed by the Company in connection with its indemnification obligations to Invivo related to this action may reduce the $350,000 holdback under the Asset Purchase Agreement.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2018
Schedule of Allowance for Doubtful Accounts	The following table summarizes the allowance for doubtful accounts for the three years ended December 31, 2018 (in thousands): 2018 2017 2016 Balance at beginning of period $ 107 $ 172 $ 236 Additions charged to costs and expenses 225 45 177 Reductions (155 ) (110 ) (241 ) Balance at end of period $ 177 $ 107 $ 172
Schedule of Current Inventory	At December 31, 2018 and 2017, inventories consisted of the following (in thousands), which includes an inventory reserve of approximately $1.1 million and $1.2 million as December 31, 2018 and 2017, respectively. As of December 31, 2018 2017 Raw materials $ 606 $ 992 Work in process 67 63 Finished Goods 914 1,068 Inventory $ 1,587 $ 2,123
Schedule of Property and Equipment Estimated Useful Lives	Property and equipment are stated at cost and depreciated using the straight-line method over the estimated useful lives of the assets or the remaining lease term, if shorter, for leasehold improvements (see below). Estimated life Equipment 3-5 years Leasehold improvements 3-5 Furniture and fixtures 3-5 Marketing assets 3-5
Roll Forward of Goodwill Activity by Reportable Segment	A rollforward of goodwill activity by reportable segment is as follows (in thousands): Detection Therapy Total Accumulated Goodwill $ — $ — $ 47,937 Accumulated impairment — — (26,828 ) Fair value allocation 7,663 13,446 — Acquisition of DermEbx and Radion — 6,154 6,154 Acquisition measurement period adjustments — 116 116 Acquisition of VuComp 1,093 — 1,093 Sale of MRI assets (394 ) — (394 ) Impairment — (13,981 ) (13,981 ) Balance at December 31, 2016 8,362 5,735 14,097 Impairment — (5,735 ) (5,735 ) Balance at December 31, 2017 8,362 — 8,362 — — — Balance at December 31, 2018 $ 8,362 $ — $ 8,362 Accumulated Goodwill 699 6,270 49,171 Fair value allocation 7,663 13,446 — Accumulated impairment — (19,716 ) (40,809 ) Balance at December 31, 2018 $ 8,362 $ — $ 8,362
Schedule of Intangible Assets	A summary of intangible assets for 2018 and 2017 are as follows (in thousands): 2018 2017 Weighted Gross Carrying Amount Patents and licenses $ 571 $ 556 5 years Technology 8,257 8,257 10 years Customer relationships 272 292 7 years Tradename 259 259 10 years Total amortizable intangible assets 9,359 9,364 Accumulated Amortization Patents and licenses $ 511 $ 503 Technology 6,958 6,610 Customer relationships 81 61 Tradename 259 259 Total accumulated amortization 7,809 7,433 Total amortizable intangible assets, net $ 1,550 $ 1,931
Schedule of Expected Amortization Expense	Estimated remaining amortization of the Company’s intangible assets is as follows (in thousands): For the years ended December 31: Estimated 2019 $ 422 2020 304 2021 226 2022 297 2023 100 Thereafter 201 $ 1,550
Summary of Impact of The Adoption On Our Consolidated Balance Sheet and Statement of Operations	In accordance with the requirements of the new standard, the disclosure of the impact of the adoption on our consolidated balance sheet and statement of operations was as follows (in thousands): As of December 31, 2018 Selected Balance Sheet As Reported Balances without Effect of Change Assets Prepaid expenses and other current assets $ 1,045 $ 763 $ (282 ) Liabilities Accrued expenses 5,060 5,060 — Deferred revenue 287 287 — Contract liabilities 5,209 5,209 — Deferred tax 3 2 (1 ) Stockholders’ equity Accumulated deficit (210,774 ) (211,056 ) (282 ) The impact to revenues as a result of applying Topic 606 for the year ended December 31, 2018 was an increase of $116,000 (table in thousands). Year ended December 31, 2018 Selected Statement of Operations As Reported Balances without Effect of Change Revenue Products $ 13,111 $ 12,944 $ 167 Service and supplies 12,510 12,561 (51 ) Cost of revenue Products 2,161 2,161 — Service and supplies 3,627 3,627 — Operating expenses Marketing and sales 8,693 8,975 (282 ) Interest expense (504 ) (504 ) — Other income 110 110 — Tax benefit (expense) 42 42 — Net loss (9,017 ) (9,415 ) (398 )
Summary of Receivables, Contract Assets and Contract Liabilities from Contracts with Customers	The following table provides information about receivables, contract assets, and contract liabilities from contracts with customers (in thousands). Balance at Receivables, which are included in ‘Trade accounts receivable’ $ 6,252 Contract assets, which are included in “Prepaid and other current assets” 19 Contract liabilities, which are included in “Deferred revenue” 5,209
Summary of Changes in Deferred Revenue	Changes in deferred revenue from contracts with customers were as follows (in thousands): Year Ended Balance at beginning of period $ 5,541 Adoption adjustment 39 Deferral of revenue 9,993 Recognition of deferred revenue (10,364 ) Balance at end of period $ 5,209
Schedule of Changes of Capitalized Costs to Obtain Contract	Changes in the balance of capitalized costs to obtain a contract were as follows (in thousands): Year Ended Balance at beginning of period $ 117 Deferral of costs to obtain a contract 368 Recognition of costs to obtain a contract (203 ) Balance at end of period $ 282
Roll forward of Warranty Cost	Warranty provisions and claims for the years ended December 31, 2018, 2017 and 2016, were as follows (in thousands): 2018 2017 2016 Beginning accrual balance $ 10 $ 11 $ 19 Warranty provision 19 49 47 Usage (17 ) (50 ) (55 ) Ending accrual balance $ 12 $ 10 $ 11
Calculation of Net Loss Per Share	A summary of the Company’s calculation of net loss per share is as follows (in thousands, except per share amounts): 2018 2017 2016 Net loss available to common shareholders $ (9,017 ) $ (14,256 ) $ (10,099 ) Basic shares used in the calculation of earnings per share 16,685 16,343 15,932 Effect of dilutive securities: Stock options — — — Restricted stock — — — Diluted shares used in the calculation of earnings per share 16,685 16,343 15,932 Net loss per share : Basic $ (0.54 ) $ (0.87 ) $ (0.63 ) Diluted $ (0.54 ) $ (0.87 ) $ (0.63 )
Schedule of Anti-dilutive Shares Excluded from Computation of Diluted Net Loss Per Share	The following table summarizes the number of shares of common stock for convertible securities, warrants and restricted stock that were not included in the calculation of diluted net loss per share because such shares are antidilutive: 2018 2017 2016 Common stock options 1,983,477 1,465,115 1,425,348 Restricted Stock 423,202 415,147 511,398 Convertible Debentures 1,742,500 — — 4,149,179 1,880,262 1,936,746
Assets and Liabilities which are Measured at Fair Value on a Recurring Basis	The following table sets forth the Company’s assets and liabilities which are measured at fair value on a recurring basis by level within the fair value hierarchy: Fair Value Measurements (000’s) as of December 31, 2018 Level 1 Level 2 Level 3 Total Assets Money market accounts $ 12,134 $ — $ — $ 12,134 Total Assets $ 12,134 $ — $ — $ 12,134 Liabilities Convertible debentures $ — $ — $ 6,970 $ 6,970 Total Liabilities $ — $ — $ 6,970 $ 6,970 Fair Value Measurements (000’s) as of December 31, 2017 Level 1 Level 2 Level 3 Total Assets Money market accounts $ 8,853 $ — $ — $ 8,853 Total Assets $ 8,853 $ — $ — $ 8,853
Schedule of Rollforward of the Company's Level 3 Instruments	The following is a roll forward of the Company’s Level 3 instruments for the year ended December 31, 2018: Convertible Balance, December 20, 2018 $ — Issuances 6,970 Fair value adjustments — Balance, December 31, 2018 $ 6,970
Accounting Standards Update 2014-09 [Member]
Summary of Cumulative Effect of The Changes	The cumulative effect of the changes made to the Company’s consolidated balance sheet for the adoption of Topic 606 were as follows (in thousands): Selected Balance Sheet Balance at Adjustments Due to ASU 2014-09 Balance at Assets Prepaid expenses and other current assets $ 1,100 $ 147 $ 1,247 Liabilities Deferred revenue — 408 408 Contract liabilities 5,910 (369 ) 5,541 Stockholders’ equity Accumulated deficit (201,865 ) 108 (201,973 )
Revenues Disaggregated by Major Good or Service Line, Timing of Revenue Recognition, and Sales Channel, Reconciled to Our Reportable Segments	The following tables presents our revenues disaggregated by major good or service line, timing of revenue recognition and sales channel, reconciled to our reportable segments (in thousands). Year ended December 31, 2018 Reportable Segments Detection Therapy Total Major Goods/Service Lines Products $ 10,783 $ 4,393 $ 15,176 Service contracts 5,311 1,450 6,761 Supply and source usage agreements — 2,261 2,261 Professional services — 264 264 Other 229 389 618 $ 16,323 $ 8,757 $ 25,080 Timing of Revenue Recognition Goods transferred at a point in time $ 10,835 $ 4,676 $ 15,511 Services transferred over time 5,488 4,081 9,569 $ 16,323 $ 8,757 $ 25,080 Sales Channels Direct sales force $ 8,335 $ 7,554 $ 15,889 OEM partners 7,988 — 7,988 Channel partners — 1,203 1,203 $ 16,323 $ 8,757 $ 25,080 Total Revenue Revenue from contracts with customers $ 16,323 $ 8,757 $ 25,080 Revenue from lease components 541 — 541 $ 16,864 $ 8,757 $ 25,621 Year ended December 31, 2017(1) Reportable Segments Detection Therapy Total Major Goods/Service Lines Products $ 11,650 $ 4,763 $ 16,413 Service contracts 5,687 1,482 7,169 Supply and source usage agreements — 1,956 1,956 Professional services — 254 254 Other 388 1,337 1,725 $ 17,725 $ 9,792 $ 27,517 Timing of Revenue Recognition Goods transferred at a point in time 11,684 5,266 $ 16,814 Services transferred over time 6,041 4,526 10,703 $ 17,725 $ 9,792 $ 27,517 Sales Channels Direct sales force $ 7,787 $ 8,354 $ 16,141 OEM partners 9,938 — 9,938 Channel partners — 1,438 1,438 $ 17,725 $ 9,792 $ 27,517 Total Revenue Revenue from contracts with customers $ 17,725 $ 9,792 $ 27,517 Revenue from lease components 585 — 585 $ 18,310 $ 9,792 $ 28,102 (1) As noted above, prior period amounts have not been adjusted under the modified retrospective method.
Accounting Standards Update 2016-02 [Member]
Summary of Changes in Deferred Revenue	The balance of deferred revenue at December 31, 2017 and December 31, 2018 is as follows (in thousands): December 31, 2017 Contract Lease revenue Total Short term $ 5,044 $ 360 $ 5,404 Long term 497 9 506 Total $ 5,541 $ 369 $ 5,910 December 31, 2018 Contract Lease revenue Total Short term $ 4,885 $ 280 $ 5,165 Long term 324 7 331 Total $ 5,209 $ 287 $ 5,496

