One whole-body MRI could replace multiple cancer scans

Post by cjensen » Tue, May 21, 2019, 1:05 AM UTC

Wowfunhappy wrote: post #160

mattkrause wrote: post #112

Earlier quoted context omitted.

You're understating the costs. Determining whether something is (non) malignant isn't trivial. It often requires a more invasive test (e.g., biopsy, exploratory surgery). We try to avoid those procedures not just because we're cheap or afraid, but because they have a real risk of harming us 'squishy humans'. For example, detecting prostate cancer a few months earlier is often not a huge win on its own. It is even les…

> For example, detecting prostate cancer a few months earlier is often not a huge win on its own. It is even less of a success if doing so requires that four people have allergic reactions to the anesthetic and two others acquire some kind of infection at the biopsy site. Then the doctor should recommend not attempting that type of detection. I find it quite hard to believe that, in an ideal world (!), less data woul…

Post by xvilka » Tue, May 21, 2019, 1:31 AM UTC

jashephe wrote: post #102

chongli wrote: post #23

Earlier quoted context omitted.

This sounds to me like doing a full workup on blood chemistry. Individuals vary so much that you can get false positives. Wouldn't it be more useful as a baseline? Scan once and store it, then scan every few years and compare. If any of the "anomalies" has grown or new ones have appeared between scans, then they might be worth a second look?

Some of the comments here don't touch on the practical limitations of this, but here's one — I'm at a 1400+ bed top-10 US academic medical center, and even our outpatient MRI machines book patients until near-midnight because the scans take so long. I'm not sure if we even have the imaging capacity at this point to be scanning healthy people.

Post by hammock » Tue, May 21, 2019, 2:40 AM UTC

CWuestefeld wrote: post #75

benaadams wrote: post #33

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NHS isn't a for profit healthcare system; and they'll break even earlier on the early detection and diagnosis as since it covers you for life treating you early is less expensive then treating you later when the treatment costs would be higher. Considerations would be different if the MRI scanner was running as for profit; or you could switch coverage so the later costs would be borne by someone else.

treating you early is less expensive then treating you later when the treatment costs would be higher. This is true retrospectively, for anyone who it turns out really has the disease. But studies show that prospectively (when you don't know if somebody actually has a given disease), the cost of preventative care - including follow-up tests and unnecessary treatments - exceeds the benefit that you outlined. EDIT: add…

Post by ohithereyou » Tue, May 21, 2019, 2:47 AM UTC

jlpom wrote: post #136

MRI are generaly considered safe but my personnal experience contradict this. I passed a 3T brain MRI (with gadolinium injection for angiography) ~80 days ago and my life has been seriously painful since then. I have experienced hypertension (often >170 of systole, seem unrelated but never had high tension of my life and like the rest of theses issues it appeared exactly after the MRI), sleep issues, head difficultie…

Post by Wowfunhappy » Tue, May 21, 2019, 2:50 AM UTC

cjensen wrote: post #181

Wowfunhappy wrote: post #160

Earlier quoted context omitted.

> For example, detecting prostate cancer a few months earlier is often not a huge win on its own. It is even less of a success if doing so requires that four people have allergic reactions to the anesthetic and two others acquire some kind of infection at the biopsy site. Then the doctor should recommend not attempting that type of detection. I find it quite hard to believe that, in an ideal world (!), less data woul…

In the US system with malpractice lawsuits, there will be followup in most cases. US Doctors are still furious over the amount of unnecessary testing that occurred as a result of the "whole body scan at third party facility" fad from a decade or two ago.