April 28, 2025 • 28 mins
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• Full body MRIs cost around $2,500 and are being promoted as the "gold standard" for preventative health without proper medical context
• Unlike established screening tests, these scans haven't been evaluated by medical societies for appropriate use in healthy populations
• 15-30% of diagnostic images have at least one incidental finding, which can lead to unnecessary anxiety and further testing
• The marketing tactics use fear-based messaging about finding cancer early, which might be ethically concerning
• These services create healthcare disparities since they're only accessible to those with financial resources
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Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ed Delesky (00:07):
Hi, welcome to your checkup.
We are the patient educationpodcast, where we bring
conversations from the doctor'soffice to your ears.
On this podcast, we try tobring medicine closer to its
patients.
I'm Ed Delesky, a familymedicine resident in the
Philadelphia area.
Nicole Aruffo (00:22):
And I'm Nicola Aruffo.
I'm a nurse.
Ed Delesky (00:24):
And we are so excited you were able to join us
here again today.
So by the time you listen tothis, we'll have had a few days
in between recording and releaseday.
But I'm wondering, after this,I'm going to get taco seasoning
to have what for dinner?
Nicole Aruffo (00:40):
Well, we're having enchiladas for dinner.
I mean, like white peopleenchiladas.
Ed Delesky (00:44):
Sure, but I always love.
This is also one of my favoritemeals.
There's a rotisserie.
Like in the next 24 to 48 hours, all I'll be able to do is talk
about enchiladas, and it leavesme very excited.
How are you feeling today?
Nicole Aruffo (01:02):
I'm feeling good today.
Ed Delesky (01:03):
Excellent.
Are you excited to be sittingdown and to get talking about
you?
Nicole Aruffo (01:09):
know, do I sound excited, you?
Ed Delesky (01:11):
do you really sound like you're ready to?
Nicole Aruffo (01:12):
I'm actually trying to.
You sprung this on me aboutseven minutes ago, so I couldn't
think of anything for pre-showbanter.
Actually, we never talked abouthow we um we finished the pit.
Ed Delesky (01:25):
Oh, we certainly did .
We talked on here aboutwatching the Pit though.
Is that correct?
Yeah, yeah, incredibly accurateshow.
We really liked it a lot.
Nicole Aruffo (01:36):
I also really liked.
I don't think we talked aboutthat last scene Well, I don't
know if it was the last scenebut the scene with what are you
doing?
The scene with um Mel at theend and she, like, picks up her
sister yeah and the sister'slike, what are we doing?
today?
It's Friday and she's like let'sget pizza and then we'll like
(01:58):
watch a movie and whatever, andlike I felt like that I don't
think we've talked about thisbecause I felt like that was
such a good representation oflike what it's like to go to
work and like something likeawful happens.
Obviously people aren't doinglike working during mass
casualties all the time, buteven if, like someone dies and
then you like go home and theperson you go home to isn't like
(02:22):
a medical person, and then, oreven if you're at work and like
you have to just like put on ahappy face, go next door and act
like the kid next door isn'tlike actively dying or something
crazy like that.
But I thought that was a reallygood representation of like
that when something crazyhappens and then like you go
home or whatever and you justhave to like act like
everything's fine, because evenlike as the viewer, like you're
(02:43):
watching it, and then like yougo home or whatever and you just
have to like act likeeverything's fine, because even
like as the viewer, like you'rewatching it and you like have
all this anxiety of like whatjust happened and then she's
just like chatting with hersister, like, yeah, let's, we're
gonna like watch a movie,because it's Friday, and order
pizza yeah don't you think?
Ed Delesky (02:58):
I do.
I think it was a really likesubtle.
That's a really subtle scenethat I don't I feel like you
kind of have to live it to knowit, and yet very powerful and
for all of the reasons that youdescribed there, um, we have a
benefit with each other.
We're like I don't know, evenyesterday I came home and I was
talking about that tough likeexperience I had and like we
(03:22):
serve as a sounding board foreach other if that ever comes up
.
But yeah, that was it.
That was a really importantscene.
Maybe I don't know if it wasunderappreciated in, like the
public eye, but you know, withwhatever medium we have here,
I'm glad you brought it up,because that was a.
That's a good point.
You didn't bring that upoutside of this, yeah, but you
(03:42):
have to compartmentalize and Iguess like, or that's a coping
mechanism for the things you seeyeah, you push your feelings
deep down and you never feelthem that's one way to do it
another might becompartmentalization or
processing.
Whatever you see and experience,I mean you've seen some, some
of the craziest things that aperson can see.
Nicole Aruffo (04:03):
So anyway, I thought it was good.
Ed Delesky (04:07):
That is good and in other TV viewing experience,
we're going to watch the Valleytonight.
Nicole Aruffo (04:13):
Oh my God, I'm so excited.
Jax is crazy.
Ed Delesky (04:16):
Yeah, I mean, they've always known this guy is
crazy.
Nicole Aruffo (04:20):
And then to oh my God Wait.
So this is going to be for aselect audience.
However, it's very important.
So Kristen was on Watch whathappens live last night and do
you remember whatever earlyseason of Vanderpump like this
green dress that Kristen worewhen her and Sandoval were
(04:43):
broken up and then she went,went to his apartment to like
pick up the cable box and shehad on this like green, like
going out dress.
She was like all dolled up.
It was like a whole scene Causeit was like I guess like
Sandoval and Schwartz maybe likeat his apartment and Kristen
just like casually comes over toum pick up the cable box and
they're like why is she alldressed up?
Like why did she wear this?
(05:04):
And then it became a thingonline and it kind of became
this like iconic thing in the.
Bravo world of.
Like Kristen's green dress Okay, and she was on watch what
happens live last night and she,like, brought the green dress
to.
Andy and she was like retiringthe green dress, and now it's in
the clubhouse.
Ed Delesky (05:21):
Oh, no, kidding, it's so iconic, that's awesome.
It's so iconic, that's awesome,that's so funny do you remember
that scene?
Nicole Aruffo (05:27):
I will have to do a rewatch if not we do.
Ed Delesky (05:30):
I mean like somehow summer house is our comfort show
um I maybe we just do yearlyrewatches of all of these shows.
