Hello, everybody out there. We've had a good quarterly result and a very focused virtual roadshow. As usual, we try to distill the key points of discussion and deliver to you a compact summary of what we believe you need to know. If you did not get a chance to meet us, or simply you want to remind yourself ahead of the next discussion involving Siemens Healthineers, our podcast is the thing you need to listen to. Let's kick it off. What were the highlights of Q1 2026 reporting from your point of view, Bernd?
Yeah, thank you, Marc. So I think the big highlight was a very solid start in what we call the synergetic core of Imaging and Precision Therapy, where we grew revenue by 6%. Even more special, I found the very, very good margin in both businesses, which meant that despite the headwinds from tariffs and FX, on a company level, we achieved the same EBIT margin of 15% as in the prior year quarter. We had a solid, or I would actually say very good, equipment book-to-bill of 1.12. Another highlight has been, by the way, a totally different topic. Yeah, the strong investment grade rating which we got from Moody's. But I also want to say that, of course, it was difficult, yeah, that Diagnostics remains impacted by the structural changes in China.
In this quarter, this meant, yeah, that the Diagnostics revenue was down by 3.1%, which was also one of the major reasons why the margin was only at 2.1%.
So speaking of the diagnostics Q1 performance, this was unsurprisingly a key topic of most meetings. People wanted to understand what drove the weakness and also why we did not see it to this extent.
Yeah, as Bernd highlighted already, the business in China is challenged by market changes, yeah, primarily expressed by Volume-based procurement, but also by reimbursement reductions. When we have flagged a weaker or slower quarter already with our Q4 results, we iterated that also at the J.P. Morgan conference, which was recorded, yeah, that we see a significant increased impact from Volume-based procurement in the quarter. And then on top, we had a short-term unfavorable instrument reagent mix, which helps obviously in the mid and long term, but is short-term a drag on margin. And then maybe also a topic which is maybe not so obvious right from the start, is that you have different sequential, I would say, impacts from the same things, yeah?
It also depending on your sales structure, we have a very large distribution partner in China who ordered relatively low volumes in the quarter. We have also, in our special lab solutions business, an OEM partner who also ordered far below the expectations, and unfortunately, we cannot expect a catch-up effect because they ordered obviously more in the prior year, yeah, and now we see the, so say, the slash-back of this, yeah.
The obvious question following this was how we expect the rest of the year to look like for the Diagnostics segment.
I mean, we are obviously more confident about the second half, as we will see the relapsing from the OEM volume, which we are missing in Q1 and Q2. We also expect benefits from volume conversion in the core lab, where our Atellica franchise is still running very, very well. Secondly, our second half will be driven by additional cost reductions, where we do have good visibility of the actionable items. They are still coming from the transformation program. Only to name a few examples, we expect further savings from the further consolidation of the platforms and for in-service, as well as additional tailoring from some site consolidation measures, which we realized last fiscal year.
Okay. Finally, on Diagnostics, the discussion often involved the question whether we would see this weak quarter potentially impacting our strategic flexibility with regards to the future of the segment.
Yeah, I mean, when it comes to this, I mean, we, first of all, knew that this is a period of about, let's say, give or take, 6 quarters, in which the new purchasing schemes and reimbursement changes in China will impact the diagnostics top line. In Q1, it was definitely more than expected, as already explained by Jochen. But overall, this is not a topic, yeah, which is changing how we think about diagnostics, but maybe even more importantly, it is not a topic which puts into question the transformation program, which we are successfully on. The team did a wonderful job in now having almost 70% of revenues in the core lab based on Atellica. We had strong instrument deliveries in this quarter.
We had a highlight of winning a big deal in Brazil with one of the biggest customers worldwide. So things are on track, and, I mean, as we said in the Capital Markets Day, for diagnostics, we are very clear that the synergies to the rest of the portfolio are very limited, yeah, which is why it has its own structure and defines its own strategy. We don't want to be a conglomerate, yeah, so and it is very likely, yeah, that we will inform you about further steps within this year.
