Do you need a whole body MRI scan? Probably not, experts say

June 2, 2023 – Last month, journalist and actor Maria Menounos told People who had been diagnosed with pancreatic cancer after a full-body MRI scan.

The scan had discovered a 1.5-inch mass on her pancreas after CT scans and other tests failed to find a problem. A biopsy confirmed that the mass was a stage II pancreatic neuroendocrine tumor. In February, she underwent surgery to remove the cancer, part of her pancreas, her spleen and 17 lymph nodes.

“I want people to know there are places where they can catch things early,” said Menounos, 44, who was diagnosed with a brain tumor in 2017 and type 1 diabetes last summer. People. “You can’t let fear get in the way. I had that moment where I thought I was a goner — but I’m fine because I caught this early enough.”

Now, Menounos’s mission is to convince insurance companies to cover full-body MRI scans for everyone. But medical organizations, as well as experts in oncology, radiology and health psychology, say the evidence doesn’t yet prove that these imaging procedures can give people the peace of mind they want or the information they need to avoid health problems.

The problem is that whole-body scans carry the risk of false-positive findings that could lead to unnecessary and potentially invasive follow-up tests and procedures that are not only costly, but fear-inducing, he said. Christopher Hess, MDchair of the Department of Radiology and Biomedical Imaging at the University of California, San Francisco.

The chances of a whole-body MRI finding a serious condition that is treatable are much less than your risk of dying in a car accident (1 in 93 people in their lifetime, according to the National Security Council), drown while swimming (1 in 1,006 people), or be seriously injured by falling down stairs (37.8 per 10,000 people in the United States), Hess said. In addition, the problems these scans often discover are in the “spectrum of normal” that typically do not require treatment, such as small brain aneurysms.

Additional tests using CT scans and positron emission tomography (PET) can also expose people to radiation increase their risk of cancer later in life, the American Academy of Family Physicians said in a statement discouraging the use of whole-body scans for early cancer detection in people who have no symptoms. Some procedures can also cause complications, Hess said. For example, a biopsy of a small kidney lesion, which normally does not require testing, can cause internal bleeding.

Researchers estimate that tumor detection is less than 2% in people without symptoms who get a whole-body MRI. But using the scans as a preventative health measure is evolving, said Resten Imaoka, MD, a musculoskeletal radiologist at Washington University School of Medicine in St. Louis.

A 2021 study published in the European journal of radiology found that one-third of 576 whole-body MRIs showed clinically relevant findings,” of which 2.6% were cancer. Imaoka says these numbers are “significantly higher” than previous research, suggesting the scans could be used with other screening methods for people without symptoms. (The study also found that 16 people studied – 2.8% – had false negative findings – scans that initially revealed no cause for concern – five of which turned out to be cancer.)

Whole-body MRIs may be helpful and even preferable in certain circumstances, Imaoka said. People with Li-Fraumeni syndrome — a rare genetic condition that makes people more likely to get many different cancers — could benefit from the scans because their entire body is threatened by disease. These scans are also helpful in detecting multiple myelomabut not so much for the early detection of colon, skin, breast, thyroid, lung and most other cancers, Hess said.

Blood-based tests may be a more useful cancer screening tool for the average person, Hess and Dahut said, because they are easier to perform than MRIs. Several have already been approved by the FDAalthough most are used in conjunction with other screening procedures such as mammograms and colonoscopies.

If you’re healthy and find you can’t stop thinking about the possibility of getting sick—which puts you in the category of the “worried pit”—seeking procedures like full-body MRIs may only bring temporary relief. and perhaps more stress, said Natalie Dattilo, PhD, a clinical psychologist and psychology instructor at Harvard Medical School in Boston.

“It doesn’t solve the root of the problem. In therapy, you work on a greater tolerance for uncertainty, becoming more comfortable with the unknown and potentially unpleasant, while gaining confidence in your ability to handle anything, even a serious illness,” she said. “Anxiety does not arise from the feared thing itself, although it certainly can be distressing, but from the fear of not knowing, or its uncertainty and unpredictability.”