Acquisitions (Tables)

Acquisitions (Tables)	12 Months Ended
	Dec. 31, 2018
MVu Breast Density [Member]
Allocation of Purchase Price Based on Estimated Fair Values of Assets Acquired and Liabilities Assumed	As a result the Company recorded a gain on litigation settlement of $249,000 in the first quarter of 2016, which is a component of the purchase price as noted below: Amount (000’s) Cash $ 6 Acquisition litigation settlement 249 Purchase price $ 255
VuComp Cancer Detection Portfolio [Member]
Allocation of Purchase Price Based on Estimated Fair Values of Assets Acquired and Liabilities Assumed	The following is a summary of the allocation of the total purchase price based on the estimated fair values as of the date of the acquisition and the amortizable life: Amount (000’s) Estimated Current assets $ 84 Property and equipment 65 3 Years Identifiable intangible assets 699 1-10 Years Goodwill 293 Current liabilities (280 ) Long-term liabilities (606 ) Purchase price $ 255
VuComp M-Vu Breast Density Product [Member]
Allocation of Purchase Price Based on Estimated Fair Values of Assets Acquired and Liabilities Assumed	The following is a summary of the allocation of the total purchase price based on the estimated fair values as of the date of the acquisition and the amortizable life (in thousands): Amount Estimated Developed Technology $ 900 8 years 9 months Goodwill 800 Purchase price $ 1,700

Sale of MRI Assets (Tables)

Sale of MRI Assets (Tables)	12 Months Ended
	Dec. 31, 2018
Discontinued Operations and Disposal Groups [Abstract]
Schedule of Net Assets Sold	The value of the net assets sold is as follows (in thousands): Assets Accounts Receivable $ 116 Intangible assets 810 Allocated Goodwill 394 Total Assets $ 1,320 Liabilities Deferred Revenue $ 746 Total Liabilities $ 746 Net Assets Sold $ 574
Schedule of Components of Gain on Sale	The components of the gain on the sale are as follows (in thousands): Gain on Sale Cash received $ 2,850 Holdback reserve 350 Fair value of transition services (118 ) Net Assets sold (574 ) Total $ 2,508

Financing Arrangements (Tables)

Financing Arrangements (Tables)	12 Months Ended
	Dec. 31, 2018
Debt Disclosure [Abstract]
Schedule of Carrying Value of Term Loan Net of Debt Issuance Costs	beginning on March 1, 2019. The carrying value of the Term Loans (net of debt issuance costs) as of December 31, 2018 and 2017 is as follows (in thousands): December 31, 2018 December 31, 2017 Principal Amount of Term Loan $ 6,000 $ 6,000 Unamortized closing costs (58 ) (64 ) Accrued final payment 163 — Carrying amount of Term Loan 6,105 5,936 Less current portion of Term Loan (1,851 ) (817 ) Notes payable long-term portion $ 4,254 $ 5,119
Schedule of Key Inputs to Simulation Model Utilized to Estimate Fair Value of Convertible Debentures	The Company notes that the key inputs to the simulation model that were utilized to estimate the fair value of the Convertible Debentures included: Input December 21, 2018 December 31, 2018 Company’s stock price $ 3.68 $ 3.70 Conversion price $ 4.00 $ 4.00 Remaining term (years) 3.00 2.97 Equity volatility 54.00 % 54.00 % Risk free rate 2.58 % 2.46 % Probability of default event 0.75 % 0.81 % Utilization of Forced Conversion (if available) 100.00 % 100.00 % Exercise of Default Redemption (if available) 100.00 % 100.00 % Effective discount rate 21.90 % 21.90 %
Schedule of Fair Value and Principal Value of Convertible Debentures	As of the issuance date of the Convertible Debentures (December 21, 2018) and December 31, 2018, the fair value and principal value of the Convertible Debentures was: Convertible Debentures December 21, 2018 December 31, 2018 Fair value, in accordance with fair value option $ 6,970 $ 6,970 Principal value outstanding $ 6,970 $ 6,970
Summary of Future Principal and Interest Payments Related to Loan Agreement and Convertible Debentures	Future principal and interest payments related to the Loan Agreement and Convertible Debentures are as follows (in thousands): Fiscal Year Amount Due 2019 $ 2,624 2020 2,895 2021 9,454 Total $ 14,972
Interest Expense in Consolidated Income Statement	The following amounts are included in interest expense in our consolidated statement of operations for the years ended December 31, 2018, 2017 and 2016 (in thousands): December 31, 2018 December 31, 2017 December 31, 2016 Cash interest expense, notes payable $ 299 $ 98 $ — Cash interest expense, convertible debentures 9 — — Amortization of debt costs 29 9 — Accrual of notes payable final payment 163 — — Amortization of settlement obligations — 26 82 Interest expense capital lease 4 1 70 Capital lease - fair value amortization — (10 ) (89 ) Total interest expense $ 504 $ 124 $ 63

Accrued Expenses (Tables)

Accrued Expenses (Tables)	12 Months Ended
	Dec. 31, 2018
Payables and Accruals [Abstract]
Accrued Expenses	Accrued expenses consist of the following at December 31 (in thousands): 2018 2017 Accrued salary and related expenses $ 1,811 $ 1,388 Accrued accounts payable 2,329 2,523 Accrued professional fees 737 418 Other accrued expenses 91 70 Deferred rent 92 76 $ 5,060 $ 4,475

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2018
Federal Home Loan Banks [Abstract]
Summary of Stock Option Activity for all Stock Option Plans	A summary of stock option activity for all stock option plans is as follows: Number of Weighted Average Weighted Average Outstanding, January 1, 2016 1,571,998 $ 5.05 Granted 127,500 $ 5.46 Exercised (75,583 ) $ 2.62 Forfeited (198,567 ) $ 6.19 Outstanding, December 31, 2016 1,425,348 $ 5.05 Granted 200,813 $ 4.14 Exercised (36,530 ) $ 2.18 Forfeited (124,516 ) $ 4.71 Outstanding, December 31, 2017 1,465,115 $ 5.03 Granted 888,263 $ 2.95 Exercised (139,556 ) $ 2.27 Forfeited (230,345 ) $ 5.41 Outstanding, December 31, 2018 1,983,477 $ 4.25 4.4 years Exercisable at December 31, 2016 1,054,211 $ 4.71 Exercisable at December 31, 2017 1,301,651 $ 4.95 Exercisable at December 31, 2018 1,296,439 $ 4.90 4.1 years
Stock-Based Compensation Expense Including Options and Restricted Stock by Category	The Company’s stock-based compensation expense, including options and restricted stock by category is as follows (amounts in thousands): Years Ended December 31, 2018 2017 2016 Cost of revenue $ 4 $ 5 $ 6 Engineering and product development 399 715 329 Marketing and sales 190 1,003 677 General and administrative expense 912 1,933 1,295 $ 1,505 $ 3,656 $ 2,307
Options Granted under Company's Stock Incentive Plans, Valuation Assumptions and Fair Values	Options granted under the stock incentive plans were valued utilizing the Black-Scholes model using the following assumptions and had the following fair values: Years Ended December 31, 2018 2017 2016 Average risk-free interest rate 2.65% 1.61% 0.98% Expected dividend yield None None None Expected life 3.5 years 3.5 years 3.5 years Expected volatility 50.4% to 61.6% 64.2% to 72.0% 68.5% to 75.3% Weighted average exercise price $2.96 $4.14 $5.46 Weighted average fair value $1.23 $1.99 $2.66
Summary of Intrinsic Values of Options and Closing Market Price	Intrinsic values of options (in thousands) and the closing market price used to determine the intrinsic values are as follows: Years Ended December 31, 2018 2017 2016 Outstanding $ 1,021 $ 449 $ 409 Exercisable 499 442 409 Exercised 224 79 201 Company’s stock price at December 31 $ 3.70 $ 3.44 $ 3.24
Summary of Restricted Stock Activity for All Equity Incentive Plans	A summary of restricted stock activity for all equity incentive plans is as follows: Years Ended December 31, 2018 2017 2016 Beginning outstanding balance 415,147 511,398 516,396 Granted 379,439 394,599 345,778 Vested (322,388 ) (469,434 ) (289,030 ) Forfeited (48,996 ) (21,416 ) (61,746 ) Ending outstanding balance 423,202 415,147 511,398
Summary of Intrinsic Values of Restricted Stock and Closing Market Price	Intrinsic values of restricted stock (in thousands) and the closing market price used to determine the intrinsic values are as follows: Years Ended December 31, 2018 2017 2016 Outstanding $ 1,566 $ 1,428 $ 1,657 Vested 1,193 1,615 936 Company’s stock price at December 31 $ 3.70 $ 3.44 $ 3.24

