Siemens HealthcareMedical Imaging Technology Overview

November 2012

© Siemens AG 2011. All rights reserved.

Tim LaganaRegional Business ManagerMolecular Imaging

Innovation is our lifeblood

Ranking, recent highlightsKey R&D figures

Our patent position in fiscal 2011: Germany: No. 3Europe: No. 1USA: No. 9

Most recent innovations:Vitamin D blood test: diagnoses Vitamin D deficiency quickly and reliablyGearless 6-megawatt wind turbine: supplies up to 6,000 households with clean energy and weighs no more than a 2.3-megawatt turbine with gearsTIA Portal software platform enables design of all automation processes from a single computer screen

R&D spending in percent of revenue

2009

5.1%

2010

5.2%

2011

5.3%

R&D spending: €3.925 billion in fiscal 2011, or 5.3% of revenue27,800 R&D employees worldwide Roughly 17,000 software engineers160 R&D locations in roughly 30 countries around the world8,600 inventions in fiscal 201153,300 patents granted

Committed to profit and growth

Revenue by Sector

Revenue and employees

Revenue by Region

Key figures

100,000

80,000

60,000

40,000

20,000

500

400

300

200

100

2000

Employees in thousands

1986 1990 1995FY 2011

Revenue in millions of euros

Healthcare€12.5 billion

Energy€27.6 billion

45%

33%

16%Industry€32.9 billion

Other

Total revenue of Sectors and Cross-Sector Businesses

17%

43%37% 26%

21%

Based on cluster location

15%

40%

18%

America

Germany

Europe, CIS,Africa, Middle East (excl. Germany)

Asia, Australia

19% 15%

38%28%

85,58274,055New orders73,51568,978Revenue

Continuing operations (in millions of euros) FY2010 FY2011

Income 5,974 9,242Free cash flow 7,043 5,885Employees 336,000 360,000

As of September 30, 2011

Urbanization

Demographic change

Megatrends shape our future

In 2009, for the first time in history, more people lived in cities than in rural areasToday 320 million people live in megacities (cities with populations greater than 10 million)In 2050, 70 % of the world's population will live in citiesUrban agglomerations contribute a disproportionally high share of economic output: Tokyo generates 40% of Japan's GDP, Paris accounts for 30% of France's

Average life expectancy continues to rise worldwide: from 48 years (1950), it has increased to 69 years (today)Every 2 seconds, the world population grows by one person. 7 billion people inhabited Earth in 2011 – by 2050, it will be 9.3 billion.The population of the least developed countries is expected to more than double, from 800 million today to 1.7 billion in 2050The 65+ generation will nearly triple from 550 million today to 1.5 billion in 2050

Globalization

Megatrends shape our future

Climate changeSince the 19th century, the average global surface temperature has increased by 0.76°CThe years from 2001 to 2010 are the warmest decade on recordGreenhouse gas emissions have increased dramatically since the beginning of industrialization. Today we face the highest CO2concentration in the atmosphere in 350,000 years

Between 1990 and 2009, global trade volume more than doubledThe number of multinational companies skyrocketed from about 10,000 in 1969 to 82,100 in 2008If present trends continue, the emerging markets will account for two thirds of the world's economic output in 2030While the volume of trade with natural resources has remainednearly constant over the last decade, prices of natural resources have increased an average of 20% annually

Siemens The Healthcare Sector

© Siemens AG 2011. All rights reserved.

Hoffman Estates(Chicago)

MIAX Piscataway

AU

Knoxville MI

Oxford MR, MI Erlangen/ Forchheim

AX, CR, MR, RS, SY, XPAU, CS, CV

Madrid XP

Shanghai CR, CV, XP

Malvern HS, SY

Mountain View US

Suzhou AU

Shenzhen MR

Goa CV, XP

Kemnath CV, CR

Rudolstadt CV

Kyongju-si US

Indonesia AU

WuxiCV

BangaloreHS, SY

Divisions/ HeadquartersMajor manufacturing sites ~51,000 employees worldwide*)

