WHOLE BODY MRIs

A patient recently inquired about a program which offers whole-body MRIs and asked what I thought.

First, as a short-term investment I suspect it is fantastic. These businesses — and I’ve seen plenty in the course of my career — have the world’s greatest hook: Their pitch always starts with the story of someone who had an unrecognized cancer that was caught on the MRI/CT/ ultrasound/genetic test that they’re advertising.

At first glance it’s irresistible, right? Who wouldn’t want to know they’re not harboring a hidden cancer?

We could take a moment to recognize that this is an investor, not physician, run company and that our major academic radiology centers — where they study this stuff — don’t endorse these. We could compare this type of study to the goal of the MRIs we order in the course of clinical practice, which is to diagnose illness in order to intervene early enough to make a difference in someone’s life. We could also dwell on the appropriate use of scarce medical resources, and what else you, the patient, could do with the time and money invested in pursuing this program.

But let’s move on. Granted the money and time, and given that MRI machines don’t use harmful radiation, what’s the downside?

I can think of three: quality, peace of mind and medical misadventure

 

Quality

Unlike a simple study like a chest X-ray, MRI technology isn’t one size fits all. Rather, each study is specifically designed and uses a particular protocol to answer a medical question. In other words, the way a study is done to look, for example, at the bile duct, is different than the way it’s done to examine a mass on the adrenal gland. Put simply, there is no one-size-fits-all when it comes to MRIs.

Radiologists, too, are not one-size-fits-all. One of main reasons we use our particular radiology group is because they are subspecialists: A brain scan is read by a neuroradiologist, an abdominal scan by a body radiologist, etc. I would be concerned about the skill of a general radiologist who spent their time reading these (mostly boring) studies.

 

Peace of mind

Let’s address this by example: A brain aneurysm (a weak area in a blood vessel) will be found in over 3% of people. Of those 20-30% will have more than one. Most of them will never cause a problem, but some will rupture, resulting in death or significant disability. A few whose scans show an aneurysm will be able to ignore the risk, many will worry and some will have their lives

changed by the fear of imagining a ticking time bomb in their brain which could bring explode at any time.

So let’s treat it right? Which brings us to medical misadventure.

 

Medical misadventure

One of the most dangerous things in medicine is the unexpected radiology finding — and these are very common — leading to what I call the Medical Slippery Slope. It goes like this:

Doctor: I have the results of your scan. It was essentially normal. (We physicians love that word “essentially.” It means most likely normal but we’re not 100% sure.)

Patient: What do you mean by essentially?

(Doctor, to himself: I hate it when they ask that.)

Doctor: Well there was a spot on your liver we can’t explain, but it’s probably nothing. Patient: Well if it’s not nothing what could it be?

(Doctor, to himself: I hate it when they ask that.)

Doctor: As I said, it’s likely nothing. But at worst it could be cancer. Patient: Well, how do we make sure it’s not cancer?

Doctor: We could do a CT (with radiation exposure and the risk of infection that goes along with starting an IV and the risk of an allergic reaction to the dye). We could do a liver biopsy (with the risk of bleeding, liver damage or infection. And if we need to treat an infection, that puts one at risk of a different kind of allergic reaction or kidney damage. You could also get a bad GI infection from spending time in a medical facility.)

I won’t go on. I’m sure you see where this is headed: Every small step is essentially safe but carries some risk, and the more we do the more the risks add up.

 

The bottom line

Getting a whole body MRI isn’t something I would do, but I can understand why you’d want one. After all, it’s essentially safe.

But while we’re at it, may I remind you that you might be better off spending the money and time on wholesome food, a gym membership, stretching or a few moments of mindfulness meditation. These are all completely safe and are guaranteed to improve your health.

 


The information posted on this blog and website are for general information only and should never be relied on as specific medical advice for an individual reader.  No financial relationship exists between us and any recommended products or persons mentioned. All material contained here is the property of the Sheldon Sowell Center for Health, PC, and cannot be copied, reprinted, or linked to without our express permission.

Phone: 303-789-4949
Fax: 303-789-7495
1780 South Bellaire Street #700
Denver, CO 80222