I think we should maybe that'swhat's happening people say
that's a sign of anxiety or youkeep rewatching the same show
over and over again because youknow what's going to happen I'm
seeing similar things, and it'slike a a tool for emotional
(05:50):
regulation, is what I saw,because there's a certain
predictability to it that youknow is comforting, or it's
anxiety, who knows?
We're both probably working onsomething with that at some
level.
Well, all right then.
What do you think?
Nicole Aruffo (06:05):
Well, all right, then Should we get started, yeah
, okay.
Ed Delesky (06:11):
So what are we going to talk about today, nick?
Nicole Aruffo (06:13):
Today we're talking about the full body MRI.
What am I trying to say?
I guess being like marketedmore to the public.
Pernuvo is like the big onethat's in like a couple of the
big cities.
I think Ezra is another one,but yeah, we're going to talk
(06:34):
about it because it's somethingthat's offered as like a private
pay.
Do this full body MRI and, youknow, find out everything you've
ever wanted to know about yourbody.
Ed Delesky (06:43):
Exactly, and I think more so it's in the zeitgeist
as a form of rapidly spreadingsocial media news.
So that's what you can expectout of this episode today Maybe
not so much of a straightforwardeducational one, but maybe more
our interpretation of a this islike a quasi pop culture thing
(07:05):
that's happening.
I would say Very topical, if youwill.
So I mean, you described ithere like people are getting
these full body MRIs and this isnothing short of like head to
toe.
You are going in an MRI whichstands for magnetic resonance
imaging.
It tends to be like a reallyexpensive imaging study but
(07:28):
there's no radiation, which is apro.
But usually it's used for veryspecific purposes as a part of
diagnostic workups.
Nicole Aruffo (07:38):
but it seems like now, when you were, when you
propose that we do this episode,that there's more out there,
there's more to these that'scoming out yeah, I mean, I
brought it up because I thinkthat people should know I don't
know, I guess, like the pros andcons of like all of it and like
maybe, like what it could leadto, why it's not something
(07:58):
that's usually recommended, andmainly because, like, a lot of
influencers are doing brandpartnerships with these
companies specifically, and it'slike okay, you're, you know, on
a reality tv show or you domakeup on the internet and like
those are all great things, butthen they're going to get these
(08:21):
full body MRIs because they wereoffered it for free or got paid
to do it.
And then they're out here kindof like talking as if this is
the gold standard for, likepreventative health and how
everyone should do it and youshould do it once a year, and
like it can find x, y and z andlike it's.
I feel like they're talking asif it's better than it is and
(08:45):
how I don't know, like whatthey're saying is just what's
the?
I feel like I'm there's a wordit's like short-sighted, poorly,
poorly contextualized.
Ed Delesky (08:56):
Yeah, and I completely agree with you.
Nicole Aruffo (08:59):
I think it's like they were offered something for
free oh yeah they did it andnow it's like oh, now, like I
have this big influence becauseof you know, my social status,
of whatever, and now I'm gonnatell all these people that they
have to go spend twenty fivehundred dollars to get this full
body mri and like this is goingto help them so much like
medically, and kind of givingthis like medical advice, that
(09:20):
they really can't speak on.
Exactly no, I, and I totallyagree with you, because these
one it's flawed, because they'rebeing paid to basically
advertise this imaging, which ismean it's the same thing as
like the influencers who dobrand partnerships, which like
there's nothing wrong with that,like I wish I could get paid to
(09:43):
do that, like I'm doing thewrong thing in life sure that
like offer this um or they getpaid to do a brand partnership
with like a supplement, andthey're like this is gonna fix x
, y and z and like it's justlike this statement has not been
reviewed by the fda?
Ed Delesky (09:56):
yeah, yeah, and I think so.
One of these content, one ofthe pieces of context here
that's important, is that, likewhen it comes to screening
because you said, like this isbeing like pitched as this, like
paragon of preventativemedicine and screening tests are
highly scrutinized by panelsand panels and panels of experts
(10:20):
, and then various differentsocieties disagree on proper
screening, and so it's importantto understand the definition of
screening.
Is that screening is lookingfor a disease in an otherwise
normal healthy population, in anotherwise normal healthy
population, like none of thepeople that you're looking for
something.
(10:40):
You expect to find something,but you're looking because you
know that if you do look, you'llfind enough where it's
beneficial to do something aboutit as opposed to other things.
So, like we're talking aboutcolon cancer screening Like age
45 and up, everyone should begetting colon cancer screening
or their cervical cancerscreening.
Like age 45 and up, everyoneshould be getting colon cancer
screening or their cervicalcancer screening.
These things have beenevaluated with very valuable,
(11:02):
high-yield tests that should bedone and have been evaluated.
What hasn't been evaluated?
The whole body MRI.
So these are some things that Ithink about when this topic
comes up.
Nicole Aruffo (11:18):
And also I think it's important to note that
there is a difference betweengetting a whole body MRI and
they typically advertise themthat they, you know, like they
only take an hour in and outreal quick.
There's a difference betweendoing that and then getting an
MRI on just one body part, likethat is more thorough, and then
(11:39):
just doing right Because youcould have an MRI on one part of
your body that could take ahalf hour, it could take over an
hour, and like that's morethorough than just doing like a
once over eyeball.
Ed Delesky (11:53):
Look Absolutely right, that like of your whole
body, that only over eyeballlook Absolutely Right.
Nicole Aruffo (11:56):
That like of your whole body.
That only takes one hour.
Ed Delesky (11:58):
Exactly, it's not all created the same.
Like you get a brain MRI, thereare different types of brain
MRI where they look at stuff,but, like you said, like you
just give it a once over up anddown, it doesn't necessarily
capture the whole picture.
So we were talking aboutscreening tests and how those
have been highly scrutinized byimportant medical societies and
(12:23):
that, like these, while they mayfind things, they may not be
the most thorough, they can missthings, I suppose.
But one thing I think thatreally needs to be stated out
(12:45):
loud is that 15% to 30% ofdiagnostic images have at least
one incidental finding.
And the concept of theincidental finding, as I get
deeper and deeper into practice,becomes more and more important
, honestly.
And they come up with the lungcancer screening, ct scans all
the time, Because for people whohave smoked for a certain age
and for a certain duration, wewill have a whole episode about
this.
There is yearly lung cancerscreening and, wouldn't you know
there are tons of things tofind in the chest that may or
(13:12):
may not have been important atone point in your life, and the
incidental finding is just avery complicated thing that has
a lot of downstream effects.
