"For the last couple of years I had it in my mind to sell if PME...

"For the last couple of years I had it in my mind to sell if PME got to $50 but now we are here I am now on the fence as to whether I should sell or continue to hold."

I share your dilemma.
It’s a dilemma that others would be glad to have, but nonetheless, it is still a dilemma.
I also bought PME shares in the 75 to 80 cent range, however, I have only sold a few, and then only recently.
The shares that I still have are very definitely a free carry, but they so dominate my portfolio that they pose a substantial risk to it.
However, whenever I have sold any PME, it has felt like I was selling the family silver.

For a long time, I was saying that Alphabet or some other acquirer could have my shares for $50, but I raised that threshold this year.
It would solve our dilemma if PME were to be acquired because it would take the decision out of our hands and we could go away satisfied that we got top price.
However, given that the two founders still own more than 50% of the company, any sale is entirely in their hands.
Presumably at some stage, one or other or both will want to exit.

I have a shy hope that PME might have gained sufficient foothold and have enough technological lead that they can go one to become the Microsoft of medical image handling and image AI.
So dominant that everybody curses PME, but equally, cannot do their job without PME’s product.
I suspect that maybe the founders share this ambition, and will try to take it as far as they can before age wearies them.

With respect to contracts, Goldman Sachs fret that PME is running out of growth runway and that maybe PME can only sell their product to the teaching institutions.
However, I take some comfort from the following remark in the Vermont contract announcement, which was prefaced by a comment about the unprecedented number of contracts already won this financial year.

“Our pipeline continues to grow.
Visage 7 with its proven cloud-native capability provides us with a significant strategic advantage that enables us to address these opportunities across a growing segment of the market both in North America and other regions.”

It is good to hear that the pipeline still bulges like Popeye's biceps, even after so many contracts have been won in this financial year.

Cheers