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Components of Income Tax Expense	The components of income tax expense for the years ended December 31, 2018, 2017 and 2016 are as follows (in thousands): 2018 2017 2016 Current provision (benefit): Federal $ — $ — $ — State 54 (26 ) 69 $ 54 $ (26 ) $ 69 Deferred provision: Federal $ (10 ) $ 7 $ 6 State (2 ) 1 1 $ (12 ) $ 8 $ 7 Total $ 42 $ (18 ) $ 76
Summary of Effective and the Federal Statutory Income Tax Rate	A summary of the differences between the Company’s effective income tax rate and the Federal statutory income tax rate for the years ended December 31, 2018, 2017 and 2016 is as follows: 2018 2017 2016 Federal statutory rate 21.0 % 34.0 % 34.0 % State income taxes, net of federal benefit 3.6 % 1.4 % 2.8 % Net state impact of deferred rate change 0.6 % (0.3 %) 0.2 % Stock compensation expense (1.1 %) (1.9 %) (3.2 %) Tax amortization on goodwill 0.1 % (0.1 %) (0.1 %) Goodwill impairment 0.0 % (13.7 %) 0.0 % Other permanent differences (0.5 %) (0.4 %) (0.4 %) Change in valuation allowance (27.6 %) 97.4 % (37.3 %) Tax credits 3.1 % 1.5 % 3.2 % Federal Rate Change 0.0 % (133.5 %) 0.0 % Accrual to TR 0.3 % (0.7 %) 0.0 % Increase Xoft NOLs under 382 Study 0.0 % 16.2 % 0.0 % Effective income tax (0.5 %) (0.1 %) (0.8 %)
Deferred Tax Assets (Liabilities)	assets will not be utilized. Deferred tax assets (liabilities) are composed of the following at December 31 (in thousands): 2018 2017 Inventory (Section 263A) $ 239 $ 287 Inventory reserves 270 305 Receivable reserves 45 27 Other accruals 88 224 Deferred revenue 85 129 Accumulated depreciation/amortization 138 320 Stock options 1,879 1,901 Developed technology 2,031 2,201 Tax credits 3,364 3,130 NOL carryforward 32,074 31,113 Net deferred tax assets 40,213 39,637 Valuation allowance (40,213 ) (39,637 ) Goodwill tax amortization (3 ) (14 ) Deferred tax liability $ (3 ) $ (14 )

Segment Reporting, Geographic_2

Segment Reporting, Geographical Information and Major Customers (Tables)	12 Months Ended
	Dec. 31, 2018
Segment Reporting [Abstract]
Summary of Segment Revenues, Gross Profit, Segment Operating Income or Loss and Reconciliation of Segment Operating Income or Loss to GAAP Loss	Segment revenues, gross profit, segment operating income or loss, and a reconciliation of segment operating income or loss to GAAP loss before income tax is as follows (in thousands, including prior periods which have been presented for consistency): Year Ended December 31, 2018 2017 2016 Segment revenues: Detection $ 16,864 $ 18,310 $ 17,133 Therapy 8,757 9,792 9,205 Total Revenue $ 25,621 $ 28,102 $ 26,338 Segment gross profit: Detection $ 14,709 $ 16,218 $ 15,113 Therapy 4,721 1,958 3,405 Segment gross profit $ 19,430 $ 18,176 $ 18,518 Segment operating income (loss): Detection $ 3,412 $ 6,401 $ 5,694 Therapy (2,373 ) (15,102 ) (7,752 ) Segment operating income (loss) $ 1,039 $ (8,701 ) $ (2,058 ) General, administrative, depreciation and amortization expense $ (9,169 ) $ (7,975 ) $ (7,912 ) Interest expense (504 ) (124 ) (63 ) Financing costs (451 ) — — Gain on sale of MRI assets — 2,508 — Other income 110 18 10 Loss on debt extinguishment — — — Loss before income tax $ (8,975 ) $ (14,274 ) $ (10,023 )
Summary of Segment Depreciation and Amortization Included in Segment Operating Income (Loss)	Segment depreciation and amortization included in segment operating income (loss) is as follows (in thousands): Year Ended December 31, 2018 2017 2016 Detection depreciation and amortization Depreciation $ 106 $ 172 $ 223 Amortization 248 246 696 Therapy depreciation and amortization Depreciation $ 177 $ 768 $ 970 Amortization 129 222 252

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2018
Commitments and Contingencies Disclosure [Abstract]
Future Minimum Rental Payments	Future minimum rental payments due under these agreements as of December 31, 2018 are as follows (in thousands): Fiscal Year Operating Leases 2019 $ 781 2020 183 $ 964
Future Minimum Lease Payments under Non-cancelable Capital Leases	The remaining minimum lease payments are as follows (in thousands): Fiscal Year Capital Lease 2019 $ 17 2020 13 subtotal minimum lease obligation 30 less interest (4 ) Total, net 26 less current portion 11 long term portion $ 15

Quarterly Financial Data (Table

Quarterly Financial Data (Tables)	12 Months Ended
	Dec. 31, 2018
Quarterly Financial Information Disclosure [Abstract]
Quarterly Financial Data	2018 Net sales Gross profit Net loss Income (loss) Weighted average First quarter $ 6,313 $ 4,498 $ (3,281 ) ($ 0.20 ) 16,583 Second quarter 6,162 4,784 $ (1,027 ) ($ 0.06 ) 16,664 Third quarter 6,192 4,738 $ (1,365 ) ($ 0.08 ) 16,700 Fourth quarter 6,954 5,410 $ (3,344 ) ($ 0.20 ) 16,774 2017 First quarter $ 6,791 $ 4,689 $ (457 ) ($ 0.03 ) 16,135 Second quarter 6,409 4,503 $ (2,631 ) ($ 0.16 ) 16,310 Third quarter 7,000 4,643 $ (6,933 ) ($ 0.42 ) 16,424 Fourth quarter 7,902 4,341 $ (4,235 ) ($ 0.26 ) 16,501

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Additional Information (Detail)	3 Months Ended								6 Months Ended				12 Months Ended
	Dec. 31, 2018USD ($)	Sep. 30, 2018USD ($)	Jun. 30, 2018USD ($)	Mar. 31, 2018USD ($)	Dec. 31, 2017USD ($)	Sep. 30, 2017USD ($)	Jun. 30, 2017USD ($)	Mar. 31, 2017USD ($)	Dec. 31, 2019USD ($)	Sep. 30, 2019USD ($)	Jun. 30, 2019USD ($)	Mar. 31, 2019USD ($)	Dec. 31, 2018USD ($)Segment	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)	Jan. 01, 2018USD ($)	Dec. 31, 2015USD ($)
Basis Of Presentation And Significant Accounting Policies [Line Items]
Business segment | Segment													2
Maturity for cash and cash equivalents													90 days
Insurance coverage													$ 250,000
Interest-bearing amounts on deposit in excess of federally	$ 11,900,000												11,900,000
Inventory reserve	1,100,000				$ 1,200,000								1,100,000	$ 1,200,000
Goodwill	8,362,000				8,362,000								8,362,000	8,362,000			$ 14,097,000
Goodwill impairment loss													0	5,735,000	$ 13,981,000
Impairment charges on long lived assets													0		0
Amortization expense related to intangible assets													383,000	494,000	983,000
Increase to retained earnings	(210,774,000)				(201,865,000)								(210,774,000)	(201,865,000)
Revenues	6,954,000	$ 6,192,000	$ 6,162,000	$ 6,313,000	7,902,000	$ 7,000,000	$ 6,409,000	$ 6,791,000					25,621,000	28,102,000	26,338,000
Allowance for doubtful accounts, receivable	177,000				107,000								177,000	107,000	172,000		236,000
Contract assets	19,000												19,000			$ 166,000
Amounts associated with service contracts accounted for under Topic 840	287,000				369,000								287,000	369,000
Unearned amount to recognize in 2018													4.9
Unearned amount to recognize in 2019	0.2												0.2
Unearned amount to recognize, thereafter	0.1												0.1
Capitalized costs to obtain a contract	282,000				117,000								$ 282,000	117,000		117,000
Product delivery period to customer													One year or less.
Medical Device Excise tax included in the cost of revenue															491,000
Advertising expense													$ 811,000	990,000	955,000
Goodwill and long-lived asset impairment														6,693,000
Impairment charges on long-lived and other assets														1,000,000
Fourth Loan Modification Agreement [Member] | Silicon Valley Bank [Member] | Scenario Forecast [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Minimum consolidated revenues									$ 14,500,000	$ 13,000,000	$ 11,600,000	$ 11,400,000
Minimum adjusted EBITDA levels									$ 2,000,000	$ 4,000,000	$ 4,000,000	$ 3,500,000
Revenue from Contract with Customer [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Allowance for doubtful accounts, receivable	6,300,000												6,300,000			8,500,000
Accounting Standards Update 2014-09 [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Increase to retained earnings	(282,000)												(282,000)			(201,973,000)
Accounting Standards Update 2014-09 [Member] | Difference between Revenue Guidance in Effect Before and After Topic 606 [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Increase to retained earnings	(211,056,000)												(211,056,000)			$ 108,000
Revenues													116,000
Amounts associated with service contracts accounted for under Topic 840	287,000												287,000
Therapy [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Goodwill																	$ 5,735,000
Goodwill impairment loss														5,735,000	13,981,000
Impairment charges on long lived assets						$ 700,000
Amortization expense related to intangible assets													129,000	222,000	$ 252,000
Therapy [Member] | ASU 2017-04 [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Fair value of goodwill	100,000				3,500,000								100,000	3,500,000
Goodwill	2,100,000				7,500,000								2,100,000	$ 7,500,000
Goodwill impairment loss	1,700,000				$ 4,000,000
Level 3 [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Fair value on nonrecurring basis	$ 0												$ 0
Minimum [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Estimated useful lives of Long-lived assets													5 years
Maximum [Member]
Basis Of Presentation And Significant Accounting Policies [Line Items]
Estimated useful lives of Long-lived assets													15 years

