You May Not Expect This To Be The Most Valuable Part Of Whole-Body Medical Imaging
I just had my repeat Prenuvo scan, and I was shocked by how differently I felt walking out of the scanner compared to my two years ago. I went in with high expectations for my first whole-body MRI, but the results this time blew those expectations away. The reason for that came down to one thing: I had a baseline to compare against.
When I sat down with Prenuvo co-founder Andrew Lacy for the latest episode of the mindbodygreen podcast, he framed this shift simply. Two years ago the scan answered one question for patients: is there something in your body? Now it answers a more interesting one: what is changing in your body?
Tune in to this week’s mindbodygreen podcast episode, created in partnership with Prenuvo. Take a proactive approach to your health with Prenuvo’s whole-body MRI. In as little as an hour, Prenuvo can help give you a broader understanding of what’s happening in your body–before symptoms appear- *finding a potentially life-saving diagnosis in 1 in 20 people. Get a $300 discount on comprehensive and executive memberships, along with a standalone whole-body scan at prenuvo.com/MINDBODYGREEN.
What actually gets measured in an hour
The imaging for a Prenuvo scan still lasts about an hour in the machine, but the amount of information coming out of that hour has expanded considerably. Lacy walked me through what's been added since my first scan:
- Quantitative brain analysis: The new NeuroQuant report measures brain volume, including the hippocampal region where volume loss tied to dementia usually starts, so you can look for changes before symptoms show up.
- A perfusion study: A look at blood flow in the brain, which matters because, as Lacy put it, "brain volume loss is preceded by changes to blood flow in the brain." He said addressing this could potentially push the timeline on brain disease back decades.
- Quantitative heart analysis: An MRI can't see the arteries feeding the heart, so this scan measures the heart muscle and the elasticity of the wall is as it beats.
- FDA-cleared fat and muscle analysis: Bathroom scales can give you a direction, but they're "not as accurate as counting actual pixels of fat or muscle on a MRI exam," Lacy says. These numbers matter for the many people on GLP-1s wondering whether they're losing muscle along with fat.
- Blood biomarkers: These connect the structure the MRI sees with how the body is functioning.
AI makes a lot of that possible. Lacy said it lets Prenuvo collect less raw data from your body and still produce a clear image, so you can spend less time in the machine—or stay the same hour and get more images. That's how a dedicated pancreatic sequence got added to every scan.
"AI's tremendously good at quantifying change," he told me. For example, measuring brain volume pixel by pixel would take a radiologist days, and AI now compares two sets of images to flag what actually changed in minutes. Prenuvo is also running research and pilot programs where AI assists with the diagnosis, with the near-term goal of making radiologists both faster and more accurate. Lacy was candid that plenty of people expect AI to eventually read scans better than radiologists do, but how that shakes out long term is still an open question.
Personally, the body composition report was my favorite part of my most recent scan. It measured abdominal visceral fat, subcutaneous fat, muscle volume, liver, kidney, spleen, and leg muscle size relative to bone length. I could see that I'm slightly stronger on my right side than my left, and that my minor scoliosis is something to watch rather than something to fix. The information isn't alarming, just specific enough to be helpful.
Nine findings is normal
Lacy said the average number of findings per scan is nine, and he doesn't remember a single scan that came back with zero. He's had nine scans himself over eight years, and Prenuvo has now done north of 200,000. From that, Lacy has learned that we've all got something. The question is whether you know what your something is, and whether it's changing.
My example this round: a roughly three-millimeter cyst on my pancreas. My first reaction was the one anyone would have—pancreas, panic. The report read "no changes to the prior finding," but I was certain I'd have remembered a pancreatic cyst from scan one. The radiologist went back and compared the actual images and found it had indeed been there all along. When the radiologist explained why it wasn't flagged on the first scan, I understood exactly why it is important to repeat these scans overtime.
Images are captured in tiny three-dimensional units called voxels, and a typical diagnostic MRI resolves at about three millimeters by one millimeter. Something that small might show up across only three voxels which, on one scan, reads as noise. On a second scan, if it's in the same place, that bundle of voxels means something, the radiologist explained. In my case it meant something small enough that most practitioners would simply monitor it, but it is good information to have. "It just shows the power of these scans when you start to look longitudinally," Lacy said.
The numbers most people never hear
Lacy broke down what actually happens when people get scanned. Roughly 70% to 80% walk away with peace of mind. They have nothing seriously wrong and can go live their lives until their next checkup. About 20% get one or two findings that are genuinely actionable, the kind you work on. And 2% to 3% receive something life-threatening.
That's a very different picture from the one most people carry into the appointment.
Lacy told me the biggest fear going in is exactly that last category, and he pointed to why it looms so large: high-profile stories draw enormous attention. For example, Busy Philips' Prenuvo scan revealed an early-stage glioma—a serious and aggressive kind of brain tumor that can progress to something worse over time—so catching it early likely saved her life. These are the only types of stories that receive real attention, so they make people think scary results are much more likely than they actually are.
What peace of mind actually buys you
Lacy has lived with both sides of this fear. He started Prenuvo after years of what he described as living badly; he was stressed, eating poorly, not sleeping or exercising enough. He expected his first scan to hand him hard lessons. Instead he learned he was generally healthy, and, as he put it, "that peace of mind was so incredibly priceless." It quieted a voice in his head that used to spend energy wondering whether a headache or stomachache was worse than what was on the surface. From his perspective, these scans are "reducing uncertainty in our lives."
And on the fear of bad news: Lacy sat in about 150 patient consults in the early days, including some where the team delivered serious findings. He expected it to be devastating to witness. Instead he watched people move straight toward action next, and hug the radiologist on the way out. "We don't give ourselves enough credit," he said, adding that, while the fear often holds people back from diagnostic tests, scary results are mostly taken in stride.
The takeaway
Lacy shared an analogy that stuck with me: we see a dentist every six to 12 months, expect a little feedback, and think nothing of it. He thinks we should have the same relationship with the other 80 or so organs you've got.
If you've been putting off a baseline because you're afraid of what it might turn up, the odds say reassurance is far more likely than a diagnosis. And if you already have a baseline, going back is where the value compounds—comparison is what turns one set of images into information.
*Based on our internal data analysis, 5% of Prenuvo scans have helped detect a potentially life-saving condition. This reflects in particular the combined prevalence of radiologically-suspected pre-cancerous/cancerous-findings or brain-aneurysms in our whole body MRI screening practice.