Dublin DX

Flanders DX

IssaquahUS

Siemens HealthcareWorldwide presence

LlanberisDX

SudburyDX

Heidelberg CR

SeoulUS

Cary CS

Elkhart DX

Walpole DX

Marburg DX

Deerfield DX

Tarrytown DX

Los AngelesDX

Berlin HS

ConcordCR

*) as of Sept. 30, 2011

SingaporeAU

Increased demand for healthcare services

Solutions for overall cost reductions Improved processes and workflows

New applications and clinical pathwaysFlexible and customer-specific IT solutions

Growing and aging populationEmerging rural healthcare

Cost pressure (e.g. Deficit Reduction Act)Financing problemsNew structure of competitors

Disease orientation Healthcare IT

Market trends Need for improved healthcare

Trends in Healthcare determine our direction

Higher life expectancy poses challenges

10-19 20-29 30-39 60-6940-49 50-59

Age

70-79

5,000

10,000

15,000

20,000

25,000

0

1995

2015

80% of costs

Average life expectancy = 77.8 years

Risk of acute diseases increases

Popu

latio

n (i

n th

ousa

nds)

Source: World Health Organization, Industrialized Countries, 2008

Early detection has clear financialand clinical benefits

0%No cancer

% alive 15 yearsafter diagnosis

Treatment cost ($000)

Survival by stage of diagnosis; American Cancer Society, 2008

10%

20%

30%

40%

50%

60%

70%

80%

0

20

40

60

80

100

120

140

Stage 0 Stage I Stage II Stage III Stage IV

Early detection increases survival rate and reduces treatment cost

Example: Breast cancer

Diagnosis of a disorder (e.g. infection, cancer, …)Localization of disease (e.g. stenosis, tumor, …)Reveal multi-morbidities

Genetic pre-dispositionPatient metabolism / immune reactionsMolecular specificities of the diseaseStratification for treatment

Assessment of similar casesStructured outcome analysisDecision support systemsStandards of Care

Understand the patient’s disease

Understand the patient’s biology

Access state-of-the-art data bases

Imaging, Diagnostics Molecular applications Healthcare IT

Our portfolio is aligned with long-term trends in medicine

Cutting-edge technology solutions

Wide range of diagnostic and therapy solutions

Basic healthcare solutions

Leading medical institutes

Medium- andlarge-sizeurban hospitals

Regional-level hospitals andtownship health centers

Products suited for all customer segments

Successful SMART® products for local markets

CT

MR

X-Ray

Example: SOMATOM Emotion 16Development in ChinaProduction in ChinaProduct management in China70% exported worldwide

Example: MAGNETOM ESSENZADevelopment in ChinaProduction in ChinaProduct management in China90% exported worldwide

Example: MULTIMOBILDevelopment in India Production in IndiaProduct management in India27% exported worldwide

+7% p.a.Unit growth1)

+9% p.a.

FY 2010

FY 2009

FY 2008

+84% p.a.

SMART: Simple, Maintenance friendly, Affordable, Reliable, Timely to market 1) Based on number of systems sold worldwide

Unit growth1)

Unit growth1)

FY 2010

FY 2009

FY 2008

FY 2010

FY 2009

FY 2008

Customized, market-driven development and manufacturing: SMART* Products

For all entry level products: R&D, production, and sourcing in Asia

*SMART: Simple, Maintenance friendly, Affordable, Reliable, Timely to market

Our innovation is driven by customer needs

Clinical utility

Workflow efficiency

Cost efficiency

Open bore MR for obese & claustrophicpatients

Lowest dose CT

Lab automation Workflow-enabling IT

Most affordable 1.5T MR

Integrated diagnostic systems

Remote service leadership

Breast cancer test(HER-2/neu)

Mobile X-ray systemMost popular entrylevel CT

Increased productivity with syngo TimCT

Congestive heartfailure test (BNP)

