Full Body MRI Scan - Preventative or Harmful?
Would you pay for a preventative full body MRI scan that might allow you to live 5-10 years longer? What if there was a chance that instead of helping you live longer, it actually harmed you?
Would you still get a whole body MRI scan?
Although you might live 5-10 years longer, due to discovering an internal health threat to your body, there are a number of negatives to consider when getting a preventative MRI scan. Some downsides include experiencing increased anxiety, follow-up with painstaking medical screenings, ineffective treatments for non-life-threatening health issues, time wasted, and large expenses.
This is the crux of the personal and ethical challenge we’re facing with the rising popularity of preventative full-body magnetic resonance imaging (MRI) scans and elective preventative screenings in general.
As preventive healthcare continues to rise, this debate will likely not go anywhere, especially as additional technology in the preventive healthcare space will continue to be developed.
Additionally, major influencers have raised the public’s awareness about MRI scans for proactive healthcare. For example, Kim Kardshian created a #NotAnAd post on Instagram about her experience with Prenuvo, a full-body MRI cancer and disease screening service.
Despite the trending popularity and potential downsides of MRI scans, there are clearly enormous benefits. In this article we aim to educate you on the ins and outs of full-body MRI scans, as it pertains to longevity, so you can decide if this is right for you.
What Is a Preventive Full Body MRI Scan?
A preventative full-body MRI scan evaluates the soft tissue of the body by using a magnetic field and computer-generated radio waves. Although MRI scans in clinical settings are used to identify a number of things, commercialized MRI scans are primarily intended to search for abnormalities that may be identified as cancer.
What Does it Detect?
A full-body MRI can detect cancerous masses, strokes, cysts, and uterine fibroids and polyps by finding abnormal water accumulation and swelling throughout the body. These can be detected in the brain, neck, chest, abdomen, and pelvis. Other conditions that can be detected include: herniated disc(s), spinal issues, musculoskeletal conditions, fatty liver diseases, hemochromatosis, advanced Alzheimer’s, and multiple sclerosis.
How Is It Different From A Regular MRI Scan?
The proprietary technology behind these commercialized full-body MRI scans is what makes them different from the MRI scans typically used in a clinical setting.
Most MRI scans use anatomical imaging, which simply shows the organs in images. This can be useful; however, the proprietary technology that companies such as Prenuvo use rely on functional imaging, which can identify how the organ works. Functional imaging allows the MRI to identify conditions that otherwise would have gone unnoticed.
Other notable differences between a regular MRI and a preventive full-body MRI scan are the costs and the time it takes to perform the scan.
Full-body diagnostic quality MRI scans on standard machines take 3-4 hours to complete and can cost up to $100,000. Because of how long it takes, it can require the use of general anesthetic. MRI scans, such as the ones Prenuvo provides, take one hour and are, on average, $2,500.
Prenuvo makes a few other comparisons between their scans and other whole-body MRI scans. Prenuvo uses multiparametric imaging (imaging the body with multiple filters), which produces high-quality images and helps to keep the false-positive rate low. Their scans can also take up to 10x more images than other scans.
Who Provides Them?
Which companies provide full-body preventive MRI scans? Here are a few:
There are a number of other companies that offer the same or similar services, but they may not have as many locations across the country or are located overseas.
Who Should Use Full Body MRI Scans?
With full-body MRI scans being elective, the question running through our minds is: who should use these MRI scans?
Depending on who you ask, you might get an answer that varies on a spectrum of “no one” to “everyone who wants to and can afford it.”
Although everyone would justifiably want to detect early signs of disease so they can treat them before they become untreatable, full-body MRI scans should generally be reserved for people who have a risk of cancer, whether that’s family history of cancer or otherwise.
PROSCAN recommends full-body MRI scans for people with:
- History of neurological problems, such as atypical headaches or family history of aneurysm
- Family history of stroke
- Any risk factor favoring early detection of cancer of the brain, bladder, liver, pancreas, prostate, gallbladder, bile ducts, liver, lymphoma,
- Hodgkin’s disease
- Joint or extremity problems or unexplained pain
- Unexplained weight loss, malaise, fatigue
- Previous history of cancer
Generally, these companies target people with unexplained pain, genetic predisposition for cancer or other diseases, and people with disposable income who want peace of mind.
Given that many of these services recommend annual screenings, the costs can start to add up, especially for those without pre-existing health issues. The demographic that’s willing to shell out on average $2,500 annually for peace of mind tends to be healthy, upper-class, and health-conscious.
What Are The Benefits?
The primary benefit of a full-body MRI scan is being able to detect and treat cancer before it’s too late.
Here are other benefits:
- Safety: Unlike with a CT scan, there’s no radiation in a full-body MRI scan. Additionally, there’s no need for contrast agents to be used during a full-body MRI scan.
- Time: These full-body MRI scans only take 1 hour to complete, versus a normal 3-4 hour MRI scan.
- Reliability: There are ten times more images, at a higher quality, taken than with a regular MRI, making the images more reliable.
- Accuracy: They can detect diseases in early stages, as it differentiates between normal and abnormal tissues with more accuracy than other modalities. Although false-positives are a wide concern with these types of scans, the latest technology can keep false-positives low through multiparametric imaging.
- Comfort and claustrophobia: Not only do you spend less time in the machine during a full-body MRI scan, but more modern machines are less claustrophobic than older ones. Some are “open-bore” machines, which allow you to have your head outside of the machine for a large portion of the scan, versus being contained in a “closed-bore” MRI.
What Are The Downsides?
Many medical professionals are against full-body MRI scans, as they say if you are not experiencing any symptoms or have a family history of cancer, these scans are unnecessary and can cause more harm than good.
