DMBN: Where do you think its main usefulness lies - neurology? I know they made a brain atlas on 7-T a couple years ago.

Sorensen: I think neuroscience will be the place. And the things that seem to be the most compelling right now from a patient care perspective are around multiple sclerosis, around head trauma, around neuro-oncology. It's a little bit of a chicken and egg problem because right now the 7-Tesla scanners are still not 510(k) cleared for marketing, which means that most insurance companies won't pay for a 7-T for an MRI. They won't even pay as much as they would for a 1.5-Tesla MRI, much less more, so that means that it's hard to ramp up the clinical infrastructure to use it. Once I think we get a breakthrough on one or two of these applications, I think things will change.

DMBN: Is there a moment you can predict that the greater expense of the 7-T MRI will be met by the supremely better clinical results?

Sorensen: I think so. I think that's actually the challenge for 7-T. It has to show it's so much better it's worth the investment. And at least so far, has that happened? I don't think quite yet. However, we're poised to do that in a couple of diseases. When you look at the costs of treating multiple sclerosis, the therapies are very expensive. And so even an expensive imaging test that can guide that treatment would be very valuable and could easily justify a high cost for its utilization. And that's the kind of the scenario where I think you kind of have to explore. It's not just, "Can I see something?" but, "Can I see something that will leverage or change a lot more expenses downstream?"

DMBN: Your background is in neuro-radiology, and you mentioned Amyvid this morning in your (Siemens media breakfast) talk - this is the in-development PET imaging agent that can help doctors find beta-amyloid deposits in living brains. There's a lot of excitement around it, but do you think its success depends in part on early-stage treatments for Alzheimer's becoming more effective? Obviously, it would be great to be better able to understand early on what your disease state is - but because Alzheimer's is basically untreatable at this point, how useful is that knowledge?

Sorensen: The classic criticism is, because we don't have strong disease modifying treatments for Alzheimer's, who really cares about the diagnosis? And while I think there's certainly some truth to that, it's also clear that many patients and their families desperately want to know the status of their disease. And we see this just because it's on the front page of The New York Times. There's tremendous pent-up interest in this disease because of its long-term implications. But I think this question that you're asking, while a good one, will become less important in the future as there are promising therapies in the pipeline, very promising therapies. We haven't seen many of them with a lot of experience yet, but the early data in some of the trials suggest that some patients actually are getting their memory back - I mean it's remarkable, some of the drugs that are in testing. So I think there actually will be a therapy for Alzheimer's disease in the not-too-distant future, and then the amyloid tracers may become even more relevant. They may even be used to monitor some of the therapies, because the treatments may have some risks associated with them. So, for example, if your amyloid load is down maybe that means you don't need to stay on the therapy. I think in a couple of years this will all become much clearer than it is now.

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