... as you often pointed out in these meetings, both of you, Bernd and Jochen, this diagnostic discussion is about 20% of group revenue, while the business representing 80% is doing just fine and was actually outperforming expectations in Q1, right?
Yeah, absolutely. Thanks. Yeah. Fundamentals are fully intact with the synergistic core. Yeah, we saw a good book-to-bill ratio of 1.12, strong revenue growth of 6%, operational margin expansion that could broadly compensate for tariffs and foreign exchange completely, yeah? In imaging, to highlight, the extraordinary growth drivers, photon-counting CT on an ongoing basis, our radiopharmaceuticals business, formerly known as PETNET, yeah, continues to drive growth this quarter. And when we talk about the margin expansion in imaging or the margin performance in imaging, we have to have in mind that prior years, Q1 was also not particularly strong.
We had a negative one-timer in there of about 50 basis points, but excluding the special items, so the 50 base point and the 200 basis points headwinds from tariffs and foreign exchange, we saw an operational margin expansion of about 100 or even above 100 basis points. By the way, the radiopharmaceuticals growth dynamics is on prior year level. You heard us talk about $1 billion of revenue this year. I think that's fully true if you take dollars, yeah. In euros, maybe slightly shy of this, yeah, but we are very, very happy with what we see here. Maybe when we are talking about PETNET and talking about good mix and margin expansion potential in the business, PETNET's P&L structure is very different to the normal imaging P&L structure. We don't own the IP, therefore we pay licenses.
This means the gross margin is significantly lower than the average of imaging. On the other hand, this is almost an OpEx-free business, therefore, profit margin equals gross margin, more or less, and this is fully in line with the margins of imaging. Coming back to precision therapy, also here we saw a strong growth of almost 6% on tougher comps of 8. Varian had a very good quarter with 9% growth and nice profitability, again, above 19%, a bit supported by a special item, but even without that, around 18%. AT had a softer start, as indicated already with our Q4 results, yeah, and when a business has a lower start from a revenue standpoint, you miss the conversion, you miss the fixed cost regression, and therefore, we also saw a weaker margin profile, yeah.
Yeah. Jochen, speaking of softer start, could you maybe also remind our listeners on what we said with regards to our expectations for the second quarter?
Yeah. I think we expect also revenue growth for the group in the second quarter below our 5%-6% range for the full fiscal year. We expect for DX to continue to face material market challenges in China, resulting in a revenue decline also in Q2. Remember, last Q2 was a strong quarter for diagnostics in China. Therefore, we expect in Q2, in diagnostics, an even more pronounced decline than in Q1. Margins should benefit slightly from improving instruments reagent mix in diagnostics. Imaging and precision therapy, we expect the growth trajectory to be around the full year assumptions. That means mid-single digit or mid to high single digits. Due to tariffs and foreign exchange, margins will be below prior year quarter in all segments.
In Imaging, it's worth to highlight that last year's Q2 was the quarter with the highest margin, unusually high, also driven by a positive one-off we disclosed last year. This year, we would expect Q4 Imaging margin is the strongest in the year. Also expect absolute higher revenues in Imaging sequentially over the quarters throughout the year.
So we had a decent beat in the quarter, despite the weak diagnostics business. This was also the basis on which we confirmed being well on track for the full year guidance. Looking at the delivery of the buckets of our EPS bridge from Q4, we also have good reasons to be optimistic. We did, however, get the question: What exactly makes us so optimistic that there will be this stronger second half, especially in terms of growth?
Yeah, I mean, first of all, we had again and again and again a very strong equipment book-to-bill ratio with 1.12. We have a very strong order book, yeah. Remember, last year, we had an equipment book-to-bill ratio of 1.15. So this gives us good visibility in terms of scheduling for the equipment revenue portion, and as you know, the equipment revenue portion in imaging and precision therapy is below 50% meanwhile. We obviously have good visibility on the service business, which is primarily contracted business, which makes around 40% of revenue in imaging and precision therapy, and we see in the procedure-based business continuous strong momentum. Yeah, we talked about Petnet beforehand, yeah. We expect also the overall revenue momentum in the regions to pick up in the second half.