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Schedule of Allowance for Doubtful Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Receivables [Abstract]
Balance at beginning of period	$ 107	$ 172	$ 236
Additions charged to costs and expenses	225	45	177
Reductions	(155)	(110)	(241)
Balance at end of period	$ 177	$ 107	$ 172

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Schedule of Current Inventory (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Inventory Disclosure [Abstract]
Raw materials	$ 606	$ 992
Work in process	67	63
Finished Goods	914	1,068
Inventory	$ 1,587	$ 2,123

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Schedule of Property and Equipment Estimated Useful Lives (Detail)	12 Months Ended
	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Property and equipment, Estimated life	3 years
Minimum [Member] | Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, Estimated life	3 years
Minimum [Member] | Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, Estimated life	3 years
Minimum [Member] | Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, Estimated life	3 years
Minimum [Member] | Marketing Assets [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, Estimated life	3 years
Maximum [Member] | Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, Estimated life	5 years
Maximum [Member] | Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, Estimated life	5 years
Maximum [Member] | Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, Estimated life	5 years
Maximum [Member] | Marketing Assets [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, Estimated life	5 years

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Roll Forward of Goodwill Activity by Reportable Segment (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Goodwill [Line Items]
Impairment	$ 0	$ (5,735)	$ (13,981)
Accumulated Goodwill	49,171		47,937
Accumulated impairment	(40,809)		(26,828)
Goodwill Balance	8,362	8,362
Acquisition measurement period adjustments			116
Sale of MRI assets			(394)
Goodwill Balance	8,362		14,097
DermEbx and Radion [Member]
Goodwill [Line Items]
Acquisition cost			6,154
VuComp M-Vu Breast Density Product [Member]
Goodwill [Line Items]
Acquisition cost			1,093
Detection [Member]
Goodwill [Line Items]
Impairment	0
Accumulated Goodwill	699
Fair value allocation	7,663
Goodwill Balance	8,362	8,362
Fair value allocation			7,663
Sale of MRI assets			(394)
Goodwill Balance	8,362		8,362
Detection [Member] | VuComp M-Vu Breast Density Product [Member]
Goodwill [Line Items]
Acquisition cost			1,093
Therapy [Member]
Goodwill [Line Items]
Impairment		$ (5,735)	(13,981)
Accumulated Goodwill	6,270
Fair value allocation	13,446
Accumulated impairment	$ (19,716)
Fair value allocation			13,446
Acquisition measurement period adjustments			116
Goodwill Balance			5,735
Therapy [Member] | DermEbx and Radion [Member]
Goodwill [Line Items]
Acquisition cost			$ 6,154

Summary of Significant Accoun_9

Summary of Significant Accounting Policies - Schedule of Intangible Assets (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Gross Carrying Amount
Gross Carrying Amount	$ 9,359	$ 9,364
Accumulated Amortization
Accumulated Amortization	7,809	7,433
Total amortizable intangible assets, net	1,550	1,931
Patent and Licenses [Member]
Gross Carrying Amount
Gross Carrying Amount	$ 571	556
Weighted average useful life	5 years
Accumulated Amortization
Accumulated Amortization	$ 511	503
Technology [Member]
Gross Carrying Amount
Gross Carrying Amount	$ 8,257	8,257
Weighted average useful life	10 years
Accumulated Amortization
Accumulated Amortization	$ 6,958	6,610
Customer Relationships [Member]
Gross Carrying Amount
Gross Carrying Amount	$ 272	292
Weighted average useful life	7 years
Accumulated Amortization
Accumulated Amortization	$ 81	61
Tradename [Member]
Gross Carrying Amount
Gross Carrying Amount	$ 259	259
Weighted average useful life	10 years
Accumulated Amortization
Accumulated Amortization	$ 259	$ 259

Summary of Significant Accou_10

Summary of Significant Accounting Policies - Schedule of Expected Amortization Expense (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Accounting Policies [Abstract]
2019	$ 422
2020	304
2021	226
2022	297
2023	100
Thereafter	201
Total amortizable intangible assets, net	$ 1,550	$ 1,931

Summary of Significant Accou_11

Summary of Significant Accounting Policies - Summary of Cumulative Effect of The Changes (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Jan. 01, 2018	Dec. 31, 2017
Assets
Prepaid expenses and other current assets	$ 1,045		$ 1,100
Liabilities
Deferred revenue	5,165		5,404
Contract liabilities	5,209		5,910
Stockholders' equity
Accumulated deficit	(210,774)		$ (201,865)
Accounting Standards Update 2014-09 [Member]
Assets
Prepaid expenses and other current assets	(282)	$ 1,247
Liabilities
Deferred revenue		408
Contract liabilities		5,541
Stockholders' equity
Accumulated deficit	(282)	(201,973)
Accounting Standards Update 2014-09 [Member] | Difference between Revenue Guidance in Effect Before and After Topic 606 [Member]
Assets
Prepaid expenses and other current assets	763	147
Liabilities
Deferred revenue		408
Contract liabilities	5,209	(369)
Stockholders' equity
Accumulated deficit	$ (211,056)	$ 108

Summary of Significant Accou_12

Summary of Significant Accounting Policies - Summary of Impact of The Adoption On Our Consolidated Balance Sheet and Statement of Operations (Detail) - USD ($)	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Jan. 01, 2018
Assets
Prepaid expenses and other current assets	$ 1,045,000				$ 1,100,000				$ 1,045,000	$ 1,100,000
Liabilities
Accrued expenses	5,060,000				4,475,000				5,060,000	4,475,000
Deferred revenue	287,000				369,000				287,000	369,000
Contract liabilities	5,209,000				5,910,000				5,209,000	5,910,000
Deferred tax	3,000				14,000				3,000	14,000
Stockholders' equity
Accumulated deficit	(210,774,000)				(201,865,000)				(210,774,000)	(201,865,000)
Revenue	6,954,000	$ 6,192,000	$ 6,162,000	$ 6,313,000	7,902,000	$ 7,000,000	$ 6,409,000	$ 6,791,000	25,621,000	28,102,000	$ 26,338,000
Cost of revenue
Cost of revenue									6,191,000	9,926,000	7,820,000
Operating expenses
Marketing and sales									8,693,000	10,503,000	10,179,000
Interest expense									(504,000)	(124,000)	(63,000)
Tax benefit (expense)									42,000	(18,000)	76,000
Net loss	(3,344,000)	$ (1,365,000)	$ (1,027,000)	$ (3,281,000)	$ (4,235,000)	$ (6,933,000)	$ (2,631,000)	$ (457,000)	(9,017,000)	(14,256,000)	(10,099,000)
Product [Member]
Stockholders' equity
Revenue									13,111,000	13,554,000	10,471,000
Cost of revenue
Cost of revenue									2,161,000	2,660,000	918,000
Service [Member]
Stockholders' equity
Revenue									12,510,000	14,548,000	15,867,000
Cost of revenue
Cost of revenue									3,627,000	$ 6,229,000	$ 5,713,000
Accounting Standards Update 2014-09 [Member]
Assets
Prepaid expenses and other current assets	(282,000)								(282,000)			$ 1,247,000
Liabilities
Contract liabilities												5,541,000
Deferred tax	(1,000)								(1,000)
Stockholders' equity
Accumulated deficit	(282,000)								(282,000)			(201,973,000)
Operating expenses
Marketing and sales									(282,000)
Net loss									(398,000)
Accounting Standards Update 2014-09 [Member] | Product [Member]
Stockholders' equity
Revenue									167,000
Accounting Standards Update 2014-09 [Member] | Service [Member]
Stockholders' equity
Revenue									(51,000)
Accounting Standards Update 2014-09 [Member] | Difference between Revenue Guidance in Effect Before and After Topic 606 [Member]
Assets
Prepaid expenses and other current assets	763,000								763,000			147,000
Liabilities
Accrued expenses	5,060,000								5,060,000
Deferred revenue	287,000								287,000
Contract liabilities	5,209,000								5,209,000			(369,000)
Deferred tax	2,000								2,000
Stockholders' equity
Accumulated deficit	$ (211,056,000)								(211,056,000)			$ 108,000
Revenue									116,000
Operating expenses
Marketing and sales									8,975,000
Interest expense									(504,000)
Tax benefit (expense)									42,000
Net loss									(9,415,000)
Accounting Standards Update 2014-09 [Member] | Difference between Revenue Guidance in Effect Before and After Topic 606 [Member] | Product [Member]
Stockholders' equity
Revenue									12,944,000
Cost of revenue
Cost of revenue									2,161,000
Accounting Standards Update 2014-09 [Member] | Difference between Revenue Guidance in Effect Before and After Topic 606 [Member] | Service [Member]
Stockholders' equity
Revenue									12,561,000
Cost of revenue
Cost of revenue									$ 3,627,000

Summary of Significant Accou_13

Summary of Significant Accounting Policies - Revenues Disaggregated by Major Good or Service Line, Timing of Revenue Recognition, and Sales Channel, Reconciled to Our Reportable Segments (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	$ 25,080	$ 27,517
Revenue from lease components	541	585
Total Revenue	25,621	28,102
Products [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	15,176	16,413
Service Contracts [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	6,761	7,169
Supply and Source Usage Agreements [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	2,261	1,956
Professional Services [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	264	254
Other [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	618	1,725
Goods Transferred at a Point in Time [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	15,511	16,814
Services Transferred over Time [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	9,569	10,703
Direct Sales Force [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	15,889	16,141
OEM Partners [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	7,988	9,938
Channel Partners [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	1,203	1,438
Detection [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	16,323	17,725
Revenue from lease components	541	585
Total Revenue	16,864	18,310
Detection [Member] | Products [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	10,783	11,650
Detection [Member] | Service Contracts [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	5,311	5,687
Detection [Member] | Other [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	229	388
Detection [Member] | Goods Transferred at a Point in Time [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	10,835	11,684
Detection [Member] | Services Transferred over Time [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	5,488	6,041
Detection [Member] | Direct Sales Force [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	8,335	7,787
Detection [Member] | OEM Partners [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	7,988	9,938
Therapy [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	8,757	9,792
Total Revenue	8,757	9,792
Therapy [Member] | Products [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	4,393	4,763
Therapy [Member] | Service Contracts [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	1,450	1,482
Therapy [Member] | Supply and Source Usage Agreements [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	2,261	1,956
Therapy [Member] | Professional Services [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	264	254
Therapy [Member] | Other [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	389	1,337
Therapy [Member] | Goods Transferred at a Point in Time [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	4,676	5,266
Therapy [Member] | Services Transferred over Time [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	4,081	4,526
Therapy [Member] | Direct Sales Force [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	7,554	8,354
Therapy [Member] | Channel Partners [Member]
Disaggregation of Revenue [Line Items]
Revenue from contracts with customers	$ 1,203	$ 1,438