Structure of the Healthcare Sector

Aud

iolo

gySo

lutio

ns

Imaging & Therapy Systems

Computed Tomography and RadiationOncology

Angiography, X-Ray

Magnetic Resonance

Molecular Imaging

Refurbished Systems

SYNGO

Diagnostics

Chemistry, Immunoassay, Automation, Diagnostics IT

Molecular, Microbiology

Point of Care

Hematology, Hemostasis, Specialty

Customer SolutionsSales, Service, Hospital Information Systems Health Services

Clinical Products

Components & Vacuum Technology

X-Ray Products

Ultrasound

Platforms

Expansion of product portfolioAchieve leading cost position

Clinical Products

* Components & Vacuum Technology; Platforms

Growth in market share, especially in emerging markets

Ultrasound CV*X-RayProducts

505,00070,000

different products

product sales p.a.

systems installed worldwide

X-Ray Products – Focused Portfolio

Women’s Health Investing in innovation in a growing market

Growth: 1.5 million new cases in 2010Mortality decreases attributed to screeningStrongest growth in emerging markets

India: >50% of women have advanced cancer at diagnosis

Share increasing: approaching 9,000 installed systems

Market trends

HER2-Neu

Screening /early detection

Diagnosis /staging

Patientstratification

Opportunity: Siemens workflow approach integrates our solutions

Breadth of portfolio unmatched in industry!

Competitive advantages:3-D Breast Tomosynthesis* System –MAMMOMAT Inspiration First system integrating all screening and diagnostic functionsFirst dedicated breast MR systemFirst operator-independent breast ultrasoundIntegrated workflow including serum tests

2D Image

TomoImage

Advanced screening and diagnostics finds disease earlier

*The product might not be approved in some countries or, for other reasons, not yet commercially available.

The world’s 1st Echocardiogram by Edler and Hertz produced with the Siemens original Reflectoscope

ACUSON Sequoia system,the world’s 1st system to use Coherent Image Formation

ACUSON 128 system, the world’s 1st computer-based ultrasound system

Vidoson, the world's1st real-timeultrasound system

ACUSON P10 system, the world’s 1st Pocketultrasound system

ACUSON SC2000 system, the1st Full 4D Echo System - Gold Standard in Volume Imaging

ACUSON S2000 ABVS, 1st and only Automated ultrasound Breast Scanner

1953 1968 1983 1996 2007 2009

Siemens UltrasoundPioneer since 1953

Imaging IT

Angiography,Interventional

Radiology

ComputedTomography and

Radiation Oncology Magnetic

ResonanceMolecularImaging

syngo.via

We are a leader in imaging, therapy, and IT

Leading in new equipment market shareExtensive installed baseStrong profitability to fuel R&D

Innovation Leadership

Customer needs

Excellent imaging for complex neurointerventions

Functional imaging in the interventional suite

Imaging solutions for stroke treatment

Artis zee Biplane

>50% market share in this segment

Excellent biplane imaging with two large flat screen detectors

Best soft tissue imaging in the market with syngo DynaCT

From structural to functional imaging with syngo iFlow and syngo

Neuro PBV IR*

*Parenchymal Blood Volume

Artis zee Biplane for minimally invasive neuro procedures

Intraoperative syngo DynaCT for planning and clipping

Surgical view syngo DynaCT + syngo iDentify

Courtesy of Courtesy of Shoichiro Ishihara M.D, PhD, Saitama International Medical Center, Japan

Clips

* option

World’s 1St Robotic C-Arm – Artis zeego

Artis zeego installation at National Heart Center, Singapore

Computed Tomography Past, Present, Future - 1972

160 positions x 180 angles = 28,800 measurements in 5 min, 6 x 2 images in 35 min

Computed Tomography Past, Present, Future

Computed Tomography Past, Present, Future 1974 vs. 1985

Computed Tomography Past, Present, Future 1974 vs. 1985

Vendor specific CT Strategies

SiemensToshibaPhilipsGE

Temp. Reso. 75msecEnergy Resolved ScansCardiac scan in 250msec @<1mSv

Larger Detector16 slices64 slices

Adaptive CT

Dual Source I

Dual Source II

320 slices; 175msecTemp. Reso. same as 64 slice

128 – 256 slicesTemp. Reso. 135-150msec

Larger Detector & better temp. Reso.