And if now we're thinking aboutgetting everyone a whole body
MRI.
There's going to be a lot ofstuff that we see.
Nicole Aruffo (13:31):
There is a lot of stuff Cause I looking up um, I
mean just now, but even likebefore this, because people on
tiktok are posting, you know,screenshots of, like their
results yeah from what they getwhich um.
When I was like looking moreinto this, it seems like these
are all also read by ai and notlike an actual trained eye of a
(13:52):
radiologist.
There you go, it'll like list,you know every kind of like body
system, and then it'll be likewhat?
Like one minor finding, oneminor finding nothing, normal,
blah, blah, blah.
But like a lot of them that Isaw would be like it would say
like one minor finding, and thenthey clicked on it and then
it's like one small um.
(14:13):
It's like in I forgot exactlywhat the wording was like one
small, indeterminate lesion yeah, and like there you go.
That can be really scary becauseit's like, okay, is that like a
cyst or is this like changingmy life now?
But then then like you go tothe doctor and you're like, oh,
I got this MRI, I have aion, andnow your doctor has to do
(14:35):
something about it and likefurther work up that you at the
end of the day, you know ideallyeverything would turn out fine,
but like might not have needed,like what if you need a biopsy?
And like that comes withanother whole host of risks and
blah, blah, blah, and it's justlike yeah, Plus, like the
(14:57):
anxiety of it on top of it isexactly the the time spent
worrying about what?
Ed Delesky (15:00):
could this be when, in a this is like such like a
fifth dimensional view of lifewhere, like you go through life
and like one act can change thearc of your entire life and like
on one path, you went throughyour entire life?
And like on one path, you wentthrough your entire life and
never knew that you had a fourmillimeter lesion in your lung
(15:21):
and you never spent a moment ofyour day worrying about that.
And there is another path whereyou had a CT scan of your chest
or you had a whole body MRI andyou know that there's a four
millimeter lesion on your lungand you are left laying
sleepless at night wondering.
Nicole Aruffo (15:41):
Yeah, it can really change the way, like a
healthy person, like thinksabout their health.
Ed Delesky (15:46):
Yeah, like you go from being a healthy person to
now a patient with a lesionovernight in one moment, and I
think the complicated thing hereis that there will be things
found.
There will be important thingsfound, like for
sensationalization, which is whythis has like come to the
forefront so much.
(16:06):
Like duane wade was like foundto have a kidney cancer and it
was early stage with the wholebody mri, and like they found
that and that happens yeah yeah,like, like people that's also
not guaranteed to happen.
Nicole Aruffo (16:22):
Like this again, like once over whole body MRI is
not guaranteed to find a cancer, even in the early stages, like
before you have any symptoms,like you, that might still
happen to you and it might notpick up on this whole body.
Less thorough MRI.
Ed Delesky (16:42):
Exactly so.
It's not as sensitive, maybenot as specific, and I can't sit
here and say like for somerandom person out there who may
stumble upon a whole body MRIand that for that individual it
doesn't change their life.
Nicole Aruffo (16:58):
Yeah for better or for worse.
Ed Delesky (17:00):
Will be a lot of people where we find things
where it didn't matter.
And one thing people shouldrecognize that often maybe isn't
explained is thatrecommendations from societies
like the colon cancer screeningrecommendation recommendation is
for populations of people andthey look at all of these people
(17:20):
and they say the best groupdecision for all of these people
is age 45 and up up to acertain upper limit should get
colon cancer screening every sooften from different methods.
But then how do you explain theindividual who has a family
history of colon cancer and theperson had colon cancer in their
family discovered at the age of45?
(17:42):
Well then, yes, that personneeds colon cancer screening at
age 35.
Nicole Aruffo (17:47):
Yeah, but honestly I feel like all of
those strong family historythings that have a big factor in
what you decide for someone,right?
Ed Delesky (17:57):
Sure, and I guess the overall arching point I'm
trying to make is thatrecommendations from societies
about these big sweeping thingsare about groups of people and
not individuals.
And so we're in a place, and Ithink in science and healthcare,
(18:18):
where there are reallymotivated, interested, capable
consumers of healthcare.
And now, like you're able topurchase a whole body MRI here,
probably outside of insurance,and like the way that health
information has flowed, movesfaster and technology moves
faster, then scientificprocesses are able to keep up
(18:44):
and make a risk assessment.
So these are coming to market,they're flushing out fast and
people are buying, buying,buying, they're scheduling,
they're going and the expertshaven't even picked a date to
meet and say let's take a lookat this and see like is this
worth it or is it not?
So it goes unstudied, questionmark, unsure.
(19:06):
When it lands across the deskof your doctor, it's like oops,
I don't know what to do aboutthis.
It's a complicated thing andit's not just isolated to these,
it's everywhere.
It's a ton of things andinformation is traveling so
quickly that it highlights thefactor that a lot of this is a
(19:27):
partnership in someone's health.
The hierarchy of informationhas flattened, incredibly and
maybe dangerously, becausethere's context to all of this.
We're taking what may be a40-minute podcast to dive into
the complexities of all of this.
Like we're taking a what may bea 40 minute podcast to dive
into the complexities of all ofthis, but like people are
scrolling and they see asentence and like form opinions
(19:48):
based on that.
Nicole Aruffo (19:49):
Yeah, I mean I could see the other side too of
like why someone like would beinterested in getting it just to
kind of like you know, see whatit says, yeah, and also like,
so the typical like going priceis $2,500, and like I could see
(20:11):
someone.
I mean like I went to schedulea brain MRI and they told me my
copay was $2,500, so I could seesomeone being like oh, why
would I do one body part when Ican just do the whole thing for
the same price?
Ed Delesky (20:27):
Totally, and that's part of the consumerism and the
market driving prices down.
So hopefully that wouldequilibrate over time.
Yeah, it leaves me wondering.
It leaves me wondering.
I mean, I have the prices uphere.
They're stratified a little bitactually.
So, yeah, it's comprehensivewhole body scan.
They say the scan time is 45minutes and $2,499 for US
(20:54):
dollars.
They're claiming that it's acomprehensive imaging based
health assessment that includesan evaluation of major organs
and spine for cancer, aneurysmsand disease, and it does not
include arms or feet.
