Full-body MRI scans have been available for years. But recent technological improvements and subsequent drops in price have made them much more widely available.
“MRI” stands for “magnetic resonance imaging,” and a standard MRI scan works through a combination of magnetic fields and radio waves. A resulting scan looks like this.
Prenuvo cofounder Raj Attariwala spent a decade developing custom software to build full-body MRI scan accuracy.
ANITA LEE
The entrepreneurs of Silicon Valley have made no secret of their desire to live forever. Elon Musk and Peter Thiel have been famously public about going after immortality. Jack Dorsey started intermittent fasting as part of his desire for longevity. Google’s Alphabet even founded Calico Labs to “harness advanced technologies and model systems” to better fight aging, according to the company’s mission statement.
Full-body MRI scans have been available for years. But recent technological improvements and subsequent drops in price have made them much more widely available.
Courtesy of Prenuvo
This obsession with biohacking has spread in the form of wearable fitness trackers, hyper-specific supplements, and health concierge services. The Signos app provides diet and exercise recommendations via continuous glucose monitoring. Everlywell offers tests that give information about gut biomes and possible food allergies. And full-body MRI scans promise to screen for a panoply of ills — promoted by the likes of Kim Kardashian and Maria Menounos, who in 2023 announced that one such scan had turned up stage 2 pancreatic cancer.
At first, the recent surge in popularity and availability of full-body MRI scans might seem like the province of those “crazy Silicon Valley immortality people,” says veteran tech journalist Fred Vogelstein, who has covered tech culture for decades for Wired and Fortune magazines. But he sees another dynamic at play. “About five to seven years ago, we got to the point where you could have your entire genome sequenced for less than $1,000,” he says.
Now, MRI technology is reaching a similar point. And when increasing appetite for health data coincides with significant leaps in technology and drops in price, things are bound to get a little bit complicated. The Gazette talked to some experts to gain clarity.
“MRI” stands for “magnetic resonance imaging,” and a standard MRI scan works through a combination of magnetic fields and radio waves. Though standard MRIs can sometimes be used for diagnoses, full-body MRIs can only point to possible trouble spots for further investigation. Anything serious will require follow-up testing — an ultrasound, biopsy, CT scan — for a conclusive and useful diagnosis.
Full-body MRI scans have been available for years. But as with genetic testing, recent technological improvements and subsequent drops in price have made them much more widely available. The cofounder of Redwood City–based Prenuvo Raj Attariwala, MD, PhD, reportedly spent a decade developing custom software to build full-body scan accuracy; coil technology within the machines themselves has also improved, as has post-scan image recognition power. All this has led to lower prices: Scanning company Ezra, which has a location in Presidio Heights, has said it hopes to offer a $500 15-minute full-body scan in the near future (much less than its current $2,350 price). And competitor simonONE currently offers 30- and 45-minute options with prices around $650, a price point that is among the lowest on the market.
At the parent company of simonONE, SimonMed Imaging, chief medical officer and radiologist Barry Sadegi, MD, points to a long list of diagnoses that have stemmed from the company’s scans as proof of their potential, from brain aneurysms and tumors to growths in the kidney, liver and pancreas to enlarged lymph nodes and signs of fatty liver disease, which can lead to fibrosis if left untreated but can be reversed with diet and exercise. (Patients often know they should make lifestyle changes, but seeing it on a scan can be the push they need, he says.)
“MRI” stands for “magnetic resonance imaging,” and a standard MRI scan works through a combination of magnetic fields and radio waves. A resulting scan looks like this.
Courtesy of Prenuvo
Prenuvo’s CEO, Andrew Lacy, started the company after having his own full-body scan. “I felt an immense weight lifted off of my shoulders,” he tells the Gazette. “The peace of mind was indescribable.” He and Sadegi hope their companies will help move American medicine from a treatment-centered approach that Prenuvo refers to as the “sick care system” to the kind of preventive paradigm more common in countries like China and Japan. They argue that the experience of losing a loved one to cancer caught too late has become all too common and that full-body MRIs should be used as a screening tool similar to a colonoscopy or mammogram. Prenuvo’s scans alert 1 out of 20 patients to “potentially lifesaving diagnoses,” Lacy says.
