interview with icometrix & neotiv

Introduce yourself, your company & how would you describe what your company does for someone who’s new to digital health?

Wim Van Hecke: I am the founder and CEO of icometrix. Our company uses artificial intelligence (AI) to support radiologists and neurologists in analyzing brain scans. Based on a brain MRI or CT scan, our icobrain software automatically detects abnormalities, quantifies lesions and brain structures, and evaluates subtle changes over time. This information is crucial for the diagnosis and for the therapeutic decision-making for people with multiple sclerosis, Alzheimer’s disease, epilepsy stroke, etc.

Chris Rehse: I’m the founder and CEO of neotiv, a healthtech company focused on translating cutting-edge neuroscience into practical solutions for early detection and monitoring of Alzheimer’s disease. Neotiv was born out of a strong collaboration with leading research institutions like the German Center for Neurodegenerative Diseases (DZNE) and the Otto-von-Guericke University Magdeburg. Early detection is critical to slowing down the progression of the disease, empowering families taking on caregiving responsibilities, and transforming Global Health outcomes - every day counts on tackling one of the most challenging diseases of the 21th century.

What drew you to work in the digital health space, especially focusing on Alzheimer’s disease?

Wim Van Hecke: While doing my PhD in medical sciences at the radiology department of the Antwerp University Hospital, being an engineer in physics by training, I was fascinated by the potential of AI to impact radiology. By developing the right solutions as a medical device, and thanks to the AI and cloud computing opportunities, you can now impact the lives of millions of people around the globe at a scale and speed that wasn’t imaginable before.

As the burden of neurological conditions is around 800b€ per year in Europe, which is more than the sum of oncology, heart disease, and diabetes, the needs in neurology are massive. Especially for people with Alzheimer’s disease, as the number of people is doubling every 2 decades because of the ageing population. By 2040, the yearly burden of Alzheimer’s disease alone will already reach that 800b€.

Chris Rehse: My background is driven by science transfer in the field of medicine. My experience establishing science incubators and scientific startup centers played a major role in shaping my path towards digital healthtech solutions. During my time at Stanford University, I had the opportunity to see firsthand how innovation in technology could intersect with healthcare, while my work with neotiv deepened my understanding of neurodegenerative diseases such as Alzheimer’s disease. The ability to translate cutting-edge research into a real-world solution that can directly impact people's lives is what motivated me to enter this space.

How do you think your products are making a difference in the lives of Alzheimer’s patients and their families?

Wim Van Hecke: Brain imaging plays a central role for all neurological conditions, and especially for Alzheimer’s disease. A brain MRI scan is needed as part of the diagnostic process, and our icobrain measures of the volumes of several brain structures are key for an early and differential diagnosis.

With the introduction of the first disease-modifying treatments in Alzheimer’s disease, the need for brain imaging AI solutions will increase dramatically as people treated with the new Alzheimer’s drugs need between 5 and 11 MRI scans in the first year of treatment to monitor for side effects. In the US, it is estimated that 17 million people could be eligible for these new treatments, from which around 5.5 million would enter the clinical workup and receive a diagnostic scan. From these, around 2.6 million are expected to be amyloid positive and will need an MRI to assess treatment eligibility, from which 2m people will start the treatment. They will need an additional 3.5 MRI scans on average in year one. Around 30% of them, or 0.6 million will develop side effects and will need an additional 3 MRI scans to monitor the brain bleeds. In total, around 17m additional MRI scans are expected per year in the US, all needing a solution such as icobrain to quantify brain structure, lesions, and side effects.

In summary, our solutions play a crucial role in being able to diagnose people early (which is needed for the therapies to have a significant effect) and being able to treat people with Alzheimer’s disease safely.

Chris Rehse: The Alzheimer’s disease cascade begins with the accumulation of beta-amyloid plaques in the brain. Tau proteins, known as neurofibrillary tangles also begin to clump together disrupting neuronal function. This triggers neuroinflammation, synaptic dysfunction, and widespread neuronal death, resulting in brain atrophy and problems with memory, language and thinking. Alzheimer’s disease is often diagnosed in middle to late adulthood, often when a person is aged 65 or older. Diagnosis usually occurs when the disease has progressed, and cognitive problems are already interfering with daily life. Early detection is crucial to not only significantly improving the quality of life for patients and their families but also to allow for better medical care and targeted treatment.

Our app designed to detect the early signs of the disease and enable timely intervention, is already being used in studies worldwide. In Germany, our health-care product “neotivCare” is being piloted with several health insurance and leading pharma companies. So far neotivCare has shown encouraging results in a large populations involving over 700 patients. Those studies have shown that the app can be an effective aid to traditional diagnostic method. Overall our solutions neotivCare and neotivTrials have been used by over 12.000 users.

Can you share a story that highlights how your technology has helped someone with Alzheimer’s?