This also includes an enhancedscreening with a whole body scan
.
This scan time is 60 minutes.
(21:16):
This is only completed in acouple cities and it's $4,000.
To round up by a dollar and itsays our most advanced
multimodality screening includesour comprehensive whole body
scan, lab testing for criticalbiomarkers and advanced brain
health assessment and our FDAcleared body composition
(21:37):
analysis.
Don't even get me started aboutthe like 500 biomarker labs of
things that also won't berelevant, most likely in your
life.
Then there's a head and torsoone 1800 bucks, 45 minutes.
You can imagine what that'sscanning and torso for a
thousand dollars.
A quick scan designed for thoseconcerned about catching cancer
(21:58):
early in the torso.
Nicole Aruffo (21:59):
Stop To identify early solid tumors.
This is emotional, likemarketing too that is awful
that's awful they're likeexploiting people to be like
we're gonna catch cancer earlywhen there's that's that's icky.
Ed Delesky (22:14):
Yeah, I don't like that.
I don't like that.
Nicole Aruffo (22:17):
I don't like that at all.
Ed Delesky (22:19):
Right, Because they're exploiting people's
emotions and fears of theunknown to push their product.
And at the same time, in 10, 15years from now, is the USPSTF
going to say grade Arecommendation 30 years old,
whole body MRI.
I don't know, Maybe.
Nicole Aruffo (22:43):
Probably not, I don't know.
That's a lot of empty promisesthey have going on over there, I
also think so.
Ed Delesky (22:46):
So, like with this technology being so new and
having not been able to bereasonably assessed, like all of
this is subject to conjectureand it's all about.
It's an access issue as well,like we have another thing
dividing the haves and have notsfor someone to be able to
(23:08):
detect something, perhaps.
Nicole Aruffo (23:10):
Yeah, I mean, you don't have to go to the doctor
get a script, you don't have tohave insurance.
Ed Delesky (23:16):
Or, like God forbid, you couldn't even afford this
to be able to do this, let itlike once let alone yearly.
so then that creates anincreased disparity, where then
I could totally see studiescoming out later saying, like
people with a highersocioeconomic status and higher
resources are maybe or maybe notexperiencing benefit from this
(23:39):
because they're able to accessit and get early detection, or
they have, like, problemsbecause of overdiagnosis and
yeah, like if you're a celebrity, even if you're, you know, like
a C-list celebrity, and you getthis and you find something.
Nicole Aruffo (23:56):
But you, you know , have connections with all the
right people and the rightdoctors and whatever, and like
you do x, y and z and maybe you,you know one incidental finding
.
Ed Delesky (24:04):
Maybe that leads to something a specialist
appointment that you waited,like three months for six months
for yeah and then like anotherimaging study after that to
maybe have a deep needle stuckin you somewhere.
Nicole Aruffo (24:20):
Yeah, I mean and also, yeah, like your average
person doesn't really have.
I mean, just think about, like,the number of people who don't
even have a primary care doctor,yep.
Like they get this informationMaybe there is something that's
found on it but like, or evenjust people who don't know how
to like navigate the healthcaresystem in this wonderful country
that we live in, right, like ifthey get this and what if
(24:42):
they're?
Like, oh, I don't know what todo with this.
Ed Delesky (24:44):
Right, oh, my aort is dilated a significant amount.
Let me just hang out with that.
Like, are they liable?
Nicole Aruffo (24:53):
That's what I don't like for discovering
something.
Yeah Cause it's not like, like,if you get imaging, those
results are sent to thephysician who ordered it.
So, like what happens with like?
Ed Delesky (25:05):
you know what happens to these Like.
Who's liable if like?
Nicole Aruffo (25:08):
I'm sure you sign something that like says
they're not.
It's like totally in the weedsand they're like we're not
liable for any findings Likewe're not liable for our
computer reading this and givingyou whatever answers it spits
out.
Ed Delesky (25:19):
You decided to get this outside of.
Like your relationship with thedoctor blah, blah blah.
It's just very complicated and,like you can tell, we're like
we're back and forth Cause likeyeah, there's a lot of issues
with it, but like there's a lotof area for study to be had
right.
Like we can't tell if someonewho actually does have access to
(25:39):
this is this going to be betterfor them, is it going to be had
right?
Like we can't tell if someonewho actually does have access to
this is this going to be betterfor them, is it going to be
worse for them?
Individuals will varypopulation wise.
I don't know yeah do you?
I don't, I guess, I just wish.
I guess I find it the key pieceyou said in the beginning.
Nicole Aruffo (25:56):
I find the like influencer, emotional marketing,
personal experience type stufffrustrating yeah, and it's not
even like it's just the factthat they're speaking again like
this is the gold standard andlike this is what everyone needs
to be doing, and like they haveno like background or anything
(26:19):
they have, like don't have a legto stand on for any kind of
these medical recommendationsthat they're making.
Right, that's like thefrustrating part.
Ed Delesky (26:27):
Yeah, that might be top of the list.
And the second thing on thelist is this If you're concerned
about cancer early in the torso, we'll look for solid tumors
for you.
Oh my God.
Well, thank you for coming backto another episode of your
Checkup.
Hopefully you were able tolearn something for yourself, a
loved one or a neighbor.
(26:48):
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came out.
(27:28):
Hopefully you learned somethingtoday.
God bless you.
Thank you, but, mostimportantly, stay healthy, my
friends, until next time.
I'm Ed Delesky.
I'm Nicole Arrufo.
Thank you, goodbye, bye.
This information may provide abrief overview of diagnosis.
Stay healthy, my friends, untilnext time I'm ed dileski I'm
nicole rufo thank you, goodbye,bye.
This information may provide abrief overview of diagnosis,
treatment and medications.
It's not exhaustive and is atool to help you understand
(27:48):
potential options about yourhealth.
It doesn't cover all detailsabout conditions, treatments or
medications for a specificperson.
This is not medical advice oran attempt to substitute medical
advice.
You should contact a healthcareprovider for personalized
guidance based on your uniquecircumstances.
We explicitly disclaim anyliability relating to the
information given or its use.
This content doesn't endorseany treatments or medications
(28:11):
for a specific patient.
Always talk to your healthcareprovider for complete
information tailored to you.
In short, I'm not your doctor,I am not your nurse, and make
sure you go get your own checkupwith your own personal doctor.