Still, there’s a difference between a “potentially life-saving diagnosis” and an actually lifesaving one. This is where Vogelstein sees parallels with genetic testing, where patients have sometimes struggled with a sudden glut of information that did not always provide the hoped-for benefit. “Most people assume that no matter what answers you get from testing, they will add to your knowledge base,” he says, “and it actually turns out that that is often not the case.”
For that reason, as full-body MRIs have become more common practice, critics like physician Joann Elmore, MD, a professor of medicine at UCLA, have started to speak out against them. “You might be trying to live longer and healthier, but there’s no data to show it will help,” Elmore says of the scans.
Whereas Lacy found profound peace of mind in his full-body scan, many patients experience the opposite, she argues. One issue: A 2019 meta-analysis of the scans of more than 5,000 asymptomatic people found that 16 percent showed false positive results. But beyond that, MRIs often pick up on more subtle changes in our bodies that will never actually impact our lives. Some doctors refer to these blips, which might stay unchanged or even disappear over time, as “incidentalomas.” They can lead to a cascade of further tests and expense — including CT scans that expose patients to harmful radiation and biopsies that can cause perforations, bleeding and infection.
Patients are required to lie completely still during the MRI exam.
Courtesy of simonONE
Even in the case that a blip turns out to be cancer, it may not ever grow, but modern medicine doesn’t know enough to determine that. “Because we can’t tell, understandably everyone undergoes treatment,” Elmore says — treatments that themselves can be deeply traumatic for the body. “But in many cases, an individual would have had it in their body for decades, and it wouldn’t have harmed them.”
Elmore also warns that there’s more variability than we might realize in the interpretation of test results. “There’s a lot of subjectivity here, and there’s a lot of money to be made,” she says. She and her coauthors explored the topic in a 1994 study in the New England Journal of Medicine, wherein they showed the same mammograms to 10 different radiologists and recorded the widely varying results.
For all these reasons, the American College of Radiology released a statement in April 2023 recommending against full-body MRIs. “There is no documented evidence that total body screening is cost-efficient or effective in prolonging life,” they wrote.
Prenuvo takes all this criticism in stride as part of the process of introducing new health technology. In interviews, Lacy has compared full-body MRIs to mammograms, which gained popularity in the 1960s but weren’t endorsed by the American Cancer Society until 1976 and weren’t covered by insurance until the 1990s.
Navigating this gray area during a period when scientific research and policy may lag behind technology can be very challenging, says Vogelstein, who recently helped edit an op-ed on this topic for the Los Angeles Times. On the one hand, the falling cost and widening availability of genetic testing led to a flurry of new medical innovation, such as gene therapies to treat cancer and other ailments. But when patients suddenly have access to medical knowledge that was once harder or more expensive to get, there often aren’t yet guardrails to protect them from possible consequences — especially because follow-up testing is so lucrative. That can be challenging for doctors too. “It’s harder to say to somebody, especially if they have good insurance, ‘I’m saving you from going down this rabbit hole,’” he says.
Sadegi cites this dynamic as a challenge of working in the full-body MRI industry. He says he understands ACR’s stance and the possible drawbacks of these scans. But “it’s a little hard to tell a patient not to get this done,” he says. “They want to find out what’s going on.” With all the pros and cons in mind, he suggests that people prone to health anxiety consider carefully before getting a scan.
Instead of traversing this particular frontier of health hacking, Elmore encourages her patients to focus on tried-and-true preventive measures, such as a balanced diet, exercise and good quality sleep. She also urges them to bring any worries about new symptoms or family histories of cancer to their primary care physicians, who will help them think through their testing options.
And everyone interviewed for this article emphasized that full-body scans should not stand in for other, more conventionally established, screenings. For all their strengths, these scans are “notoriously less than optimal,” Sadegi says, for detecting lung nodules, cannot see into the inside of the bowel, cannot screen for leukemia, and are not as good as mammography for spotting breast cancer. “We always give those caveats,” he continues. That means that a full-body MRI does not replace mammograms, lung CTs, colonoscopies, or prostate cancer screenings, he stresses. At least, that is, until Silicon Valley changes the game once again.
