Calvin Sun was a healthy 37-year-old when a full-body MRI scan showed a cyst in his kidney. Sun saw a urologist who was cautiously optimistic that it wasn’t cancerous and offered him a surgery appointment several weeks away to inspect the kidney and operate if necessary. “I was like, how about tomorrow?” Sun recalls.
As an ER doctor, Sun is used to decisive problem-solving. It’s the “right mindset” for undergoing a whole-body MRI, he says. “You have to be willing to take 100% responsibility for the consequences, good and bad.”
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Instead of traditional scans, like CTs or MRIs of a specific part of the body, full-body MRI scans require just an hour to image you from head-to-toe. Celebrities and influencers are holding them up as a pillar of preventive health to catch problems early on, wherever they’re hiding—before they become hard-to-treat diseases. Dwyane Wade, for example, recently credited a whole-body MRI with alerting him to an early-stage kidney cancer.
However, most medical experts are more wary. “The odds that you’re going to be hurt are higher than the odds you’re going to be helped,” says Dr. Matthew Davenport, professor of urology and radiology at the University of Michigan.
Here’s what to know about this relatively new technology—both its promise and shortcomings.
What is a full-body MRI scan?
First offered in the early 2000s, a whole-body MRI is like looking at a city from a distance, says Dr. Heide Daldrup-Link, professor of pediatric oncology at Stanford. “You might always find a high-rise building, but you won’t find a spider,” she says.
With this panoramic view of the body, doctors may spot big problems, like a large tumor. “But we can very easily miss small tumors” without scans that zoom in, Daldrup-Link explains. CTs or organ-specific MRIs are needed to fully investigate health issues like cancer and most brain abnormalities, she says.
An advantage of whole-body MRIs over CTs is that they use magnets and radio waves, which eliminate the type of radiation linked to cancer. But that doesn’t mean they’re risk-free or the right choice for everyone, Davenport says.
Who benefits?
For nine years, Dr. Dan Durand oversaw an outcomes-focused health care network in Baltimore’s poorest neighborhoods. Some people are incredulous, he says, that he’s now the chief medical officer at Prenuvo, a company specializing in whole-body MRIs starting at $2,500 a pop (and not covered by insurance for the average, symptom-free person).
But Durand and others view whole-body MRIs as key to the future of health for everybody, not just rich bodies. “We’ll look back on whole-body MRIs the same way as your cell phone or computer,” he says.
They’re already beginning to change health care, he says, by detecting “silent killers lurking,” like aneurysms or cancers. “We can find Stage I cancers before symptoms appear,” he says. The technology is advancing, becoming faster and more accurate.
Read More: What to Do If Your Doctor Doesn’t Take Your Symptoms Seriously
Daldrup-Link agrees that whole-body MRIs can “detect diseases in early stages.” Dwyane Wade’s case “may underscore the potential benefits of early cancer detection.” But the patients who benefit most have unique risks, such as people born with certain genetic syndromes that cause random cancers throughout the body. “Whole-body scans are really helpful” to identify these cancers, she says.
Such syndromes are relatively rare, though Daldrup-Link gives about two whole-body scans per week and sees a wide variety of cancer predispositions like Li Fraumeni syndrome and retinoblastoma.
Full-body MRIs provide information about some other conditions besides cancer and brain pathologies, she notes, like certain skin and muscle infections, and disorders involving abnormal blood vessels.
People with such known conditions or risks get “even more value” from the images, Durand says, but this type of MRI can raise awareness about anyone’s state of health, he adds. His own scan picked up on joint inflammation and damage, which he’s now treating to keep in check.
They can also show excess visceral fat before heart disease and other chronic illnesses develop. Such findings provide benchmarks for tracking how interventions are working. Prenuvo recommends adults under age 40 get scans once every two years if their first scan didn’t show a problem. If you’re older or your first scan did find an issue, the company advises scans yearly or even more often. However, these are just the company’s recommendations; major medical groups do not currently recommend whole-body MRIs for the general population.
The drawbacks
If you have no symptoms or unique risks, the drawbacks of whole-body MRI scans outweigh the benefits of early detection, some experts have found. “Metaphorically, you could go to Vegas and win the jackpot,” Davenport says, “but the average expected result is losing money, especially if you’re gambling regularly.”