Hi, welcome to your checkup.
We are the patient educationpodcast, where we bring
conversations from the doctor'soffice to your ears.
On this podcast, we try tobring medicine closer to its
patients.
I'm Ed Delesky, a familymedicine resident in the
Philadelphia area.
Nicole Aruffo (00:22):
And I'm Nicola Aruffo.
I'm a nurse.
Ed Delesky (00:24):
And we are so excited you were able to join us
here again today.
So by the time you listen tothis, we'll have had a few days
in between recording and releaseday.
But I'm wondering, after this,I'm going to get taco seasoning
to have what for dinner?
Nicole Aruffo (00:40):
Well, we're having enchiladas for dinner.
I mean, like white peopleenchiladas.
Ed Delesky (00:44):
Sure, but I always love.
This is also one of my favoritemeals.
There's a rotisserie.
Like in the next 24 to 48 hours, all I'll be able to do is talk
about enchiladas, and it leavesme very excited.
How are you feeling today?
Nicole Aruffo (01:02):
I'm feeling good today.
Ed Delesky (01:03):
Excellent.
Are you excited to be sittingdown and to get talking about
you?
Nicole Aruffo (01:09):
know, do I sound excited, you?
Ed Delesky (01:11):
do you really sound like you're ready to?
Nicole Aruffo (01:12):
I'm actually trying to.
You sprung this on me aboutseven minutes ago, so I couldn't
think of anything for pre-showbanter.
Actually, we never talked abouthow we um we finished the pit.
Ed Delesky (01:25):
Oh, we certainly did .
We talked on here aboutwatching the Pit though.
Is that correct?
Yeah, yeah, incredibly accurateshow.
We really liked it a lot.
Nicole Aruffo (01:36):
I also really liked.
I don't think we talked aboutthat last scene Well, I don't
know if it was the last scenebut the scene with what are you
doing?
The scene with um Mel at theend and she, like, picks up her
sister yeah and the sister'slike, what are we doing?
today?
It's Friday and she's like let'sget pizza and then we'll like
(01:58):
watch a movie and whatever, andlike I felt like that I don't
think we've talked about thisbecause I felt like that was
such a good representation oflike what it's like to go to
work and like something likeawful happens.
Obviously people aren't doinglike working during mass
casualties all the time, buteven if, like someone dies and
then you like go home and theperson you go home to isn't like
(02:22):
a medical person, and then, oreven if you're at work and like
you have to just like put on ahappy face, go next door and act
like the kid next door isn'tlike actively dying or something
crazy like that.
But I thought that was a reallygood representation of like
that when something crazyhappens and then like you go
home or whatever and you justhave to like act like
everything's fine, because evenlike as the viewer, like you're
(02:43):
watching it, and then like yougo home or whatever and you just
have to like act likeeverything's fine, because even
like as the viewer, like you'rewatching it and you like have
all this anxiety of like whatjust happened and then she's
just like chatting with hersister, like, yeah, let's, we're
gonna like watch a movie,because it's Friday, and order
pizza yeah don't you think?
Ed Delesky (02:58):
I do.
I think it was a really likesubtle.
That's a really subtle scenethat I don't I feel like you
kind of have to live it to knowit, and yet very powerful and
for all of the reasons that youdescribed there, um, we have a
benefit with each other.
We're like I don't know, evenyesterday I came home and I was
talking about that tough likeexperience I had and like we
(03:22):
serve as a sounding board foreach other if that ever comes up
.
But yeah, that was it.
That was a really importantscene.
Maybe I don't know if it wasunderappreciated in, like the
public eye, but you know, withwhatever medium we have here,
I'm glad you brought it up,because that was a.
That's a good point.
You didn't bring that upoutside of this, yeah, but you
(03:42):
have to compartmentalize and Iguess like, or that's a coping
mechanism for the things you seeyeah, you push your feelings
deep down and you never feelthem that's one way to do it
another might becompartmentalization or
processing.
Whatever you see and experience,I mean you've seen some, some
of the craziest things that aperson can see.
Nicole Aruffo (04:03):
So anyway, I thought it was good.
Ed Delesky (04:07):
That is good and in other TV viewing experience,
we're going to watch the Valleytonight.
Nicole Aruffo (04:13):
Oh my God, I'm so excited.
Jax is crazy.
Ed Delesky (04:16):
Yeah, I mean, they've always known this guy is
crazy.
Nicole Aruffo (04:20):
And then to oh my God Wait.
So this is going to be for aselect audience.
However, it's very important.
So Kristen was on Watch whathappens live last night and do
you remember whatever earlyseason of Vanderpump like this
green dress that Kristen worewhen her and Sandoval were
(04:43):
broken up and then she went,went to his apartment to like
pick up the cable box and shehad on this like green, like
going out dress.
She was like all dolled up.
It was like a whole scene Causeit was like I guess like
Sandoval and Schwartz maybe likeat his apartment and Kristen
just like casually comes over toum pick up the cable box and
they're like why is she alldressed up?
Like why did she wear this?
(05:04):
And then it became a thingonline and it kind of became
this like iconic thing in the.
Bravo world of.
Like Kristen's green dress Okay, and she was on watch what
happens live last night and she,like, brought the green dress
to.
Andy and she was like retiringthe green dress, and now it's in
the clubhouse.
Ed Delesky (05:21):
Oh, no, kidding, it's so iconic, that's awesome.
It's so iconic, that's awesome,that's so funny do you remember
that scene?
Nicole Aruffo (05:27):
I will have to do a rewatch if not we do.
Ed Delesky (05:30):
I mean like somehow summer house is our comfort show
um I maybe we just do yearlyrewatches of all of these shows.
I think we should maybe that'swhat's happening people say
that's a sign of anxiety or youkeep rewatching the same show
over and over again because youknow what's going to happen I'm
seeing similar things, and it'slike a a tool for emotional
(05:50):
regulation, is what I saw,because there's a certain
predictability to it that youknow is comforting, or it's
anxiety, who knows?
We're both probably working onsomething with that at some
level.
Well, all right then.
What do you think?
Nicole Aruffo (06:05):
Well, all right, then Should we get started, yeah
, okay.
Ed Delesky (06:11):
So what are we going to talk about today, nick?
Nicole Aruffo (06:13):
Today we're talking about the full body MRI.
