Joe Biden might have snubbed our leaders in favour of dealing with a wee $US31 trillion debt issue at home, but lung imaging house 4D Medical (ASX:4DX) still has 420 billion reasons to call POTUS a buddy.

That’s because Congress has allocated a stupendous $US280 billion ($420 billion) to deal with the ‘new Agent Orange’ – the scandalous legacy of burn pits used by the US military in Afghanistan and Iraq.

Supersized versions of Dad’s belching 1970s backyard incinerator, these cavities would combust anything from computers to uniforms to medical and human waste.

Allocated over 10 years, the spending is classed as mandatory and can’t be part of debt ceiling cost-cutting negotiations.

A key proponent of the relief measure, Biden believes the toxic emissions from burn pits might have contributed to the glioblastoma that killed his serving son Beau.

The burn pits were used because burning disc drives and uniforms in situ was cheaper than shipping them home and was better than leaving them for the local insurgents.

“About 3.5 million US soldiers have been exposed to burn pits and it has damaged the lungs of hundreds of thousands of them, giving them a mystery disease that doesn’t show up in CT (computer tomography) scans, x-rays or pulmonary function tests,” says 4D chief Andreas Fouras.

(The disease has been dubbed post deployment respiratory syndrome.)

The burn pit package stipulates the use of “four-dimensional models of lung function”. As it happens, 4D Medical is the world’s only dedicated provider of 4D lung imaging, via its algorithm-based lung ventilation analysis software.

Fouras says that detecting the fine particles in the lung currently requires a surgical biopsy: cutting through the ribs and extracting a sample in three places.

The pain factor and the three-day hospital stay aside, the tests cost $US15,000 a pop.

4D this month carried out its first commercial veterans scan, at the Harry S Truman Memorial Veterans Hospital in Colombia, Missouri.

The company hopes to sign up more of the 170 veteran care facilities, which collectively are bigger than the entire Australian hospital system.

Advised by former Department of Veterans Affairs secretary Dr David Shulkin, 4D reps have been talking to key congressmen and veterans’ advocates, in view of an ‘all-in-one’ deal.

As a rule of thumb, Fouras says, diagnostics account for about 4 per cent of healthcare: “On that sum 4D still has an addressable market of $US11 billion over 10 years, just in the burn pit money.”

4D is also angling for US insurance reimbursement of about $US200 per test, which would open up a broader market for screening the broader populace.

The US respiratory diagnostic market is estimated at $US13.7 billion per year, with 74 million tests carried out.

Coincidentally, ASX peer Cyclopharm (ASX:CYC) has been waiting for three decades for the US Food and Drug Administration to approve its nuclear imaging agent Technegas for pulmonary embolism detection.

Already used in 64 countries including Australia and Canada, Technegas promises safer and more thorough treatment in any part of the lung the oxygen (and the gas) reaches.

The FDA must provide an answer by September 29 this year.

The dividend paying Cyclopharm is worth around $200 million.

4D Medical is valued at $240 million, pending completion of a $35 million placement and share purchase plan. The company expects to be profitable in the next two to three years, so it’s still a slow, er, burn.

Both companies hope to emulate the $6 billion home-grown Pro Medicus (ASX:PME), the imager of choice for a slew of sandstone US academic hospitals.

This column does not constitute financial product advice. You should consider obtaining independent advice before making any financial decisions.