This has been my experience. And I’ve had oncologists echo exactly this. In the words of one: MRIs find too much.
The CT and the PET/CT are the gold standards for finding cancer, finding recurrences, and staging cancer. The trouble is the radiation dose.
MRI provides very inconclusive results. You’ll see something but it’ll be unclear what it is. And often what you see is not even visible on a CT. Or it’s visible on a PET/CT and is showing metabolic activity indicating its cancer.
MRIs are great for certain things like herniated disks in your back. They suck at cancer.
Doctor warned me up front that the odds the images find something that looks weird is high but not to panic because of how many false positives there are when looking inside someone’s body.
While I am happy to report they didn’t find anything serious, I do take slight offense to the following at the top of my results:
Last name, First name: Unremarkable
(Kidding of course but still got a chuckle out of me)
One caveat is that regular PET isn't so good in the brain - there is so much metabolic activity that everything glows. So I get an MRI Brain to go with my regular full body PET/CT (cancer 5 years ago with recurrence 18 months later, currently NED).
My father is a part of "full body PET scan every 3 years" program as part of post - cancer treatment, and it worked twice: early detected lung and prostate tumors, both removed.
These treatments are wonderful and it is great that they exist. But many people fail to understand the difference in terms of pretest probability, etc.
I can absolutely see the heavy psychological impact pending biopsy results may have. People are quick to discount these issues when you raise them as a concern, but only if they never went through this stress themselves
> One study in 2020 found that 95% of asymptomatic patients had some type of "abnormal" finding, but just 1.8% of these findings were indeed cancer.
So a bit less than 1.8% of the time in this study
> Prenuvo's recent Polaris Study followed 1,011 patients for at least one year following a whole-body MRI scan. Of these patients, 41 had biopsies. More than half of the 41 were diagnosed with cancer.
That's 2.0%
Note that this doesn't mean that 1.7~2.0% of people have cancer without knowing it. It could be more:
> A negative scan doesn’t mean you’re disease-free. Some cancers and conditions simply aren’t visible yet or aren’t reliably detected on a one-time full-body MRI."
But also perhaps less, in a way:
> "You're finding something that never would have caused you any problem in your life, and in cancer, we call that overdiagnosis," Vickers says.
It found a weird spot on me that turned out to a pancreatic rest.
The only reason we did the scans were because we were making a significant life decision that we didn’t want to have to backtrack if either got diagnosed with cancer within a year . We knew nothing was guaranteed but we wanted to do some tests.
Is it though? Isn't it possible you could be early-detecting something serious that is much easier to treat now vs when symptoms appear?
Nothing in medicine comes for free—everything is a tradeoff.
It could be. It could also be the cade that you undergo invasive surgery for something that would have never caused you problems within your life. The problem is that cancer isn‘t cancer. Even if it originates from the same tissue, some tumors behave very different from others.
So if you have abnormal findings in 10% of patients that merit follow-up scans, you can trivially do a series of 3-4 scans without affecting the overall cost too much.
Doctors simply need to get out of the headspace where MRIs are extremely scarce tools of last resort and treat them like we treat blood tests.
Maybe I don't want to look for cancer right now but if I spend $1,000 every 5 years to take an image for later use... isn't that useful?
(for some people that question may not apply, of course, but at a population level it does, and we have population-level questions about effective use of MRI time.). And if there's something better, you should spend it on that and then ask the question _again_. So it could be that getting a whole-body MRI is something like $30k down the list of best ways to spend money for improved health.
I'm not sure what the best use of $1k is from a health standpoint is, just noting that it's good to have a comparator.
Let everyone who wants to pay get their scans! But don’t make me pay for you
2. i can afford the money for the chance of early detection. Many cancers are symptomatic only in the latter stages. It does not hurt to check.