What am I trying to say?
I guess being like marketedmore to the public.
Pernuvo is like the big onethat's in like a couple of the
big cities.
I think Ezra is another one,but yeah, we're going to talk
(06:34):
about it because it's somethingthat's offered as like a private
pay.
Do this full body MRI and, youknow, find out everything you've
ever wanted to know about yourbody.
Ed Delesky (06:43):
Exactly, and I think more so it's in the zeitgeist
as a form of rapidly spreadingsocial media news.
So that's what you can expectout of this episode today Maybe
not so much of a straightforwardeducational one, but maybe more
our interpretation of a this islike a quasi pop culture thing
(07:05):
that's happening.
I would say Very topical, if youwill.
So I mean, you described ithere like people are getting
these full body MRIs and this isnothing short of like head to
toe.
You are going in an MRI whichstands for magnetic resonance
imaging.
It tends to be like a reallyexpensive imaging study but
(07:28):
there's no radiation, which is apro.
But usually it's used for veryspecific purposes as a part of
diagnostic workups.
Nicole Aruffo (07:38):
but it seems like now, when you were, when you
propose that we do this episode,that there's more out there,
there's more to these that'scoming out yeah, I mean, I
brought it up because I thinkthat people should know I don't
know, I guess, like the pros andcons of like all of it and like
maybe, like what it could leadto, why it's not something
(07:58):
that's usually recommended, andmainly because, like, a lot of
influencers are doing brandpartnerships with these
companies specifically, and it'slike okay, you're, you know, on
a reality tv show or you domakeup on the internet and like
those are all great things, butthen they're going to get these
(08:21):
full body MRIs because they wereoffered it for free or got paid
to do it.
And then they're out here kindof like talking as if this is
the gold standard for, likepreventative health and how
everyone should do it and youshould do it once a year, and
like it can find x, y and z andlike it's.
I feel like they're talking asif it's better than it is and
(08:45):
how I don't know, like whatthey're saying is just what's
the?
I feel like I'm there's a wordit's like short-sighted, poorly,
poorly contextualized.
Ed Delesky (08:56):
Yeah, and I completely agree with you.
Nicole Aruffo (08:59):
I think it's like they were offered something for
free oh yeah they did it andnow it's like oh, now, like I
have this big influence becauseof you know, my social status,
of whatever, and now I'm gonnatell all these people that they
have to go spend twenty fivehundred dollars to get this full
body mri and like this is goingto help them so much like
medically, and kind of givingthis like medical advice, that
(09:20):
they really can't speak on.
Exactly no, I, and I totallyagree with you, because these
one it's flawed, because they'rebeing paid to basically
advertise this imaging, which ismean it's the same thing as
like the influencers who dobrand partnerships, which like
there's nothing wrong with that,like I wish I could get paid to
(09:43):
do that, like I'm doing thewrong thing in life sure that
like offer this um or they getpaid to do a brand partnership
with like a supplement, andthey're like this is gonna fix x
, y and z and like it's justlike this statement has not been
reviewed by the fda?
Ed Delesky (09:56):
yeah, yeah, and I think so.
One of these content, one ofthe pieces of context here
that's important, is that, likewhen it comes to screening
because you said, like this isbeing like pitched as this, like
paragon of preventativemedicine and screening tests are
highly scrutinized by panelsand panels and panels of experts
(10:20):
, and then various differentsocieties disagree on proper
screening, and so it's importantto understand the definition of
screening.
Is that screening is lookingfor a disease in an otherwise
normal healthy population, in anotherwise normal healthy
population, like none of thepeople that you're looking for
something.
(10:40):
You expect to find something,but you're looking because you
know that if you do look, you'llfind enough where it's
beneficial to do something aboutit as opposed to other things.
So, like we're talking aboutcolon cancer screening Like age
45 and up, everyone should begetting colon cancer screening
or their cervical cancerscreening.
Like age 45 and up, everyoneshould be getting colon cancer
screening or their cervicalcancer screening.
These things have beenevaluated with very valuable,
(11:02):
high-yield tests that should bedone and have been evaluated.
What hasn't been evaluated?
The whole body MRI.
So these are some things that Ithink about when this topic
comes up.
Nicole Aruffo (11:18):
And also I think it's important to note that
there is a difference betweengetting a whole body MRI and
they typically advertise themthat they, you know, like they
only take an hour in and outreal quick.
There's a difference betweendoing that and then getting an
MRI on just one body part, likethat is more thorough, and then
(11:39):
just doing right Because youcould have an MRI on one part of
your body that could take ahalf hour, it could take over an
hour, and like that's morethorough than just doing like a
once over eyeball.
Ed Delesky (11:53):
Look Absolutely right, that like of your whole
body, that only over eyeballlook Absolutely Right.
Nicole Aruffo (11:56):
That like of your whole body.
That only takes one hour.
Ed Delesky (11:58):
Exactly, it's not all created the same.
Like you get a brain MRI, thereare different types of brain
MRI where they look at stuff,but, like you said, like you
just give it a once over up anddown, it doesn't necessarily
capture the whole picture.
So we were talking aboutscreening tests and how those
have been highly scrutinized byimportant medical societies and
(12:23):
that, like these, while they mayfind things, they may not be
the most thorough, they can missthings, I suppose.
But one thing I think thatreally needs to be stated out
(12:45):
loud is that 15% to 30% ofdiagnostic images have at least
one incidental finding.
And the concept of theincidental finding, as I get
deeper and deeper into practice,becomes more and more important
, honestly.
And they come up with the lungcancer screening, ct scans all
the time, Because for people whohave smoked for a certain age
and for a certain duration, wewill have a whole episode about
this.
There is yearly lung cancerscreening and, wouldn't you know
there are tons of things tofind in the chest that may or
(13:12):
may not have been important atone point in your life, and the
incidental finding is just avery complicated thing that has
a lot of downstream effects.
And if now we're thinking aboutgetting everyone a whole body
MRI.
There's going to be a lot ofstuff that we see.
Nicole Aruffo (13:31):
There is a lot of stuff Cause I looking up um, I
mean just now, but even likebefore this, because people on
tiktok are posting, you know,screenshots of, like their
results yeah from what they getwhich um.
When I was like looking moreinto this, it seems like these
are all also read by ai and notlike an actual trained eye of a
(13:52):
radiologist.