Chris Rehse: One of the early users of our cognitive assessment app was a middle-aged woman with a family history of Alzheimer’s disease. She started using our tools as part of a regular health routine, and our assessments indicated slight but consistent changes in her memory performance over time. Because we caught these changes early, she was able to seek medical advice, where follow-up testing confirmed the early stages of cognitive decline. The early diagnosis allowed her to begin a treatment regimen, make lifestyle adjustments, and participate in clinical trials aimed at slowing the progression of the disease. This case is a great example of how combining scientific research with a digital and scalable technology can directly improve an individual’s outcome.

What role do AI and machine learning play in your approach to Alzheimer's care?

Wim Van Hecke: At icometrix, AI and machine learning play a crucial role. AI and software can look at brain scans in ways our human eyes can’t. This allows us to detect diseases earlier, monitor their progression more accurately and make more informed clinical decisions. In a few minutes, our deep-learning neural networks can generate insights that a human could only get after days of working with these brain scans, and many of the insights wouldn’t even be detected.

Chris Rehse: AI and machine learning are at the core of our data analytics approach. We use these technologies to analyze large datasets from cognitive tests and identify patterns that can indicate early cognitive decline, even before symptoms are noticeable to the individual. Machine learning models help us refine our assessments, making them more personalized and sensitive to subtle changes in memory performance.

What are the biggest challenges you face in developing and scaling digital health solutions for Alzheimer’s disease?

Wim Van Hecke: I believe that most challenges are not specific to digital solutions or to Alzheimer’s disease, but are related to introducing new technology in a healthcare ecosystem in general.

It starts with numerous challenges in the development phase, from data access to setting up quality management solutions, and developing AI solutions that will have an impact and are developed based on relevant (real-world) data. This is followed by regulatory challenges and making sure that the solution can become available clinically as a medical device, with specific regulations in several regions in the world. But the biggest challenge is for solutions to become the standard of care, as this includes large scale validation studies and clinical trials to generate trust in the solution, but also a sustainable (financial) business model that can answer the most important question in healthcare: who is going to pay for the solution (and how much)?

Chris Rehse: One of the biggest challenges is translating complex scientific research into something that is easy for the average person to use, while still being medically accurate. Alzheimer’s disease is a particularly difficult field because the disease develops slowly, and early symptoms can be subtle. Ensuring that our solutions are sensitive enough to detect these early changes while remaining user-friendly is a constant challenge. Another challenge is scaling our solutions across different healthcare systems, where regulatory requirements and clinical practices can vary widely. However, working with institutions like DZNE provides us with the credibility and partnerships needed to overcome these barriers.

If you could fast forward 10 years, what would you hope to see in the world of Alzheimer’s care and digital health?

Chris Rehse: In 10 years, I hope that cognitive health screening and monitoring will be as common as heart health monitoring is today. My vision is for everyone to have access to regular, validated cognitive assessments, with the ability to track their brain health as easily as they can track their physical health. neotiv will become the blood pressure monitor for the brain.

Wim Van Hecke: I see many evolutions happing at a very fast pace now, involving early diagnosis and prevention, the availability of treatment options, and precision medicine.

I believe in 10 years, we’ll be able to diagnose Alzheimer’s disease 20 years earlier. With an increasing amount of treatment options that are expected to becoming available, we will be able to slow down and manage this disease much better. Finally, thanks to new digital health technologies, we will be able to assess when which patient needs which treatment and develop new advanced treatments using companion diagnostics.

What’s one piece of advice you’d give to someone interested in getting into the digital health space?

Wim Van Hecke: First, define the problem you are solving and the need of your potential customers very well. This is often mentioned, but rarely done in a through way. Secondly, don’t get too excited about technology and all the cool things AI can do. AI and technology are a means, not the goal. Thirdly, think ahead. Be aware of future challenges early, so you can build the right product, with the right validations and be able to collaborate with the right customers, partners and stakeholders that will support your growth.

As these are three pieces of advise, I can summarize them into one: focus. As you can only achieve the above by a laser sharp focus, there is no room for distraction.

As a last question since we’re all working in the technological space: do you have any favorite tech gadgets or apps that you can’t live without?

Wim Van Hecke: Strangely enough, I’m not a gadget person :). I don’t need to have the newest technology myself first. On the technology adoption life cycle, I think I can be considered as early (for some things even more late) majority. But maybe that helped me to focus more on the solution needed, not on the technology itself, and to understand how to cross the chasm towards that majority group.

Chris Rehse: Me on the other hand, I rely heavily on health-tracking gadgets like my wearable fitness tracker, which monitors my sleep and activity levels. It’s a constant reminder of how technology can provide valuable insights into personal health, something I think about often at neotiv as we work on potentially combining those technologies regarding cognitive health. It’s fascinating to see how small changes in behavior, detected through technology, can have a large impact on long-term health. Especially with the respect on one of our most powerful organs, the brain.