Here are some of the downsides to getting a full-body MRI scan:
- Cost: As of now, insurance doesn’t cover full-body MRI scans, so individuals would need to pay out of pocket.
- Overdiagnosis & overtreatment: Although it’s logical to think the more diagnosis leads to more treatment and better health, more diagnosis can make healthy people more vulnerable and less healthy. As Dr. H. Gilbert Welch says in his book Overdiagnosed: Making People Sick in the Pursuit of Health, “excessive diagnosis can literally make you feel sick.” The same applies to the resulting overtreatment that occurs from overdiagnosis. The estimated cost of overtreatment in 2011 to the U.S. healthcare system was between $158 billion and $226 billion.
- False positives, false negatives, & incidentalomas: The rate of false positives in these scans can be substantial. On the other hand, false negatives can also give false reassurance. Even when there are no false positives or negatives, results can show “incidentalomas,” which are incidental findings of asymptomatic tumors that can lead to needless anxiety, work ups, biopsies, and more.
- Increased anxiety: The entire process of overdiagnosis and overtreatment, particularly for false positives, can increase patients’ anxiety unnecessarily. Tracking down false positives or non-issues can lead to additional invasive testing.
- Loss of time and money: Unnecessary testing and treatment wastes time and money, not just for the individual patient, but for the healthcare system as well. It can make the cost of care less affordable and accessible, create additional workload for doctors, and diverts health resources from patients that may be in dire need of care.
The downsides can be summarized from this systematic review:
“However, discovery of indeterminate incidental findings (ie, findings for which the effectiveness of intervention or treatment is unknown) and false‐positive findings (ie, findings which eventually prove to be benign) can lead to unnecessary additional examinations, intervention, and treatment, with the associated risk of complications and costs. Moreover, knowledge of the existence of a critical finding for which no preventive or positive action can be taken, or informing a patient about the presence of an indeterminate incidental finding, can negatively affect psychological quality of life. In addition, a false‐negative finding may lead to false reassurance.”
What Are The Financial Costs?
The cost for a full-body MRI scan is roughly around $2,500. It may include a medical review beforehand, the MRI scan, an assessment of the images, then a follow-up with a medical professional to review the report of your scan. These scans are not currently covered by insurance.
Although you may find cheaper services out there, cheaper is not necessarily better. Other services may rely on CT scans, which involve radiation and are less accurate. Additionally, some services may use non-diagnostic quality MRI, which results in even more false or indeterminate findings that require more testing.
What Do Medical Professionals Say?
Medical professionals and studies believe that although the technological advances with MRI scans are promising, conducting screening on patients without any symptoms is not justifiable.
The American College of Radiology made this statement in April 2023 regarding whole-body MRI scans:
"The American College of Radiology® (ACR®), at this time, does not believe there is sufficient evidence to justify recommending total body screening for patients with no clinical symptoms, risk factors or a family history suggesting underlying disease or serious injury. To date, there is no documented evidence that total body screening is cost-efficient or effective in prolonging life. In addition, the ACR is concerned that such procedures will lead to the identification of numerous non-specific findings that will not ultimately improve patients' health but will result in unnecessary follow-up testing and procedures, as well as significant expense. The ACR will continue to monitor scientific studies concerning the utility of screening total body MRI."
Additionally, in the list of the American College of Preventive Medicine’s top five recommendations, the third recommendation says, “Don’t Use Whole-Body Scans for Early Tumor Detection in Asymptomatic Patients.”
The report claims that whole-body MRI scans “are likely to result in little benefit to patients, cause significant harms, and waste money and healthcare resources. Therefore, whole-body scanning is neither recommended by medical professional societies for asymptomatic individuals, nor is it a routinely practiced screening procedure in healthy individuals.”
Instead, medical professionals say preventive screenings should follow the U.S. Preventive Services Task Force’s (USPSTF) guidelines.
Should You Get a Preventative MRI Scan?
The rise of hypochondria (and cyberchondria), internet health information increasingly affecting patients’ ability to trust their physicians, and growing consumer-centricity in healthcare has created the perfect storm for preventive full-body MRI scans to hit their heyday.
Companies like Prenuvo, Ezra, PROSCAN, and SimonONE are riding the wave of these trends.
As patients and customers, we have to be mindful of the factors that influence companies that operate in the healthcare space. It’s important to understand that the ethical responsibility physicians carry may not necessarily carry over to companies whose primary allegiance is to their bottom line.
With MRI scans becoming more of a status symbol among the elite and part of what Rohin Francis calls Silicon Valley medicine can inadvertently exacerbate overdiagnosis and overtreatment of non-health issues with no checks or balances. Capitalizing on celebrity marketing points to the fact that these companies may be less concerned with stringent guidelines around preventive care and more preoccupied with giving the people (of the well-paid variety) what they want.
A company wanting to turn a profit isn’t a crime. However, a company is not necessarily bound by the same obligations physicians are. Without the ethical responsibility physicians have to place their patients’ welfare above their own self-interest, a company outlining the benefits of their health service could simply be deploying great marketing – not putting the client or patient first.
So, should you get a preventive MRI scan?
Only you can answer that. The onus is on you to make an informed purchase-decision that will actually benefit you. To do this, you need to weigh your personal risk tolerance for false positives, costs, and the risk of not being screened against the possibility of detecting a life-threatening issue before it’s too late.
Medical professionals advise that unless you are experiencing symptoms, have risk factors, or have a family history of cancer or other diseases that can be detected with a full-body MRI scan, there’s no need to get a scan. In fact, it may actually cause more harm than good, particularly with the prevalence of “indeterminate incidental findings, the lack of verification data, and the apparent substantial proportion of false-positive findings.”
So we’ll turn it back to you. Are you ready to open Pandora’s Box?
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