SCHEDULE 13D/A 0000950103-11-002489 0001032011 XXXXXXXX LIVE 5 Common Stock, no par value 09/29/2025 false 0000744825 029595105 AMERICAN SHARED HOSPITAL SERVICES

601 MONTGOMERY STREET SUITE 850 SAN FRANCISCO CA 94111

John F. Ruffle (973) 769-1232 603 Mountain Avenue Apartment 231 New Providence NJ 07974 Joseph R. DeHondt (248) 203-0700 Dykema Gossett PLLC 39577 Woodward Avenue Suite 300 Bloomfield Hills MI 48304 0001032011 N RUFFLE JOHN F PF N X1 0.00 0.00 0.00 0.00 0.00 N 0.0 IN Common Stock, no par value AMERICAN SHARED HOSPITAL SERVICES 601 MONTGOMERY STREET SUITE 850 SAN FRANCISCO CA 94111 This Schedule 13D/A constitutes Amendment No. 5 (this "Schedule 13D/A No. 5") to the Schedule 13D originally filed by John F. Ruffle ("Mr. Ruffle") with the Securities and Exchange Commission (the "SEC") on June 27, 2011, and amended by Schedules 13D/A filed on June 18, 2014, October 27, 2014, January 20, 2016, and December 18, 2023 (as amended, the "Original Schedule 13D") with respect to the common stock, no par value (the "Common Stock"), of American Shared Hospital Services, a California corporation (the "Issuer"). Only those items that are reported in this Schedule 13D/A No. 5 are amended; all other items reported in the Original Schedule 13D remain unchanged. Information given in response to each item shall be deemed incorporated by reference in all other items, as applicable. Capitalized terms used but not defined in this Schedule 13D/A No. 5 have the meanings given to them in the Original Schedule 13D. On September 29, 2025, Mr. Ruffle transferred 410,746 shares of Common Stock (the "Transferred Shares") as a gift for no consideration to the Ruffle Family Foundation (the "Foundation"), a donor-advised fund established through the J.P. Morgan Charitable Giving Fund, which is administered by the National Philanthropic Trust. Upon Mr. Ruffle's donation to the Foundation, he ceased having control over the Transferred Shares. Following the transfer, Mr. Ruffle does not beneficially own any shares of Common Stock. The information reported in Item 3 of this Schedule 13D is incorporated by reference into this Item 4 to the extent applicable. Mr. Ruffle donated the Transferred Shares to the Foundation for estate planning and charitable purposes. Mr. Ruffle does not have any current plans or proposals that relate to or would result in any of the matters specified in subparagraphs (a) through (j) of Item 4 of Schedule 13D. Mr. Ruffle reserves the right to increase or decrease his position in the Issuer through, among other things, the purchase or sale of securities of the Issuer on the open market, in private transactions, or otherwise, on such terms and at such times as Mr. Ruffle may deem advisable. As of the filing date of this Schedule 13D/A No. 5 (the "Filing Date"), and following the transfer of all of Mr. Ruffle's shares of Common Stock to the Foundation, Mr. Ruffle does not beneficially own any shares of Common Stock, representing 0% of the issued and outstanding shares of the Issuer's Common Stock. As of the Filing Date, Mr. Ruffle does not have the power to vote or to direct the voting of, and to dispose or to direct the disposition of, any shares of Common Stock. Except for Mr. Ruffle's transfer to the Foundation disclosed in this Schedule 13D/A No. 5, Mr. Ruffle has not effected any transactions in the Issuer's Common Stock during the past 60 days. Not applicable. Mr. Ruffle does not beneficially own any shares of Common Stock. On September 29, 2025, Mr. Ruffle ceased to be the beneficial owner of more than 5% of the Issuer's Common Stock. There are no contracts, arrangements, understandings, or similar relationships between Mr. Ruffle and any other person with respect to the securities of the Issuer. RUFFLE JOHN F /s/ John F. Ruffle 12/16/2025