Master influencer Kim Kardashian donning hospital garb before a powerful magnetic resonance imaging machine? Check.

Actress and television host Maria Menounos had unexplained pain for months. Maria decided to get a Prenuvo scan to investigate the issue further.

The bottom line? Menounos had an early pancreas neuroendocrine tumor, a rare form of pancreas cancer. Fortunately, she has a good prognosis after she had a resection of the tumor (and parts of her pancreas), spleen, and 17 nearby lymph nodes.

But should you and I consider a full-body MRI? Today, we’ll examine the debate over full-body MRIs (and their risks).

MRI

How does a whole-body MRI work?

The device uses radio waves and extraordinarily strong magnetic fields to scan the body. The technologist obtains detailed images from the subject’s head to toe.

The image acquisition can take 40 to 60 minutes and can identify inflammation, cancer, or other concerning growths in the body.

MRI — Details

I cannot resist releasing a bit of my inner nerd. Let’s look at how MRIs work in more detail.

First, the strong magnetic field created by the MRI scanner leads to your body’s atoms aligning in the same direction.

Second, the machine sends radio waves to move these atoms out of their original position. As the radio waves are turned off, the atoms return to their original position and release radio waves.

Finally, a computer converts these radio waves into an image of the examined body part. The radiologist can view the images on a viewing monitor.

Because the scan does not use ionizing radiation, there is no radiation exposure risk with an MRI.

Should you have an MRI?

You will not be surprised that Maria Menounos’ experience has made her a strong advocate for full-body MRI.

“I’m working diligently to get this covered by insurance for people and it’s my mission,” Menounos said in an interview with TODAY. “I’m going to get it covered for everyone to have an annual scan because it just makes sense.”

However, radiologists are more skeptical of whole-body MRI for screening. Listen to Zhen Jane Wang, MD, chief of abdominal imaging at the University of California San Francisco (USA) Department of Radiology and Biomedical Imaging:

“There’s really no evidence-based findings to show that full-body MRI in a larger population will save lives.”

MRI price

Let’s start with the costs. As of 13 January 2024, a whole-body MRI with Prenuvo costs US $2499.

Do you only want the head and torso? That will set you back US $1799.

Finally, a torso-only (without additional dedicated prostate-focused imaging) MRI scan is US $999.

In the United States, the odds that your health insurance will cover the cost are greater for those with a genetic predisposition.

MRI risks

One of the biggest problems with MRIs is that they are sensitive enough to pick up subtle abnormalities that can only be clarified with additional tests. We may discover that a growth is benign (not cancer).

These added tests can lead to

• radiation exposure (for example, if a CT scan is needed to direct a biopsy needle)
• infections
• pain
• psychological distress
• financial issues.

In addition, the test may find a cancer that was so indolent that the patient would not have ever known it was there. With a cancer diagnosis, many often offer treatment (even if it is not mandatory for a very low-grade process). I call these “incidentalomas.”

Final thoughts — Navigating the Controversy: The Debate Over Full-Body MRIs and Their Risks

On the other hand, the test may save your life.

However, we should discuss wonderful stories such as that of Maria Menounos in the context of the risks I described.

Plus, given her symptoms, an MRI scan directed at the abdomen would have discovered the problem.

I am particularly intrigued with the idea of using full-body MRI scans for those who are at high risk for cancer. For example, those with particular genetic disorders might be good candidates.

The average person would benefit from a full-body MRI less than 0.1 percent of the time, under one in 1,000. Still, it might save your life.

For me, I’ll wait for higher-level evidence of efficacy.

The post Navigating the Controversy: The Debate Over Full-Body MRIs and Their Risks appeared first on Medika Life.

When a patient comes in complaining of lower back pain they want answers. They may be scared and anxious. My patients often search online for their symptoms and what that ache or stabbing in their back can mean, they read horror stories and anecdotes which heighten their dread. When they ask me what could be causing their pain they often want an MRI to confirm a diagnosis.

A good doctor who takes a detailed history, listens to you, performs a competent exam, and gives reasonable advice and a treatment plan that aligns with your goals and expectations…this approach has been well studied and there is much evidence to demonstrate it’s superiority over expensive MRI scans and cookie cutter treatments.

The Need To Know

Yet, there is the human desire to KNOW what is going on inside our bodies. There are also costs to knowing that you have a disc protrusion, or osteoarthritis, or degenerative disc disease.

What that MRI won’t tell you is that the prevalence of disk degeneration in asymptomatic individuals increases from 37% of 20-year-old individuals to 96% of 80-year-old individuals¹.

An MRI is great at showing tissue structure such as discs, cartilage, and tendons. An MRI will not show you what hurts, not definitively.

Your story, experiences, and your doctor’s exam should do a much better job in most cases in identifying the culprit. Imaging for many cases can not determine the age of these findings, sometimes providers are not skilled in identifying old versus new injuries, sometimes it is just impossible to tell. The imaging findings may correlate with your symptoms, or they may not, or they may match up with what you are feeling AND still not be the pain generator.

Say you are a runner. You’ve been running for decades and have had various minor injuries, aches, and pains. Now you are in your 50’s and your back starts hurting after a run, like it has on occasion many times over the years, but this time it lasts a little longer and is more intense than before, so you seek care with your primary doctor and they prescribe you some Ibuprofen and tell you to take it easy for a couple weeks. Two weeks pass and your back doesn’t feel much better, you go back to your doctor and they order an MRI.5 Steps To Overcome Long COVIDPost-Acute Sequelae of SARS CoV-2 infection, or PASC, is increasingly reported. Here’s what you can do to combat these…medium.com

The MRI shows a disc protrusion at L5-S1 and mild osteoarthritis at multiple levels. What the MRI doesn’t tell you is if you take 100 people without back pain off the street, on average 36 of them are going to have a disc protrusion at your age. So is the disc protrusion causing your pain? The MRI can’t tell you that, but now you know you have a disc protrusion, maybe your doctor tells you to stop running so as to not make it worse, maybe you are referred to a surgeon for an injection. There is a whole cascade of possible outcomes, none of which have been shown to be all that helpful versus a gradual return to general exercise and a wait and see approach.

All that care is very expensive though, and healthcare is a business, and lower back pain is a $100 billion a year subset of that industry.

You Can’t Unsee Your MRI

With 36% of people in their 50’s out there running around with disc protrusions and not having any symptoms, it may be hard to believe a radiologist pointed it out on your scan and it might not be important as a source of your pain.

However, many normal changes that occur with aging are routinely noted as abnormal.

Try to remember that wrinkles do not hurt, greying hair is not painful, and that rotator cuff or labrum tear, disc bulge, or torn meniscus…could just be part of the bodies normal aging process.

Find a doctor, chiropractor, physical therapist, or other licensed health care provider who takes a detailed history, performs a thorough examination, and works with you on goal setting and an individualized treatment plan.

******

Sources:

Brinjikji, W et al. “Systematic literature review of imaging features of spinal degeneration in asymptomatic populations.” AJNR. American journal of neuroradiology vol. 36,4 (2015): 811–6. doi:10.3174/ajnr.A4173

The post When Your Back Hurts, Sometimes It’s Better Not Knowing Exactly Why appeared first on Medika Life.