There you go, it'll like list,you know every kind of like body
system, and then it'll be likewhat?
Like one minor finding, oneminor finding nothing, normal,
blah, blah, blah.
But like a lot of them that Isaw would be like it would say
like one minor finding, and thenthey clicked on it and then
it's like one small um.
(14:13):
It's like in I forgot exactlywhat the wording was like one
small, indeterminate lesion yeah, and like there you go.
That can be really scary becauseit's like, okay, is that like a
cyst or is this like changingmy life now?
But then then like you go tothe doctor and you're like, oh,
I got this MRI, I have aion, andnow your doctor has to do
(14:35):
something about it and likefurther work up that you at the
end of the day, you know ideallyeverything would turn out fine,
but like might not have needed,like what if you need a biopsy?
And like that comes withanother whole host of risks and
blah, blah, blah, and it's justlike yeah, Plus, like the
(14:57):
anxiety of it on top of it isexactly the the time spent
worrying about what?
Ed Delesky (15:00):
could this be when, in a this is like such like a
fifth dimensional view of lifewhere, like you go through life
and like one act can change thearc of your entire life and like
on one path, you went throughyour entire life?
And like on one path, you wentthrough your entire life and
never knew that you had a fourmillimeter lesion in your lung
(15:21):
and you never spent a moment ofyour day worrying about that.
And there is another path whereyou had a CT scan of your chest
or you had a whole body MRI andyou know that there's a four
millimeter lesion on your lungand you are left laying
sleepless at night wondering.
Nicole Aruffo (15:41):
Yeah, it can really change the way, like a
healthy person, like thinksabout their health.
Ed Delesky (15:46):
Yeah, like you go from being a healthy person to
now a patient with a lesionovernight in one moment, and I
think the complicated thing hereis that there will be things
found.
There will be important thingsfound, like for
sensationalization, which is whythis has like come to the
forefront so much.
(16:06):
Like duane wade was like foundto have a kidney cancer and it
was early stage with the wholebody mri, and like they found
that and that happens yeah yeah,like, like people that's also
not guaranteed to happen.
Nicole Aruffo (16:22):
Like this again, like once over whole body MRI is
not guaranteed to find a cancer, even in the early stages, like
before you have any symptoms,like you, that might still
happen to you and it might notpick up on this whole body.
Less thorough MRI.
Ed Delesky (16:42):
Exactly so.
It's not as sensitive, maybenot as specific, and I can't sit
here and say like for somerandom person out there who may
stumble upon a whole body MRIand that for that individual it
doesn't change their life.
Nicole Aruffo (16:58):
Yeah for better or for worse.
Ed Delesky (17:00):
Will be a lot of people where we find things
where it didn't matter.
And one thing people shouldrecognize that often maybe isn't
explained is thatrecommendations from societies
like the colon cancer screeningrecommendation recommendation is
for populations of people andthey look at all of these people
(17:20):
and they say the best groupdecision for all of these people
is age 45 and up up to acertain upper limit should get
colon cancer screening every sooften from different methods.
But then how do you explain theindividual who has a family
history of colon cancer and theperson had colon cancer in their
family discovered at the age of45?
(17:42):
Well then, yes, that personneeds colon cancer screening at
age 35.
Nicole Aruffo (17:47):
Yeah, but honestly I feel like all of
those strong family historythings that have a big factor in
what you decide for someone,right?
Ed Delesky (17:57):
Sure, and I guess the overall arching point I'm
trying to make is thatrecommendations from societies
about these big sweeping thingsare about groups of people and
not individuals.
And so we're in a place, and Ithink in science and healthcare,
(18:18):
where there are reallymotivated, interested, capable
consumers of healthcare.
And now, like you're able topurchase a whole body MRI here,
probably outside of insurance,and like the way that health
information has flowed, movesfaster and technology moves
faster, then scientificprocesses are able to keep up
(18:44):
and make a risk assessment.
So these are coming to market,they're flushing out fast and
people are buying, buying,buying, they're scheduling,
they're going and the expertshaven't even picked a date to
meet and say let's take a lookat this and see like is this
worth it or is it not?
So it goes unstudied, questionmark, unsure.
(19:06):
When it lands across the deskof your doctor, it's like oops,
I don't know what to do aboutthis.
It's a complicated thing andit's not just isolated to these,
it's everywhere.
It's a ton of things andinformation is traveling so
quickly that it highlights thefactor that a lot of this is a
(19:27):
partnership in someone's health.
The hierarchy of informationhas flattened, incredibly and
maybe dangerously, becausethere's context to all of this.
We're taking what may be a40-minute podcast to dive into
the complexities of all of this.
Like we're taking a what may bea 40 minute podcast to dive
into the complexities of all ofthis, but like people are
scrolling and they see asentence and like form opinions
(19:48):
based on that.
Nicole Aruffo (19:49):
Yeah, I mean I could see the other side too of
like why someone like would beinterested in getting it just to
kind of like you know, see whatit says, yeah, and also like,
so the typical like going priceis $2,500, and like I could see
(20:11):
someone.
I mean like I went to schedulea brain MRI and they told me my
copay was $2,500, so I could seesomeone being like oh, why
would I do one body part when Ican just do the whole thing for
the same price?
Ed Delesky (20:27):
Totally, and that's part of the consumerism and the
market driving prices down.
So hopefully that wouldequilibrate over time.
Yeah, it leaves me wondering.
It leaves me wondering.
I mean, I have the prices uphere.
They're stratified a little bitactually.
So, yeah, it's comprehensivewhole body scan.
They say the scan time is 45minutes and $2,499 for US
(20:54):
dollars.
They're claiming that it's acomprehensive imaging based
health assessment that includesan evaluation of major organs
and spine for cancer, aneurysmsand disease, and it does not
include arms or feet.
This also includes an enhancedscreening with a whole body scan
.
This scan time is 60 minutes.
(21:16):
This is only completed in acouple cities and it's $4,000.
To round up by a dollar and itsays our most advanced
multimodality screening includesour comprehensive whole body
scan, lab testing for criticalbiomarkers and advanced brain
health assessment and our FDAcleared body composition
(21:37):
analysis.
Don't even get me started aboutthe like 500 biomarker labs of
things that also won't berelevant, most likely in your
life.