Summary of Significant Accou_14

Summary of Significant Accounting Policies - Summary of Receivables, Contract Assets and Contract Liabilities from Contracts with Customers (Detail) - USD ($)	Dec. 31, 2018	Jan. 01, 2018	Dec. 31, 2017
Contract with Customer, Asset and Liability [Abstract]
Receivables, which are included in 'Trade accounts receivable'	$ 6,252,000
Contract assets, which are included in "Prepaid and other current assets"	19,000	$ 166,000
Contract liabilities, which are included in "Deferred revenue"	$ 5,209,000		$ 5,541,000

Summary of Significant Accou_15

Summary of Significant Accounting Policies - Summary of Deferred Revenue (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Deferred Revenue Arrangement [Line Items]
Contract liabilities	$ 5,209	$ 5,541
Lease revenue	287	369
Total	5,496	5,910
Short-term Contract with Customer [Member]
Deferred Revenue Arrangement [Line Items]
Contract liabilities	4,885	5,044
Lease revenue	280	360
Total	5,165	5,404
Long-term Contract with Customer [Member]
Deferred Revenue Arrangement [Line Items]
Contract liabilities	324	497
Lease revenue	7	9
Total	$ 331	$ 506

Summary of Significant Accou_16

Summary of Significant Accounting Policies - Summary of Changes in Deferred Revenue from Contracts with Customers (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2018USD ($)
Deferred Revenue Disclosure [Abstract]
Balance at beginning of period	$ 5,541
Adoption adjustment	39
Deferral of revenue	9,993
Recognition of deferred revenue	(10,364)
Balance at end of period	$ 5,209

Summary of Significant Accou_17

Summary of Significant Accounting Policies - Schedule of Changes of Capitalized Costs to Obtain Contract (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2018USD ($)
Capitalized Contract Cost, Net [Abstract]
Balance at beginning of period	$ 117
Deferral of costs to obtain a contract	368
Recognition of costs to obtain a contract	(203)
Balance at end of period	$ 282

Summary of Significant Accou_18

Summary of Significant Accounting Policies - Roll Forward of Warranty Cost (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Beginning accrual balance	$ 10	$ 11	$ 19
Warranty provision	19	49	47
Usage	(17)	(50)	(55)
Ending accrual balance	$ 12	$ 10	$ 11

Summary of Significant Accou_19

Summary of Significant Accounting Policies - Calculation of Net Loss Per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Earnings Per Share, Diluted, by Common Class, Including Two Class Method [Line Items]
Net loss available to common shareholders	$ (3,344)	$ (1,365)	$ (1,027)	$ (3,281)	$ (4,235)	$ (6,933)	$ (2,631)	$ (457)	$ (9,017)	$ (14,256)	$ (10,099)
Basic shares used in the calculation of earnings per share									16,685	16,343	15,932
Effect of dilutive securities:
Diluted shares used in the calculation of earnings per share									16,685	16,343	15,932
Basic									$ (0.54)	$ (0.87)	$ (0.63)
Diluted									$ (0.54)	$ (0.87)	$ (0.63)
Stock Options [Member]
Effect of dilutive securities:
Restricted stock									0	0	0
Restricted Stock [Member]
Effect of dilutive securities:
Restricted stock									0	0	0

Summary of Significant Accou_20

Summary of Significant Accounting Policies - Schedule of Anti-dilutive Shares Excluded from Computation of Diluted Net Loss Per Share (Detail) - shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common stock options, warrants and restricted stock	4,149,179	1,880,262	1,936,746
Stock Options [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common stock options, warrants and restricted stock	1,983,477	1,465,115	1,425,348
Restricted Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common stock options, warrants and restricted stock	423,202	415,147	511,398
Convertible Debentures [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common stock options, warrants and restricted stock	1,742,500

Summary of Significant Accou_21

Summary of Significant Accounting Policies - Assets and Liabilities which are Measured at Fair Value on a Recurring Basis (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Level 3 [Member] | Convertible Debentures [Member]
Liabilities
Total Liabilities	$ 6,970
Fair Value, Measurements, Recurring [Member]
Assets
Total Assets	12,134	$ 8,853
Liabilities
Total Liabilities	6,970
Fair Value, Measurements, Recurring [Member] | Convertible Debentures [Member]
Liabilities
Total Liabilities	6,970
Fair Value, Measurements, Recurring [Member] | Money Market Accounts [Member]
Assets
Total Assets	12,134	8,853
Fair Value, Measurements, Recurring [Member] | Level 1 [Member]
Assets
Total Assets	12,134	8,853
Fair Value, Measurements, Recurring [Member] | Level 1 [Member] | Money Market Accounts [Member]
Assets
Total Assets	12,134	$ 8,853
Fair Value, Measurements, Recurring [Member] | Level 3 [Member]
Liabilities
Total Liabilities	6,970
Fair Value, Measurements, Recurring [Member] | Level 3 [Member] | Convertible Debentures [Member]
Liabilities
Total Liabilities	$ 6,970

Summary of Significant Accou_22

Summary of Significant Accounting Policies - Level 3 Instruments (Detail) - Level 3 [Member] - Convertible Debentures [Member] $ in Thousands	12 Months Ended
	Dec. 31, 2018USD ($)
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Beginning Balance	$ 6,970
Issuances	6,970
Fair value adjustments	0
Ending Balance	$ 6,970

Acquisitions - Acquisition of V

Acquisitions - Acquisition of VuComp Cancer Detection Portfolio - Additional Information (Detail) - USD ($)	3 Months Ended	12 Months Ended
	Mar. 31, 2016	Dec. 31, 2018	Dec. 31, 2017	Jan. 13, 2016	Dec. 31, 2015
Business Acquisition [Line Items]
Goodwill		$ 8,362,000	$ 8,362,000		$ 14,097,000
MVu Breast Density [Member]
Business Acquisition [Line Items]
Gain on litigation settlement	$ 249,000
VuComp Cancer Detection Portfolio [Member]
Business Acquisition [Line Items]
Goodwill		$ 293,000		$ 293,000
Goodwill amortization expense useful life		15 years

Acquisitions - Allocation of Pu

Acquisitions - Allocation of Purchase Price Based on Estimated Fair Values of Assets Acquired and liabilities Assumed (Detail) - USD ($)	Jan. 13, 2016	Apr. 29, 2015	Dec. 31, 2018	Dec. 31, 2016	Dec. 31, 2017	Dec. 31, 2015
Business Acquisition [Line Items]
Cash				$ 6,000
Goodwill			$ 8,362,000		$ 8,362,000	$ 14,097,000
Equipment expected life			3 years
Minimum [Member]
Business Acquisition [Line Items]
Estimated amortizable life			5 years
Maximum [Member]
Business Acquisition [Line Items]
Estimated amortizable life			15 years
MVu Breast Density [Member]
Business Acquisition [Line Items]
Cash	$ 6,000
Acquisition litigation settlement	249,000
Purchase price	255,000
VuComp Cancer Detection Portfolio [Member]
Business Acquisition [Line Items]
Current assets	84,000
Property and equipment	65,000
Identifiable intangible assets	699,000
Goodwill	293,000		$ 293,000
Current liabilities	(280,000)
Long-term liabilities	(606,000)
Purchase price	$ 255,000
Equipment expected life	3 years
VuComp Cancer Detection Portfolio [Member] | Minimum [Member]
Business Acquisition [Line Items]
Estimated amortizable life	1 year
VuComp Cancer Detection Portfolio [Member] | Maximum [Member]
Business Acquisition [Line Items]
Estimated amortizable life	10 years
VuComp M-Vu Breast Density Product [Member]
Business Acquisition [Line Items]
Cash		$ 1,700,000
Developed Technology		900,000
Goodwill		800,000
Purchase price		$ 1,700,000
Estimated amortizable life		8 years 9 months

Acquisitions - Acquisition of_2

Acquisitions - Acquisition of VuComp M-Vu Breast Density Product - Additional Information (Detail) - USD ($)	Apr. 29, 2015	Dec. 31, 2016
Business Acquisition [Line Items]
Business acquisition paid in cash		$ 6,000
VuComp M-Vu Breast Density Product [Member]
Business Acquisition [Line Items]
Business acquisition paid in cash	$ 1,700,000
Estimated amortizable life	8 years 9 months

Sale of MRI Assets - Additional

Sale of MRI Assets - Additional Information (Detail) - USD ($)	Jan. 30, 2017	Dec. 31, 2018	Dec. 31, 2016
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Holdback reserve related to sale and transfer of intangible assets		$ 350,000
VersaVue Software and DynaCAD Product and Related Assets [Member] | Asset Purchase Agreement [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Sale and transfer of intangible assets			$ 3,200,000
Holdback reserve related to sale and transfer of intangible assets	$ 350,000
Allocation of goodwill to asset held for sale		$ 394,000
Gain on sale and transfer of intangible assets	2,508,000
Proceeds from sale and transfer of intangible assets	$ 2,900,000

