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Having a body is scary. You don’t know what kind of problem might be lurking in your organs or arteries, waiting to ambush your health. But what if there was a simple test that could tell you immediately if you had any tumors, aneurysms or other abnormalities before you had symptoms? Enter: whole-body MRIs, which scan your body from your head to (almost) your toes, giving you a comprehensive look at your body and its major organs.
Several companies are now offering these scans commercially and have racked up endorsements from celebrities like Kim Kardashian. They’re now available in many U.S. cities, including Seattle, for anyone willing to shell out thousands of dollars.
Will whole-body MRIs allow you to feel more in control of your health, or just give you more to worry about? Before you splurge on one, here’s what you need to know about whole-body MRIs.
What are whole-body MRIs?
Radiologists have used magnetic resonance imaging for 30 years. According to Dushyant Sahani, MD, chair of the Radiology Department at UW School of Medicine, it is a particularly good imaging test for making high-resolution and high-contrast images of soft tissue structures like the brain; other organs, like the liver, pancreas and kidneys; cartilage and ligaments in and around the joints; and the heart and blood vessels. It’s an important tool for diagnosing a wide array of conditions, including tumors, organ injuries, vascular abnormalities like aneurysms, potential sources of epilepsy and changes from Alzheimer’s disease.
And in recent years, the technology has improved significantly. Radiologists can now create a comprehensive picture of the whole body in just an hour or two.
“Before you could just scan the head or you could scan the abdomen or the chest, but now there’s technology where you can actually stitch these images together and take a look at the whole-body together,” says Manjiri Dighe, MD, medical director of Ultrasound at UW Medicine and a professor of radiology at the UW School of Medicine.
These advances have occurred alongside a wellness obsession with tracking health using watches, rings and even glucose monitors. In response, companies have started selling commercial whole-body MRIs, claiming they offer the most detailed picture of your health and can catch tumors before they spread or aneurysms before they rupture.
Should I get a whole-body MRI?
It turns out, though, that many healthcare organizations, including UW Medicine, recommend against it. While many hospitals also have the ability to do whole-body MRIs, they only prescribe them to targeted patient populations in very specific situations.
There are a few reasons why they’re not recommended:
It is often unnecessary
If you go onto the websites of the companies offering whole-body MRIs, they list hundreds of diseases and conditions that their scans can detect. There’s a catch though: You don’t need an MRI to diagnose the vast majority of them because you’ll know if you’re experiencing them.
“Things like atrophy of the kidney, bladder polyps, bursitis of the knee, you’ll have symptoms, you don’t need the whole-body MRI to discover this,” says Natalia Usoltseva, MD, the physician lead for best practices in population health for UW Medicine Primary Care and the medical director at UW Medicine Primary & Urgent Care at Ballard.
And when you visit your doctor for the pain or discomfort you’re having, they will then order specific tests to diagnose it, not a whole-body MRI.
“If a patient has, say, blood in their stool, that needs a very specific exam to be done to look at it,” says Dighe. “They shouldn’t actually go get whole-body MRIs done because that’s not the right exam for them.”
Even if a person is at high risk for pancreatic cancer or liver disease, for example, their doctor will likely order targeted imaging, not whole-body scans. There is currently no evidence that getting whole-body MRIs improves health outcomes or prolongs the lives of people who get them.
Incidental findings
One reason scanning the whole-body is often not a good idea is that it very likely will turn up incidental findings. These are spots, nodules, cysts and other abnormalities that turn out not to be harmful.
One review of studies looking at whole-body MRIs found that 95% of the 6,214 patients in these studies had an abnormal finding but only 1% ended up having malignant cancer.
The problem is that each of those findings has to be looked at to confirm it is benign.
“From head to toe, it might pick up things in the brain, in the thyroid, in the lymph nodes, in the chest, somewhere in the abdomen and pelvis, and we’ll end up chasing a lot of these things and getting sucked into a rabbit hole of doing more investigation and even interventions,” says Sahani.
This means a whole cascade of steps from further imaging to biopsies and other procedures, which could unleash a flood of testing onto already resource-strapped healthcare organizations.
“If everybody gets a whole-body MRI, and we keep finding these incidental things and they get investigated, you can understand the amount of burden we would have on the healthcare system as a whole,” says Dighe. “So maybe there’s a patient who has a cancer who’s getting treatment, and they need an MRI to be done earlier, but they will not get it just because of the amount of workload that we have.”
Increased anxiety
Worriers out there: you might wonder if whole-body MRIs could help with your health anxiety, but the reality is there is a high likelihood that getting these scans will actually make it worse.
Even if you intellectually know that most abnormalities found in whole-body MRIs are benign, once you’re aware they exist, it introduces the idea that it could be something bad. And because further testing and diagnostics might take a while, you’re going to need to sit with that uncertainty and stress.
“Even if you are in perfect health, getting into this machine feels like something is wrong with you,” says Usoltseva. “So it can actually exacerbate anxiety instead of giving peace of mind for some individuals.”
False confidence
On the other hand, whole-body MRIs that come back without any concerning findings can give you a false sense of security. Some cancers are difficult to detect with a standard whole-body MRI scan or require different kinds of imaging altogether. In the case of breast cancer, for example, traditional mammograms and dedicated breast MRIs (for high-risk patients) are the best tests to use. Whole-body MRI exams often lack intravenous contrast, which is nearly essential to diagnose breast cancer.
There’s no guarantee a cancer won’t appear afterwards.
“It’s not known what frequency you should get whole-body MRIs,” says Usoltseva. “If you do it today, we are giving you clean bill of health, but if we do it tomorrow, next week, two years, five years, will we have different results?”
In short? A clean scan doesn’t automatically mean future good health.
Do these things instead to stay on top of your health
There are many other things you can do to prevent sneaky health issues. Here are some of the big ones.
Schedule your annual exam
It’s tough to get a primary care appointment these days, but try to get on your doctor’s schedule for wellness exams, where your doctor can order tests that are most likely to benefit you.
“There are other diagnostic tests and lab tests that are far more sensitive for picking up certain things,” says Sahani. “For example, we might use an ultrasound for symptoms a young woman is having or if I have a familial risk of cardiac disease, I might get my cholesterol checked and make sure my blood pressure is okay.”
Stay on top of your cancer screenings
They’re not sexy, but exams like colonoscopies and pap smears are evidence-based ways to catch cancer early and increase the chance it’s treatable. Some cancer screenings, like prostate-specific antigen tests, only require a simple blood test.
Get genetic testing
If the reason you’re worried about getting cancer is that other people in your family have gotten it, you can get tested for genetic variants that increase your risk for cancer — just make sure to go to a qualified genetic counselor and get a medical-grade test, as direct-to-consumer DNA tests are often not reliable. If you do have a hereditary cancer syndrome, then that might actually be a case where your doctor recommends whole-body MRIs, though there are many other more targeted screenings that they’re more likely to suggest.
Make healthy choices
Last but not least, we know more than ever about how our lifestyles, including our diets, our drinking habits, our sleep quality and the amount of exercise we get, affect our health.
“The basic stuff is proven to work. It’s diet, exercise, quality of sleep, avoiding tobacco, alcohol, maintaining peace of mind and being happy in life,” says Usoltseva.
It can be tempting to have a test that catches a harmful disease early or make sure something isn’t missed, especially when access to healthcare is challenging. But the reality is, the chances are much higher that a whole-body MRI will find something that’s not concerning in the end.
“I don’t want to be the judge for whether someone gets one or not, those are personal decisions,” says Sahani. “But I want them to be careful both with their decisions and with their dollars.”