Temp. Reso. 85msecEnergy Resolved Scans

4D scans > 30cm

Spectral Imaging

Two X-ray Sources / Detectors Defining Leading Edge:

> 850 routine clinical installations worldwide

~ 3,000,000 cCTA scans without -blockers

More than 300,000 Dual Energy scans

>250 peer reviewed publications with DSCT

2005: SOMATOM Definition New Imaging Horizons with Dual Source Technology

Flash speed CT at lowest dose

Customer needs

Increased throughput

Lower cost

Complete chest pain diagnosis

Broad application range

SOMATOM Definition Flash

>50% market share in this segment

80% dose saving compared to standard chest pain protocolNo motion artifacts25% contrast media saving

< 1 mSv

SOMATOM Definition FlashFlash speed. Lowest dose.

Conventional Technology DSCT Flash Spiral

Thorax: 5 s, breath holdTriple rule-out: 20 s, 20 mSvPediatric: > 4s, sedationWhole body: > 10 s4D dynamic scans: 16 cm

Thorax: 0.6 s, no breath hold Triple rule-out: 0.6 s, < 5 mSvPediatric: < 1s, no sedationWhole body: 4 s4D dynamic scans: 48 cm

321Scan 321Scan

SOMATOM Definition FlashSplit-second thorax

HR 90 bpm

SOMATOM Definition FlashSub-mSv heart SOMATOM

DefinitionFlashFlash speed.Lowest dose.

0.8 mSv 250 ms acquisitionHR independent temp res. 75 msspatial res. 0.33 mm100 kV

SOMATOM Definition FlashSub-mSv heart

<1 mSv

Tumor / Body Perfusion: up to 15 cm Tumor assessment

Dynamic CTA: up to 48 cm Phase differentiation in vascular studies

Visualization of kinematics: up to 48 cm Joint movement evaluation

Neuro Perfusion: up to 14.8 cm Stroke - perfusion characterization of the brain

4D Adaptive Spiral PlusAdaptive 4D Imaging

MRI

The definitive portfolio for MRI.

Always secure.Always ahead.

MAGNETOM Family

*

*

*

*

* The product is still under development and not commercially available yet. Its future availability cannot be ensured.

MAGNETOM Family

New Technology and Patient Comfort

MR in Surgical Imaging

Improved Imaging sequences and

New Applications

MR-PET

Trends to Ultra High-Field

Future trends in MRI Imaging

70 cm Bore as standard

48 – 64 – 128 RF channels

Ultra high density coils

SW Guided scans

Unmatched open-bore experience

Redefining ultra high-density array

Ultra high-density array

Ultra density array with up to 204 elements

Channels configurations starting at 48

Previous configurations offered [102x32]

Redefining ultra high-density array

Transforming productivity and economics in MR

MAGNETOM Aera and MAGNETOM Skyra integrate Tim and Dot, significantly optimizing your resources. Tim 4G gives you the power you need for superb image quality.Dot takes away the complexity inherent in MR scanning that can slow you down. Reduce staff workload. Radically improve your return on investment. Deliver excellent quality of care to your patients.

MAGNETOM AeraMAGNETOM SkyraTransforming 3T productivity Transforming 1.5T economics

Siemens offers an excellent solution for the Intra-operative imaging

MAGNETOM 7T Replacing the Anatomical Atlas

MAGNETOM 7T*

* Works in Progress. The information about this product is preliminary. The product is under development and is not commercially available in the U.S., and its future availability cannot be ensured.