Sale of MRI Assets - Schedule o

Sale of MRI Assets - Schedule of Net Assets Sold (Detail) - Disposal Group, Held-for-sale, Not Discontinued Operations [Member] - VersaVue Software and DynaCAD Product and Related Assets [Member] $ in Thousands	12 Months Ended
	Dec. 31, 2018USD ($)
Assets
Accounts Receivable	$ 116
Intangible assets	810
Allocated Goodwill	394
Total Assets	1,320
Liabilities
Deferred Revenue	746
Total Liabilities	746
Net Assets Sold	$ 574

Sale of MRI Assets - Schedule_2

Sale of MRI Assets - Schedule of Components of Gain on Sale (Detail) - USD ($)	Jan. 30, 2017	Dec. 31, 2017	Dec. 31, 2018
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Cash received		$ 2,850,000
Holdback reserve			$ 350,000
Asset Purchase Agreement [Member] | VersaVue Software and DynaCAD Product and Related Assets [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Cash received	$ 2,850,000
Holdback reserve	350,000
Fair value of transition services	(118,000)
Net Assets sold	(574,000)
Total	$ 2,508,000

Financing Arrangements - Additi

Financing Arrangements - Additional Information (Detail)	Dec. 21, 2018	Dec. 31, 2018USD ($)$ / shares	Jul. 30, 2019USD ($)	Dec. 31, 2018USD ($)Trial$ / shares	Dec. 20, 2018USD ($)	Aug. 07, 2017USD ($)
Debt Instrument [Line Items]
Maturity date of revolving loans				Mar. 1, 2022
Description on maturity date of revolving loans and term loans				The maturity date of the Revolving Loans is March 1, 2022. However, the maturity date will become April 30, 2020 or April 30, 2021 if (after the Fourth Loan Modification Agreement, see Note 1(t) Subsequent Events), on or before March 15, 2020 or 2021, as applicable, the Company does not agree in writing to the Detection revenue and adjusted EBITDA covenant levels proposed by the Bank with respect to the upcoming 2020 or 2021 calendar year.
Termination fee percentage				2.00%
Accrued Final Payment				$ 163,000
Line of credit, closing costs		$ 74,000		$ 74,000
Prime Rate [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate		0.50%		0.50%
Minimum [Member]
Debt Instrument [Line Items]
Term loan advances prior to maturity				1.00%
Maximum [Member]
Debt Instrument [Line Items]
Term loan advances prior to maturity				3.00%
Convertible Debt [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate		5.00%		5.00%
Aggregate principal amount					$ 7,000,000
Frequency of periodic payment of interest				Payable semi-annually on December 21st and June 21st, beginning on June 21, 2019
Maturity date				Dec. 21, 2021
Debt conversion, conversion price per share | $ / shares		$ 4		$ 4
Percentage of common stock shares issued and outstanding upon conversion of convertible debentures	19.99%
Debt issuance costs		$ 503,000		$ 503,000
Convertible Debt [Member] | Monte Carlo Simulation [Member]
Debt Instrument [Line Items]
Number of trials to detremine fair value | Trial				100,000
Debt insrument redemption description				The simulation utilizes the assumptions that if the Company is able to exercise its Forced Conversion right (if the requirements to do so are met), that it will do so in 100% of such scenarios. Additionally, if an event of default occurs during the simulated trial (based on the Company’s probability of default), the Investors will opt to redeem the Convertible Debentures in 100% of such scenarios.
Convertible Debt [Member] | Minimum [Member]
Debt Instrument [Line Items]
Percentage of repurchase price				115.00%
Interest rate upon an event of default				10.00%
Convertible Debt [Member] | Directors And Employees [Member]
Debt Instrument [Line Items]
Aggregate principal amount		$ 670,000		$ 670,000
Purchase pecentage of principal value of convertible debentures		10.00%		10.00%
Term Loan A [Member]
Debt Instrument [Line Items]
Credit facility, contingent borrowing capacity		$ 3,000,000		$ 3,000,000
Accrued Final Payment				$ (163,000)
Term loan final payment percentage		8.50%		8.50%		8.00%
Term Loan A [Member] | Silicon Valley Bank [Member]
Debt Instrument [Line Items]
Credit facility						$ 6,000,000
Term Loan A [Member] | Silicon Valley Bank [Member] | Tranche One [Member]
Debt Instrument [Line Items]
Beginning date of repayment				Mar. 1, 2019
Term loan monthly installments				30
Maturity date of revolving loans				Aug. 1, 2021
Term Loan A [Member] | Minimum [Member] | Silicon Valley Bank [Member]
Debt Instrument [Line Items]
Detection revenue		$ 8,750,000
Adjusted EBITDA		$ 1,000,000
Term Loan A [Member] | Maximum [Member]
Debt Instrument [Line Items]
Period to evaluate accounting impact of each modification				12 months
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate		1.50%		1.50%
Percentage of outstanding liabilities to bank				125.00%
Revolving Credit Facility [Member] | Silicon Valley Bank [Member]
Debt Instrument [Line Items]
Credit facility						$ 4,000,000
Scenario Forecast [Member] | Term Loan A [Member] | Minimum [Member] | Silicon Valley Bank [Member]
Debt Instrument [Line Items]
Net revenues			$ 21,500,000

Financing Arrangements - Schedu

Financing Arrangements - Schedule of Carrying Value of Term Loan Net of Debt Issuance Costs (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Shares Issued And Outstanding [Line Items]
Accrued final payment	$ (163)
Less current portion of Term Loan	(1,851)	$ (817)
Notes payable long-term portion	4,254	5,119
Term Loan A [Member]
Shares Issued And Outstanding [Line Items]
Principal Amount of Term Loan	6,000	6,000
Unamortized closing costs	(58)	(64)
Accrued final payment	163
Carrying amount of Term Loan	6,105	5,936
Less current portion of Term Loan	(1,851)	(817)
Notes payable long-term portion	$ 4,254	$ 5,119

Financing Arrangements - Sche_2

Financing Arrangements - Schedule of Key Inputs to Simulation Model Utilized to Estimate Fair Value of Convertible Debentures (Detail) - Convertible Debt [Member]	Dec. 31, 2018yr	Dec. 31, 2017yr
Company's Stock Price [Member]
Debt Instrument [Line Items]
Debt Instrument Measurement Input	3.68	3.70
Conversion Price [Member]
Debt Instrument [Line Items]
Debt Instrument Measurement Input	4	4
Remaining Term (Years) [Member]
Debt Instrument [Line Items]
Debt Instrument Measurement Input	3	2.97
Equity Volatility [Member]
Debt Instrument [Line Items]
Debt Instrument Measurement Input	0.5400	0.5400
Risk Free Rate [Member]
Debt Instrument [Line Items]
Debt Instrument Measurement Input	0.0258	0.0246
Probability of Default Event [Member]
Debt Instrument [Line Items]
Debt Instrument Measurement Input	0.0075	0.0081
Utilization of Forced Conversion [Member]
Debt Instrument [Line Items]
Debt Instrument Measurement Input	1	1
Exercise of Default Redemption [Member]
Debt Instrument [Line Items]
Debt Instrument Measurement Input	1	1
Effective Discount Rate [Member]
Debt Instrument [Line Items]
Debt Instrument Measurement Input	0.2190	0.2190

Financing Arrangements - Sche_3

Financing Arrangements - Schedule of Fair Value and Principal Value of Convertible Debentures (Detail) - USD ($)	Dec. 31, 2018	Dec. 21, 2018
Debt Disclosure [Abstract]
Fair value, in accordance with fair value option	$ 6,970	$ 6,970
Principal value outstanding	$ 6,970	$ 6,970

Finance Arrangements - Summary

Finance Arrangements - Summary of Future Principal and Interest Payments Related to Loan Agreement and Convertible Debentures (Detail) - Term Loan A [Member] $ in Thousands	Dec. 31, 2018USD ($)
Shares Issued And Outstanding [Line Items]
2019	$ 2,624
2020	2,895
2021	9,454
Total	$ 14,972

Finance Arrangements - Interest

Finance Arrangements - Interest Expense in Consolidated Income Statement (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Interest Expense [Line Items]
Amortization of debt costs	$ 29	$ 9
Accrual of notes payable final payment	163
Amortization of settlement obligations		26	$ 82
Interest expense capital lease	4	1	70
Capital lease - fair value amortization		(10)	(89)
Total interest expense	504	124	$ 63
Term Loan A [Member]
Interest Expense [Line Items]
Cash interest expense	299	$ 98
Accrual of notes payable final payment	(163)
Convertible Debt [Member]
Interest Expense [Line Items]
Cash interest expense	$ 9

Accrued Expenses - Accrued Expe

Accrued Expenses - Accrued Expenses (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Payables and Accruals [Abstract]
Accrued salary and related expenses	$ 1,811	$ 1,388
Accrued accounts payable	2,329	2,523
Accrued professional fees	737	418
Other accrued expenses	91	70
Deferred rent	92	76
Accrued Expenses Total	$ 5,060	$ 4,475

