Elective MRI Screening of the General Public—Buyer Beware

Elective MRI Screening of the 
General Public—Buyer Beware.

I saw an article by Matthew Davenport and Scott Reeder published recently in JAMA (The Journal of the American Medical Association) titled “Elective MRI Screening of the General Public—Buyer Beware.” My initial reaction was “oh no, not more nonsense about the health risks of static magnetic fields!” Fortunately, that’s not what the article is about. No risks from exposure to magnetic fields are mentioned. So, what’s the problem?

Apparently many people are paying for elective whole body magnetic resonance imaging scans, even when not recommended by standard medical practice. In these images, benign growths can look just like small, early-stage tumors; you can’t distinguish them. This leads to additional procedures—such as biopsies, endoscopies, or surgeries—which each carry their own risk. Also, a false positive result can cause anxiety, sleeplessness, and financial strain. When you put all these issues together, elective whole body MRI scans may cause more harm than good, even if the direct risks of having a MRI are nonexistent (take “direct risk” here to mean the risk you are exposed to if you have an MRI scan for free but then the image is accidentally deleted before anyone can look at it).

This may seem an odd topic for a blog about Intermediate Physics for Medicine and Biology. But it reminds us that while physics is important in medicine, other non-technical issues are also critical. You might think that having an image of the inside of the body is always better than not having an image. But apparently it’s not.

Does this mean we should stop striving to develop even better MRI scanners? No! Better scanners should lead to better images and therefore better diagnoses. But we must be careful when interpreting the images (even improved images) especially when screening, where false positives will always be a challenge. As Russ Hobbie and I say in Chapter 5 of IPMB when analyzing the artificial kidney, we must recognize “the distinction between a high-technology treatment [or, in this case, image] and a real conquest [or identification] of a disease.”