2D FLASHTR/TE 500/30 ms

Matrix 1024x10240.22 x 0.22 x 1 mm3 (48nl)

TA 8 min

MGH, Boston, USA

Molecular Imaging is one of theFastest Growing Imaging Tests

30%procedure growth(Source IMV report of average US PET growth per year in the recent 7 years; 0.248 millions in 2001 to 1.521 millions in 2008 )

Siemens MI Product Overview

Oncology syngo®.viaSymbia.net

Cardiology

Neurology

Clinical Solutions

BiomarkerInveon™

Customer Care

Symbia SSymbia E TruePointSymbia T mCTc.cam mMR

Biograph™Symbia™

Eclipse™

Preclinical

PETNETResearch Explora™

Preclinical Imaging SolutionsPETSPECTCTMultimodalityInveon Research Workplace

mCT 20 Excel

General NM

Industry-leading NEMA specifications*

Up to 75% less injected doseLowest CTDI dose for CTAC*4x more patients

Fully automated quality control and collimator exchange

High-end SPECTDiagnostic CTIn-field upgradability

High-Definition SPECT•CT Minimum Dose, Maximum Speed

Full Automation Seamless Integration

Symbia T Series

* Competitive information is based on published literature at the time of printing, data on file.

Industry-best volumetric resolution* of 87mm³

½ dose and 2x speed with FAST CARE

78 cm large-bore and high-end CT to grow patient access

Intelligently Reproducible Quantification

Finest Volumetric Image Accuracy

Minimum Dose And Maximum Speed

Engineered Clinical Flexibility

* Competitive information is based on published literature at the time of printing, data on file.

Biograph mCTmolecular CT. quantification redefined.

Accurate and reproducible quantification with SMART technologies and daily QC

Cutting-edge innovation: Biograph mMR: For the first time, MR and PET are one

One exam. One room. The world’s only simultaneous whole-body molecular MRFully integrated 3T MRI and PET systemSimultaneous acquisition of morphology, function, and metabolism Opening new doors in the diagnosis and understanding of disease

One-stop-shop, multiparametric imaging ....at the molecular level

sequential is now simultaneous.Molecular MR may support comprehensive follow-up

MRI T1 MPRAGE

18FDG PET

BrainPET

Massachusetts General Hospital, Boston, USA

Follow-up Glioblastoma patient after surgerySimultaneous imaging may improve evaluation of small changes in lesion boundary

Data Courtesy of Chang Gung Memorial Hospital, Linkou, Taiwan

AM

YVID

F18-

FDG

Alzheimer’s Disease Normal Control

Biograph mCT & MAGNETOM Trio

MR

I

Amyloid PET

High amyloid burden in MCI patients who convert to AD

potential is now reality.The power of MR.PET for Alzheimer’s Disease evaluation

The Hallmarks of CancerGuiding Siemens imaging biomarker research efforts

The Hallmarks of Cancer Siemens proprietary oncology imaging biomarkers

Early Stage Advanced Stage

HypoxiaAngiogenesisHypoxia & Malignancy

Apoptosis

To identify hypoxic (oxygen deprived) areas of tumors

To detect cell-surface receptors that promote angiogenesis to better qualify patients for anti-angiogenesis therapy

To ascertain the degree of hypoxia in tumors to allow for appropriate therapy modifications

To monitor protein activity central to apoptosis to monitor effectiveness of cancer therapies

Clinical Trial Stage

PSMA

Researching anti- prostate specific membrane antigen antibodies to image benign and malignant prostate tissue

My cases – ready.Automated Case preparationStructured Case Navigation Insightful Disease Orientation

My places – networked.Universal AccessInnovative Integration Effective Information Sharing

My needs – anticipated.Continued InnovationsIntegrated ServicesPredictable Life-cycle Costs

syngo.viaImages. My way.

Copyright © 2011 Siemens Healthcare. All rights reserved.Page 62

Excellent service in diagnostics

First in the industry with remote monitoring worldwide

Real-time monitoring of more than 450 parameters (voltage, pressure, temperature, etc.) for every instrument, judged to be the more innovative in the industry

Analytical quality control, peer reviews, updates via remote monitoring, virus protection, PC remote monitoring

Leading in remote monitoring of imaging systems

Monitoring in real-time, unique in the industry

8% less on-site service since 2006

More than 70,000 systems connected

Updates via remote monitoring without disruption of the customer’s workflow –two years earlier than the competition

Application management improves profitability of the customer – three years earlier than the competition

Excellent service

Answers for life.

© Siemens AG 2011. All rights reserved.