Whole Body MRI Can Be Beneficial Until It’s Not

Advances in technology and more attention to preventative health care—and social media endorsements from celebrities—have led people to explore whole-body MRI. The question is whether or not this is the promising health care solution many people are searching for.

That may be the wrong question, according to Daniel K. Sodickson, MD, PhD, chief of innovation, Department of Radiology at New York University and principal investigator at NYU’s Center for Advanced Imaging Innovation and Research (CAI2R).

Dr. Sodickson argued in favor of the scans during a debate session on Thursday. Though he is not an evangelist on the use of the technology in this way, Dr. Sodickson suggested that the conversation focus on health monitoring and how radiologists play a role in that future.

“I am committed to engaging in this debate primarily because I am concerned that we may be debating the wrong things,” Dr. Sodickson said. “Some people in the radiologic community are singularly focused right now on demonstrating the inadvisability of whole-body MRI as it currently exists, rather than treating its advent in the market as a stimulus to consider how imaging-based health monitoring might become a practical reality.”

He said the term “whole body MRI” can raise alarms for people when the point is not about full body coverage, but early warning.

“After more than a quarter century of developing and using medical imaging devices, I am frustrated that we still use these devices by and large only when we already know you are sick,” Dr. Sodickson noted.

Saurabh Jha, MBBS, MRCS, associate professor of radiology at the University of Pennsylvania, Philadelphia, argued against the idea of whole-body MRI screenings during the debate, raising concerns about overdiagnosis and doing more harm to patients than help.

He referenced South Korea’s thyroid cancer “epidemic” which occurred when the country implemented widespread US screening for thyroid cancer. Increased screening meant rates of thyroid cancer in South Korea increased 15 times over between 1993 and 2011, but mortality remained stable because many of the cancers being detected were very small or slow growing and would not have caused health problems for the patients. 

“The better we get at detecting, we don’t necessarily get better outcomes, we just get better at finding things,” Dr. Jha said.

Dr. Jha’s position is supported by the American College of Radiology (ACR), which issued a statement on the topic in 2023, in part stating that there is not sufficient evidence to justify recommending total body screening for patients with no clinical symptoms, risk factors or a family history suggesting underlying disease or serious injury.

Dr. Sodickson works as a scientific advisor for Ezra, a company which uses whole body MRI to provide early warning for cancer, but said he was not always in favor of the technology.  

“The future of proactive health is coming, and yet, despite the rich information content of our imaging modalities, we are not positioning ourselves to play a central role in that future,” he said. “Rather than simply activating our field’s well-intentioned conservative instincts to make sure things aren’t being done wrong today, I would like to engage the creativity of our field in figuring out how to do health monitoring right, for the benefit of everyone.”

What is your stance on whole body MRI? #RSNA24

— RSNA (@RSNA) December 5, 2024

Access the presentations, “Against Whole Body MRI,” (R4-CNPM16B) and “In Favor of Whole Body MRI,” (R4-CNPM16C) on demand at RSNA.org/MeetingCentral.