We expect continued strength in the United States, expect EMEA growth to pick up again after stabilizing on high levels throughout the last couple of quarters, and we also expect growth in APJ to pick up in the second half because we had tough comps in the first half of this fiscal year, yeah. In the segments, we expect Diagnostics to return to a positive prefix on growth in the second half, as I elaborated already on. In Imaging, photon-counting CT, Radiopharmaceuticals business to remain a growth driver throughout the year. In Precision Therapy, Varian continues to perform, and we expect, last but not least, momentum-
... from the new NGO platforms in AT.
Exactly. Speaking of launches, Bernd, we also got several questions on the new LINAC that is expected to be launched in 2026. What can you tell the audience about this at this point of time?
Yeah, so we still have some months to go until the launch of the next generation of high-end systems in Varian. But what I can share is that the feedback from the early customers with whom we have collaboration agreements is extremely positive. And, funny enough, there is two ways to look at it, yeah. One is how you phrased the question, the new LINAC. Yeah, so it is setting an exclamation mark on top of the most popular system in radiation therapy, yeah, the TrueBeam, yeah, which is, on the one hand, the gold standard, yeah, but also the system worldwide with the biggest installed base. But what I find even more exciting is, that with this new technology comes a new way of treating cancer patients.
Cancer patients, especially those with multiple metastases, who so far have not really been possible to get treated with radiation oncology. So one of the quotes I really like of one of our key collaboration partners is: "You should launch that product at ASCO." Yeah, so the American Society of Clinical Oncology, and because it's a new treatment option, we will not do this. Yeah, so the launch will be at ASTRO, just from a timing point of view, in end of September. But I'm very proud of what the team is coming up with.
Thanks, Bernd. It's very topical at the moment, and especially during this roadshow and moving markets, is the discussion around AI disruptiveness. How are we positioned? What do you think, Bernd?
See, there's the disruption or the disruptive potential we are using, and we are in a very positive and strong position to use is, on the one hand, that AI gives us the chance to further enhance the performance of our systems, yeah. So when you look at technologies like Deep Resolve, yeah, which is changing how fast MRI can be used, which is making lower field strength and more compact designs possible, we are disrupting how MRI is done. When you look at, in a very similar fashion, at the new AT portfolio, one of the most exciting aspects is the so-called OPTIQ AI feature, which is AI-based denoising, as they call it technically, which significantly enhances image quality or allows you to get to very good image quality at low X-ray dose.
Yeah, so there is a lot of topic, yeah, which we can use close to our traditional strength, yeah, in what I would call physical AI. And the other topic is that, I mean, our business so far is not in human labor, yeah. Human labor is, you know, the people who do the treatment planning, the radiologists who are doing the image interpretation, the technologists who are selecting the scans, yeah so. And step by step, we can work into this part of the value add, so to say, of our customers and help to replace it by technology, yeah. So AI also is increasing the pie of the addressable market for us.
Thanks. And finally, in almost every meeting, we got a question on the potential timing of the spin. We obviously are not in the driver's seat here, Siemens AG is, so we can only comment on the things that have been said in public, most recently at the Siemens AGM. It seems that the plans for the spin are on track, with some continued uncertainty around the timing, and Siemens continues to point to calendar Q2 for more clarity on the timing. We are in the process of getting prepared also for a fast track that would likely involve the spin happening earliest somewhere in October. We plan to ramp up IR activity massively towards the event, are doing detailed investor targeting, and have involved two major global investment banks, which are supporting us throughout the process.
So for me, it remains to say thank you, Bernd and Jochen, for doing this again with me, and thank you to our listeners for their continued interest in Siemens Healthineers. Stay safe and healthy. Bye-bye.