June 2, 2023 – Last month, journalist and actor Maria Menounos told People that she’d been diagnosed with pancreatic cancer after having a full-body MRI scan.
The scan had detected a 1.5-inch mass on her pancreas after CT scans and other testing couldn’t find a problem. A biopsy confirmed the mass was a stage II pancreatic neuroendocrine tumor. In February, she had surgery to remove the cancer, part of her pancreas, her spleen, and 17 lymph nodes.
“I need people to know there are places they can go to catch things early,” Menounos, 44, who was diagnosed with a brain tumor in 2017 and type 1 diabetes last summer, told People. “You can’t let fear get in the way. I had that moment where I thought I was a goner – but I’m OK because I caught this early enough.”
Now, Menounos’s mission is to convince insurance companies to cover whole-body MRI scans for everyone. But medical organizations, as well as experts in oncology, radiology, and health psychology, say the evidence does not yet prove these imaging procedures can give people the peace of mind they want or the information they need to prevent health issues.
“We do think a world in which screening is personalized and adaptable over time is an aspirational goal. At this time, there are specific imaging screening recommendations for folks with specific inherited, genetic mutations such as BRCA2,” said William Dahut, MD, chief scientific officer for the American Cancer Society, referring to a mutation known to cause breast cancer. “This is different, however, from a full-body MRI scan.”
MRIs typically focus on one organ or area of the body and require referrals from qualified medical professionals. But now, private companies, per your request and for a hefty price, will scan your entire body, even if you don’t have symptoms or concerns.
Whole-body scans use powerful magnets and radio waves to produce 3D images of your organs, tissues, and skeletal system without the use of radiation. Companies like Prenuvo, VitalScan, and simonONE say their scans – which cost from about $500 to $2,500 – can detect hundreds of medical conditions, including early-stage cancers.
The problem is that full-body scans carry a risk of false-positive findings that can lead to unnecessary and potentially invasive follow-up testing and procedures that are not only expensive, but also anxiety-inducing, said Christopher Hess, MD, chair of the Department of Radiology and Biomedical Imaging at the University of California, San Francisco.
The likelihood a whole-body MRI finds a serious condition that’s treatable is far lower than your risk of dying in a car accident (1 in 93 people over their lifetime, according to the National Safety Council), drowning while swimming (1 in 1,006 people), or being seriously injured from falling down stairs (37.8 per 10,000 people in the United States), Hess said. Plus, the issues these scans often discover tend to be on the “spectrum of normal” that typically do not require treatment, such as small brain aneurysms.
Additional testing with CT scans and positron emission tomography (PET) can also expose people to radiation that may raise their risk of cancer later in life, the American Academy of Family Physicians said in a statement that discouraged the use of whole-body scans for early cancer detection in people who don’t have symptoms. Some procedures could cause complications as well, Hess said. For example, a biopsy of a small kidney lesion, which normally wouldn’t need testing, could cause internal bleeding.
The American College of Radiology also opposes the practice. “To date, there is no documented evidence that total body screening is cost-efficient or effective in prolonging life” in people with no symptoms, risk factors, or family history of disease, the group said in a statement posted in April. The FDA released a similar statement in 2017 regarding full-body CT scans, saying no evidence indicates such procedures provide “more benefit than harm.”
Exceptional Case
Experts agree that Menounos’s case is the rare exception to the rule. Although CT scans and other testing appeared normal, she kept having severe belly pain and diarrhea. The extra imaging she sought “was certainly logical and as it turns out necessary,” Dahut said, although an MRI of just her belly would have sufficed. Still, early-stage pancreatic cancers can often be difficult to find on routine scans.
Researchers have estimated that tumor detection is less than 2% in people without symptoms who get a whole-body MRI. But the use of the scans as a preventive health measure is evolving, said Resten Imaoka, MD, a musculoskeletal radiologist at the 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,” 2.6% of which were cancers. Imaoka says these numbers are “considerably higher” than those of past research, suggesting that 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 did not at first reveal cause for concern – five of which proved to be cancer.)
Whole-body MRIs can be helpful and even preferred in certain circumstances, Imaoka said. People who have Li-Fraumeni syndrome – a rare genetic disorder that makes people more likely to have many different cancers – may benefit from the scans because their entire bodies are threatened by disease. These scans are also helpful in detecting multiple myeloma, but 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’re easier to perform than MRIs. Several have already been approved by the FDA, although most are used along with other screening procedures like mammograms and colonoscopies.
If you’re healthy and find you can’t stop thinking about the chance of being sick – putting you in the category of the “worried well” – seeking procedures like whole-body MRIs may only bring temporary relief, and maybe more stress, said Natalie Dattilo, PhD, a clinical psychologist and psychology instructor at Harvard Medical School in Boston.
“It doesn’t fix the root of the problem. In therapy, you work to build a greater tolerance for uncertainty, get more comfortable with the unknown and potentially unpleasant, while gaining confidence in your ability to handle anything, even a serious illness,” she said. “Fear stems not from the feared thing itself, although it can certainly be upsetting, but from the fear of not knowing, or the uncertainty and unpredictability of it.”