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2018USD ($)Incentive_Planshares	Dec. 31, 2017shares	Dec. 31, 2016shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of stock option | Incentive_Plan	6
Total unrecognized compensation costs | $	$ 1,800,000
Period of expected recognized over a weighted average	1 year
Dividends paid on common stock | $	$ 0
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Period of options granted	1 year
Number of restricted stock granted	379,439	394,599	345,778
Performance Based Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of restricted stock granted	189,583	162,500
Performance Based Restricted Stock [Member] | Vesting Period One [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares expected to vest	63,194
Performance Based Restricted Stock [Member] | Vesting Period Two [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares expected to vest	63,194
Performance Based Restricted Stock [Member] | Vesting Period Three [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares expected to vest	63,194
Time Based Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of restricted stock granted	144,500
Time Based Restricted Stock [Member] | Vesting Period One [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares expected to vest	45,356
Maximum [Member] | Performance Based Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of additional shares available for granted	108,333
2002 Stock Option Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate purchase of Company's common stock	100,000
Percentage of stockholders exercise price	10.00%
Percentage of market Price for calculation of purchase price	110.00%
Percentage of options granted	100.00%
Period of expiration	10 years
Number of percentage of stockholders	10.00%
Period of expiration for specific stockholders	5 years
Period of exercisable stock option granted	10 years
Vesting date of grant, First anniversaries	33.00%
Vesting date of grant, Second anniversaries	33.00%
Vesting date of grant, Third anniversaries	33.00%
Number of share options available for grant	0
2002 Stock Option Plan [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Period of options granted	5 years
2002 Stock Option Plan [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Period of options granted	6 months
2004 Stock Option Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of stockholders exercise price	10.00%
Percentage of market Price for calculation of purchase price	110.00%
Percentage of options granted	100.00%
Period of options granted	5 months
Period of expiration	10 years
Number of percentage of stockholders	10.00%
Period of expiration for specific stockholders	5 months
Period of exercisable stock option granted	10 years
Vesting date of grant, First anniversaries	33.00%
Vesting date of grant, Second anniversaries	33.00%
Vesting date of grant, Third anniversaries	33.00%
Number of share options available for grant	0
Stock Repurchase Program, Number of Shares Authorized to be Repurchased	200,000
2005 Stock Option Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate purchase of Company's common stock	120,000
Percentage of stockholders exercise price	10.00%
Percentage of market Price for calculation of purchase price	110.00%
Percentage of options granted	100.00%
Period of options granted	3 years
Period of expiration	5 years
Number of percentage of stockholders	10.00%
Period of expiration for specific stockholders	5 years
Period of exercisable stock option granted	10 years
Vesting date of grant, First anniversaries	33.00%
Vesting date of grant, Second anniversaries	33.00%
Vesting date of grant, Third anniversaries	33.00%
Number of share options available for grant	0
2007 Stock Option Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate purchase of Company's common stock	1,050,000
Percentage of stockholders exercise price	10.00%
Percentage of market Price for calculation of purchase price	110.00%
Number of share options available for grant	0
Aggregate purchase of Company's common stock, maximum	160,000
Percentage of options granted	100.00%
2012 Stock Option Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate purchase of Company's common stock	1,600,000
Percentage of stockholders exercise price	10.00%
Percentage of market Price for calculation of purchase price	110.00%
Number of share options available for grant	99,215
Aggregate purchase of Company's common stock, maximum	250,000
Percentage of options granted	100.00%
2016 Stock Option Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Aggregate purchase of Company's common stock	2,600,000
Number of share options available for grant	866,504
Aggregate purchase of Company's common stock, maximum	1,000,000
Percentage of options granted	10000.00%
Number of share options available for grant | $	$ 100,000
2016 Stock Option Plan [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of share options available for grant	1,000,000
2016 Stock Option Plan [Member] | Maximum [Member] | Non Employee Directors [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of share options available for grant	120,000

Stockholders' Equity - Summary

Stockholders' Equity - Summary of Sock Option Activity for all Stock Option Plan (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Beginning balance	1,465,115	1,425,348	1,571,998
Granted	888,263	200,813	127,500
Exercised	(139,556)	(36,530)	(75,583)
Forfeited	(230,345)	(124,516)	(198,567)
Ending balance	1,983,477	1,465,115	1,425,348
Weighted Average, Beginning Balance	$ 5.03	$ 5.05	$ 5.05
Granted	2.95	4.14	5.46
Exercised	2.27	2.18	2.62
Forfeited	5.41	4.71	6.19
Weighted Average, Ending Balance	$ 4.25	$ 5.03	$ 5.05
Weighted Average Remaining Contractual Term, Outstanding	4 years 4 months 24 days
Exercisable, Number of Shares	1,296,439	1,301,651	1,054,211
Exercisable, Weighted Average Exercise Price	$ 4.90	$ 4.95	$ 4.71
Weighted Average Remaining Contractual Term, Exercisable	4 years 1 month 6 days

Stockholders' Equity - Stock-Ba

Stockholders' Equity - Stock-Based Compensation Expense Including Options and Restricted Stock by Category (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Allocated share-based compensation expense	$ 1,505	$ 3,656	$ 2,307
Cost of Revenue [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Allocated share-based compensation expense	4	5	6
Engineering and Product Development [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Allocated share-based compensation expense	399	715	329
Marketing and Sales [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Allocated share-based compensation expense	190	1,003	677
General and Administrative Expense [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Allocated share-based compensation expense	$ 912	$ 1,933	$ 1,295

Stockholders' Equity - Options

Stockholders' Equity - Options Granted under Company's Stock Incentive Plans, Valuation Assumptions and Fair Values (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average exercise price	$ 2.95	$ 4.14	$ 5.46
Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Average risk-free interest rate	2.65%	1.61%	0.98%
Expected dividend yield	0.00%	0.00%	0.00%
Expected life	3 years 6 months	3 years 6 months	3 years 6 months
Weighted average exercise price	$ 2.96	$ 4.14	$ 5.46
Weighted average fair value	$ 1.23	$ 1.99	$ 2.66
Stock Options [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility	50.40%	64.20%	68.50%
Stock Options [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility	61.60%	72.00%	75.30%

Stockholders' Equity - Summar_2

Stockholders' Equity - Summary of Intrinsic Values of Options (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock options outstanding	$ 1,021	$ 449	$ 409
Stock options exercisable	499	442	409
Stock options exercised	$ 224	$ 79	$ 201
Stock price	$ 3.70	$ 3.44	$ 3.24

Stockholders' Equity - Summar_3

Stockholders' Equity - Summary of Restricted Stock Activity for All Equity Incentive Plans (Detail) - Restricted Stock [Member] - shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning outstanding balance	415,147	511,398	516,396
Granted	379,439	394,599	345,778
Vested	(322,388)	(469,434)	(289,030)
Forfeited	(48,996)	(21,416)	(61,746)
Ending outstanding balance	423,202	415,147	511,398

Stockholders' Equity - Summar_4

Stockholders' Equity - Summary of Intrinsic Values of Restricted Stock (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Number of stock options outstanding, Beginning of period	$ 1,566	$ 1,428	$ 1,657
Number of stock options outstanding, Vested	$ 1,193	$ 1,615	$ 936
Number of stock options outstanding, Stock price	$ 3.70	$ 3.44	$ 3.24

Income Taxes - Components of In

Income Taxes - Components of Income Tax Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Current provision (benefit):
Federal	$ 0	$ 0	$ 0
State	54	(26)	69
Current provision (benefit), Total	54	(26)	69
Deferred provision:
Federal	(10)	7	6
State	(2)	1	1
Deferred provision, Total	(12)	8	7
Total	$ 42	$ (18)	$ 76

Income Taxes - Summary of Effec

Income Taxes - Summary of Effective and the Federal Statutory Income Tax Rate (Detail)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Schedule Of Income Tax Expense [Line Items]
Federal statutory rate	21.00%	34.00%	34.00%
State income taxes, net of federal benefit	3.60%	1.40%	2.80%
Net state impact of deferred rate change	0.60%	(0.30%)	0.20%
Stock compensation expense	(1.10%)	(1.90%)	(3.20%)
Tax amortization on goodwill	0.10%	(0.10%)	(0.10%)
Goodwill impairment	0.00%	(13.70%)	0.00%
Other permanent differences	(0.50%)	(0.40%)	(0.40%)
Change in valuation allowance	(27.60%)	97.40%	(37.30%)
Tax credits	3.10%	1.50%	3.20%
Federal Rate Change	0.00%	(133.50%)	0.00%
Accrual to TR	0.30%	(0.70%)	0.00%
Effective income tax	(0.50%)	(0.10%)	(0.80%)
Xoft Inc [Member]
Schedule Of Income Tax Expense [Line Items]
Increase Xoft NOLs under 382 Study	0.00%	16.20%	0.00%

Income Taxes - Deferred Tax Ass

Income Taxes - Deferred Tax Assets (Liabilities) (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Inventory (Section 263A)	$ 239	$ 287
Inventory reserves	270	305
Receivable reserves	45	27
Other accruals	88	224
Deferred revenue	85	129
Accumulated depreciation/amortization	138	320
Stock options	1,879	1,901
Developed technology	2,031	2,201
Tax credits	3,364	3,130
NOL carryforward	32,074	31,113
Net deferred tax assets	40,213	39,637
Valuation allowance	(40,213)	(39,637)
Goodwill tax amortization	(3)	(14)
Deferred tax liability	$ (3)	$ (14)

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Schedule Of Income Tax Expense [Line Items]
Federal statutory rate	21.00%	34.00%	34.00%
Goodwill	$ 8,362,000	$ 8,362,000		$ 14,097,000
Maximum percentage of taxable income allowed to offset by net operating loss carryforwads	80.00%
Tax benefit	$ (11,761)
Federal net operating loss carryforwards	134,900,000
Net operating losses utilized	0	0
Unrecognized tax benefits	0	0
Interest or penalties related to uncertain tax positions	$ 0	0	$ 0
Company preceding tax years	3 years
Provision to income tax expense for revalue of deferred tax assets and liabilities	$ 19,100,000
Change in valuation allowance	(19,100,000)
Expire Between 2019 And 2037 [Member]
Schedule Of Income Tax Expense [Line Items]
Federal net operating loss carryforwards	127,700,000
Indefinite Period [Member]
Schedule Of Income Tax Expense [Line Items]
Federal net operating loss carryforwards	$ 7,200,000
Minimum [Member]
Schedule Of Income Tax Expense [Line Items]
Expiring date of net operating loss carryforward	2019
Maximum [Member]
Schedule Of Income Tax Expense [Line Items]
Expiring date of net operating loss carryforward	2037
Asset Acquisition January 2016 [Member]
Schedule Of Income Tax Expense [Line Items]
Goodwill	$ 293,307
Goodwill amortization expense useful life	15 years
Effective income tax rate amortization on goodwill amount		$ 7,434
Xoft Inc [Member]
Schedule Of Income Tax Expense [Line Items]
Federal net operating loss carryforwards	$ 56,700,000
Net operating losses that are subject to limitations	7,900,000
Net operating losses that are subject to limitations that can be used through 2029	656,000
Future Income tax liabilities offset With operation loss carryforward	$ 3,400,000
Tax credit carryforward expiration year	2038