Sun, the ER doctor, had no family history of cancer. He exercised, ate a plant-based diet, and was “super healthy.” When his Prenuvo scan found the cyst—and a more targeted follow-up MRI showed it in more detail—he knew it might still mean nothing. Even so, he persuaded his doctors to expedite surgery to avoid “spending months stewing and ruminating” about worst-case scenarios.
His care team prepared to potentially remove a small part of his right kidney as a precautionary measure. Every expectation was that it would be benign.
When Sun woke up five hours later, he learned the kidney was “completely gone,” he says. The surgeons removed it because they thought the surface looked malignant.
Read More: What to Expect at Cataract Surgery
Sun had no complications from surgery, but at 37, he recognizes he’s less vulnerable than some. Older people tend to be less protected due to age-related changes. Having an unnecessary surgery, which could involve serious consequences, is one risk Davenport cites. “Every time someone does an endoscopy, biopsy, or surgical procedure, risks include a bleeding complication or difficulty with anesthesia,” he says. “It can be life threatening.”
Davenport is underwhelmed by the potential benefits, at least for people without any known health issues. About 15-30% of whole-body MRIs show a red flag, but the vast majority of these concerns end up being nothing to worry about. Even when cancer is ultimately removed, it’s often unclear if it would’ve grown or how fast. “Both patient and doctor are happy because they found cancer early, but 15 years later, when you look at the data, it didn’t improve mortality,” Davenport says.
Larger studies are needed, and several are tracking how interventions based on whole-body-MRIs contribute (or not) to longer, healthier lives. But researchers must follow people for decades to see a survival benefit. Without more evidence, the leading associations of radiologists, the American College of Radiology and the Radiological Society of North America, haven’t recommended whole-body MRIs for the average healthy person.
Another risk is giving someone a false sense of reassurance after full-body MRIs come back clean. It’s a mistake to then assume that health screening measures, like colonoscopies, aren’t necessary. Full-body MRIs show some organs better than others. “The kidney and liver are very well depicted,” Daldrup-Link says, but the scans less reliably image colon cancer, lesions in the prostate, and small lung cancers. “That’s a big caveat,” Daldrup-Link says.
Durand agrees, while noting that recommended screenings can’t catch everything. “Whole-body MRIs don’t replace primary care doctor visits and consensus-based screenings. They’re on top of these screenings.”
The mental health consequences of full-body MRI scans
Sun was shocked and worried to learn his kidney was removed. “What if they literally took out my kidney for no reason?” he kept thinking.
Yes, the organ had looked diseased, but a biopsy would need to confirm that. Thus began a week of agonizing over the possibility that it wasn’t cancer. “That is the danger of doing full-body MRIs,” Sun says.
Read More: The Race to Explain Why More Young Adults Are Getting Cancer
The results of full-body scans are frequently hard to interpret, difficult to act upon, and detrimental to mental health, Davenport says. “Someone who identifies as a normal, healthy person is quickly converted into a patient,” even though they might be perfectly healthy. “This creates anxiety that is meaningful and measurable.”
A week after surgery, Sun got the call. “I don’t know what possessed you to get that scan,” his surgeon told him, “but you saved your life. It was an aggressive cancer.”
Sun felt reassured. At least his kidney hadn’t been robbed without justification. Then confusion and sadness sunk in as his identity suddenly reconceptualized as both a cancer patient and survivor. How could this happen to a healthy 37-year-old?
Alternatives to full-body MRI scans
Maybe a line can be drawn in the sand dividing people with high cancer risk and people without such risk, but it’s wind-swept and covered with footprints. Cancer is often caused by interactions between various genes and environmental factors, and many of them aren’t well understood. “We will never know with 100% precision which patients are most at risk,” Davenport says.
The mysterious rise of cancer in young adults is the subject of myriad theories and debates. Relatively few people have been diagnosed with genetically-rooted cancer syndromes, yet scientists are “constantly discovering new types” of these syndromes, Daldrup-Link says.
To better understand your personal risk for cancer and other diseases, speak with your doctors about family history. Regular blood tests can show elevated markers associated with diseases and genetic risks for cancer and heart disease. (Sun’s test, however, showed no genetic risk.) This information may warrant individualized, targeted screening, including detailed CTs of relevant organs.
Meanwhile, the technology for whole-body MRI scans continues to improve. “The genuine interest to want to know what’s inside the body is totally understandable,” Davenport says. “Whether you get a whole-body MRI is a personal decision, but it’s important to consider the risks as well as potential benefits.”