Then there's a head and torsoone 1800 bucks, 45 minutes.
You can imagine what that'sscanning and torso for a
thousand dollars.
A quick scan designed for thoseconcerned about catching cancer
(21:58):
early in the torso.
Nicole Aruffo (21:59):
Stop To identify early solid tumors.
This is emotional, likemarketing too that is awful
that's awful they're likeexploiting people to be like
we're gonna catch cancer earlywhen there's that's that's icky.
Ed Delesky (22:14):
Yeah, I don't like that.
I don't like that.
Nicole Aruffo (22:17):
I don't like that at all.
Ed Delesky (22:19):
Right, Because they're exploiting people's
emotions and fears of theunknown to push their product.
And at the same time, in 10, 15years from now, is the USPSTF
going to say grade Arecommendation 30 years old,
whole body MRI.
I don't know, Maybe.
Nicole Aruffo (22:43):
Probably not, I don't know.
That's a lot of empty promisesthey have going on over there, I
also think so.
Ed Delesky (22:46):
So, like with this technology being so new and
having not been able to bereasonably assessed, like all of
this is subject to conjectureand it's all about.
It's an access issue as well,like we have another thing
dividing the haves and have notsfor someone to be able to
(23:08):
detect something, perhaps.
Nicole Aruffo (23:10):
Yeah, I mean, you don't have to go to the doctor
get a script, you don't have tohave insurance.
Ed Delesky (23:16):
Or, like God forbid, you couldn't even afford this
to be able to do this, let itlike once let alone yearly.
so then that creates anincreased disparity, where then
I could totally see studiescoming out later saying, like
people with a highersocioeconomic status and higher
resources are maybe or maybe notexperiencing benefit from this
(23:39):
because they're able to accessit and get early detection, or
they have, like, problemsbecause of overdiagnosis and
yeah, like if you're a celebrity, even if you're, you know, like
a C-list celebrity, and you getthis and you find something.
Nicole Aruffo (23:56):
But you, you know , have connections with all the
right people and the rightdoctors and whatever, and like
you do x, y and z and maybe you,you know one incidental finding
.
Ed Delesky (24:04):
Maybe that leads to something a specialist
appointment that you waited,like three months for six months
for yeah and then like anotherimaging study after that to
maybe have a deep needle stuckin you somewhere.
Nicole Aruffo (24:20):
Yeah, I mean and also, yeah, like your average
person doesn't really have.
I mean, just think about, like,the number of people who don't
even have a primary care doctor,yep.
Like they get this informationMaybe there is something that's
found on it but like, or evenjust people who don't know how
to like navigate the healthcaresystem in this wonderful country
that we live in, right, like ifthey get this and what if
(24:42):
they're?
Like, oh, I don't know what todo with this.
Ed Delesky (24:44):
Right, oh, my aort is dilated a significant amount.
Let me just hang out with that.
Like, are they liable?
Nicole Aruffo (24:53):
That's what I don't like for discovering
something.
Yeah Cause it's not like, like,if you get imaging, those
results are sent to thephysician who ordered it.
So, like what happens with like?
Ed Delesky (25:05):
you know what happens to these Like.
Who's liable if like?
Nicole Aruffo (25:08):
I'm sure you sign something that like says
they're not.
It's like totally in the weedsand they're like we're not
liable for any findings Likewe're not liable for our
computer reading this and givingyou whatever answers it spits
out.
Ed Delesky (25:19):
You decided to get this outside of.
Like your relationship with thedoctor blah, blah blah.
It's just very complicated and,like you can tell, we're like
we're back and forth Cause likeyeah, there's a lot of issues
with it, but like there's a lotof area for study to be had
right.
Like we can't tell if someonewho actually does have access to
(25:39):
this is this going to be betterfor them, is it going to be had
right?
Like we can't tell if someonewho actually does have access to
this is this going to be betterfor them, is it going to be
worse for them?
Individuals will varypopulation wise.
I don't know yeah do you?
I don't, I guess, I just wish.
I guess I find it the key pieceyou said in the beginning.
Nicole Aruffo (25:56):
I find the like influencer, emotional marketing,
personal experience type stufffrustrating yeah, and it's not
even like it's just the factthat they're speaking again like
this is the gold standard andlike this is what everyone needs
to be doing, and like they haveno like background or anything
(26:19):
they have, like don't have a legto stand on for any kind of
these medical recommendationsthat they're making.
Right, that's like thefrustrating part.
Ed Delesky (26:27):
Yeah, that might be top of the list.
And the second thing on thelist is this If you're concerned
about cancer early in the torso, we'll look for solid tumors
for you.
Oh my God.
Well, thank you for coming backto another episode of your
Checkup.
Hopefully you were able tolearn something for yourself, a
loved one or a neighbor.
(26:48):
And please, if you found thisinteresting or you found any of
our other episodes interesting,do two things.
If you could send this to aloved one or a neighbor and go
to the bottom of our show notes,where you found our episode,
and go looking for our emaillist and you can sign up.
(27:08):
You'll get email notificationsthat episodes came out, but you
will also, as we expand ourwritten materials available, be
subject to newsletters.
God bless you.
Subject to newsletters.
When we have blog posts onSubstack, you'll be notified
that way and you'll get thenotification that new episodes
came out.
(27:28):
Hopefully you learned somethingtoday.
God bless you.
Thank you, but, mostimportantly, stay healthy, my
friends, until next time.
I'm Ed Delesky.
I'm Nicole Arrufo.
Thank you, goodbye, bye.
This information may provide abrief overview of diagnosis.
Stay healthy, my friends, untilnext time I'm ed dileski I'm
nicole rufo thank you, goodbye,bye.
This information may provide abrief overview of diagnosis,
treatment and medications.
It's not exhaustive and is atool to help you understand
(27:48):
potential options about yourhealth.
It doesn't cover all detailsabout conditions, treatments or
medications for a specificperson.
This is not medical advice oran attempt to substitute medical
advice.
You should contact a healthcareprovider for personalized
guidance based on your uniquecircumstances.
We explicitly disclaim anyliability relating to the
information given or its use.
This content doesn't endorseany treatments or medications
(28:11):
for a specific patient.
Always talk to your healthcareprovider for complete
information tailored to you.
In short, I'm not your doctor,I am not your nurse, and make
sure you go get your own checkupwith your own personal doctor.
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