Segment Reporting, Geographic_3

Segment Reporting, Geographical Information and Major Customers - Additional Information (Detail) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018USD ($)	Sep. 30, 2018USD ($)	Jun. 30, 2018USD ($)	Mar. 31, 2018USD ($)	Dec. 31, 2017USD ($)	Sep. 30, 2017USD ($)	Jun. 30, 2017USD ($)	Mar. 31, 2017USD ($)	Dec. 31, 2018USD ($)SegmentCustomer	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)
Schedule Of Geographical Information [Line Items]
Number of reporting segments | Segment									2
Percentage of export sales to any single country									10.00%
Total Export Sales									$ 25,621	$ 28,102
Outstanding receivables	$ 6,252								$ 6,252
Number of major customers | Customer									1
Total Revenue	6,954	$ 6,192	$ 6,162	$ 6,313	$ 7,902	$ 7,000	$ 6,409	$ 6,791	$ 25,621	28,102	$ 26,338
GE Healthcare [Member]
Schedule Of Geographical Information [Line Items]
Outstanding receivables	1,600								1,600
OEM Partners [Member]
Schedule Of Geographical Information [Line Items]
Outstanding receivables	2,500								2,500
Three Customers [Member]
Schedule Of Geographical Information [Line Items]
Outstanding receivables	800								800
Eight Customers [Member]
Schedule Of Geographical Information [Line Items]
Outstanding receivables	3,300								3,300
Detection [Member]
Schedule Of Geographical Information [Line Items]
Total Export Sales									16,864	18,310
Sales [Member] | GE Healthcare [Member]
Schedule Of Geographical Information [Line Items]
Total Revenue									$ 6,100	$ 7,100	$ 3,900
Sales [Member] | Customer Concentration Risk [Member] | GE Healthcare [Member]
Schedule Of Geographical Information [Line Items]
Percentage of receivables									24.00%	25.00%	15.00%
Sales [Member] | Customer Concentration Risk [Member] | Five Customers [Member]
Schedule Of Geographical Information [Line Items]
Percentage of receivables									33.00%	39.00%	30.00%
Sales [Member] | Detection [Member] | Customer Concentration Risk [Member] | Five Customers [Member]
Schedule Of Geographical Information [Line Items]
Percentage of receivables									50.00%	55.00%	47.00%
Accounts Receivable [Member] | Customer Concentration Risk [Member] | GE Healthcare [Member]
Schedule Of Geographical Information [Line Items]
Percentage of receivables									25.00%
Accounts Receivable [Member] | Customer Concentration Risk [Member] | OEM Partners [Member]
Schedule Of Geographical Information [Line Items]
Percentage of receivables									37.00%
Accounts Receivable [Member] | Customer Concentration Risk [Member] | Three Customers [Member]
Schedule Of Geographical Information [Line Items]
Percentage of receivables									12.00%
Accounts Receivable [Member] | Customer Concentration Risk [Member] | Eight Customers [Member]
Schedule Of Geographical Information [Line Items]
Percentage of receivables									50.00%
Non-US [Member]
Schedule Of Geographical Information [Line Items]
Percentage of export sales of total sale									12.00%	14.00%	9.00%
Total Export Sales									$ 3,200	$ 3,900	$ 2,300
Outstanding receivables	$ 1,100				$ 2,100				$ 1,100	$ 2,100

Segment Reporting, Geographic_4

Segment Reporting, Geographical Information and Major Customers - Summary of Segment Revenues, Gross Profit, Segment Operating Income or Loss and Reconciliation of Segment Operating Income or Loss to GAAP Loss (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Segment revenues:
Total Revenue	$ 6,954	$ 6,192	$ 6,162	$ 6,313	$ 7,902	$ 7,000	$ 6,409	$ 6,791	$ 25,621	$ 28,102	$ 26,338
Segment gross profit:
Segment gross profit	$ 5,410	$ 4,738	$ 4,784	$ 4,498	$ 4,341	$ 4,643	$ 4,503	$ 4,689	19,430	18,176	18,518
Segment operating income (loss):
Segment operating income (loss)									1,039	(8,701)	(2,058)
General, administrative, depreciation and amortization expense									(9,169)	(7,975)	(7,912)
Interest expense									(504)	(124)	(63)
Financing costs									(451)
Gain on sale of MRI assets										2,508
Other income									110	18	10
Loss on debt extinguishment									0	0	0
Loss before income tax									(8,975)	(14,274)	(10,023)
Product [Member]
Segment revenues:
Total Revenue									13,111	13,554	10,471
Service [Member]
Segment revenues:
Total Revenue									12,510	14,548	15,867
Detection [Member]
Segment gross profit:
Segment gross profit									14,709	16,218	15,113
Segment operating income (loss):
Segment operating income (loss)									3,412	6,401	5,694
Detection [Member] | Product [Member]
Segment revenues:
Total Revenue									16,864	18,310	17,133
Therapy [Member]
Segment gross profit:
Segment gross profit									4,721	1,958	3,405
Segment operating income (loss):
Segment operating income (loss)									(2,373)	(15,102)	(7,752)
Therapy [Member] | Service [Member]
Segment revenues:
Total Revenue									$ 8,757	$ 9,792	$ 9,205

Segment Reporting, Geographic_5

Segment Reporting, Geographical Information and Major Customers - Summary of Segment Depreciation and Amortization Included in Segment Operating Income (Loss) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenues from External Customers and Long-Lived Assets [Line Items]
Depreciation	$ 325	$ 995	$ 1,322
Amortization	383	494	983
Detection [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Depreciation	106	172	223
Amortization	248	246	696
Therapy [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Depreciation	177	768	970
Amortization	$ 129	$ 222	$ 252

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail)	Dec. 27, 2018USD ($)	Nov. 08, 2018USD ($)	Jul. 31, 2017USD ($)	Feb. 28, 2010USD ($)	Dec. 31, 2018USD ($)Lease	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)	Aug. 31, 2017USD ($)	Jan. 30, 2017USD ($)
Schedule Of Leases [Line Items]
Lease obligations | Lease					3
Annual base rent					$ 30,000			$ 50,000
Operating lease, annual rent, current					781,000
Operating lease, annual rent					964,000
Operating lease, annual rent, second year					183,000
Rent expense					896,000	$ 899,000	$ 745,000
Liability recorded on capital leases					$ 26,000			$ 42,000
Equipment expected life					3 years
Purchase obligations to suppliers for future product deliverables					$ 2,000,000
Employer matching Contribution					500,000
Employer matching Contribution to be paid in next fiscal year					500,000
Minimum annual royalty payment					250,000
Fair value of patent license					$ 100,000
Patent license, Estimated Amortizable Life					4 years
Minimum royalty obligations					$ 400,000
Amount of indemnification obligation					350,000
Holdback reserve related to sale and transfer of intangible assets					$ 350,000
Chief Executive Officer [Member]
Schedule Of Leases [Line Items]
Accrued separation benefis		$ 1,009,000
Separation benefits severance period		24 months
Separation benefits health benefits period		18 months
Separation benefits payable beginning date		2019-05
Chief Financial Officer [Member]
Schedule Of Leases [Line Items]
Defined Benefit Plan, Benefit Obligation, Special and Contractual Termination Benefits	$ 0
VersaVue Software and DynaCAD Product and Related Assets [Member] | Asset Purchase Agreement [Member]
Schedule Of Leases [Line Items]
Sale and transfer of intangible assets							$ 3,200,000
Holdback reserve related to sale and transfer of intangible assets									$ 350,000
Proceeds from sale and transfer of intangible assets									$ 2,900,000
Nashua [Member]
Schedule Of Leases [Line Items]
Term of lease					5 years
Annual base rent					$ 184,518
San Jose California [Member]
Schedule Of Leases [Line Items]
Operating lease, annual rent, current					295,140
Operating lease, annual rent					540,588
Operating lease, annual rent, second year					558,120
Operating lease, annual rent, third year					$ 286,368
CADx Medical Systems Inc [Member]
Schedule Of Leases [Line Items]
Tax re-assessment received			$ 6,800,000
Reduced tax re-assessment received				$ 703,000

Commitments and Contingencies_2

Commitments and Contingencies - Future Minimum Rental Payments (Detail) $ in Thousands	Dec. 31, 2018USD ($)
Leases [Abstract]
2019	$ 781
2020	183
Total	$ 964

Commitments and Contingencies_3

Commitments and Contingencies - Schedule of Future Minimum Lease Payments under Capital Leases (Detail) - USD ($)	Dec. 31, 2018	Dec. 31, 2017	Aug. 31, 2017
Leases [Abstract]
2019	$ 17,000
2020	13,000
subtotal minimum lease obligation	30,000		$ 50,000
less interest	(4,000)
Total, net	26,000		42,000
Total, net	26,000		$ 42,000
less current portion	11,000
long term portion	$ 11,000	$ 27,000

Quarterly Financial Data - Quar

Quarterly Financial Data - Quarterly Financial Data (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Quarterly Financial Information Disclosure [Abstract]
Net sales	$ 6,954	$ 6,192	$ 6,162	$ 6,313	$ 7,902	$ 7,000	$ 6,409	$ 6,791	$ 25,621	$ 28,102	$ 26,338
Gross profit	5,410	4,738	4,784	4,498	4,341	4,643	4,503	4,689	19,430	18,176	18,518
Net loss	$ (3,344)	$ (1,365)	$ (1,027)	$ (3,281)	$ (4,235)	$ (6,933)	$ (2,631)	$ (457)	$ (9,017)	$ (14,256)	$ (10,099)
Income (loss) per share	$ (0.20)	$ (0.08)	$ (0.06)	$ (0.20)	$ (0.26)	$ (0.42)	$ (0.16)	$ (0.03)
Weighted average number of shares outstanding	16,774	16,700	16,664	16,583	16,501	16,424	16,310	16,135