What Prenuvo Scans Won’t Tell You

Before I hop on the MRI table, I’m asked if I’d like to take a photo beside the gleaming machine.

I know what such a picture might look like: Last August, Kim Kardashian posed in Prenuvo’s signature gray scrubs beside the scanner. She shared it on Instagram along with an effusive message: “I recently did this @prenuvo scan and had to tell you all about this life saving machine. The Prenuvo full-body scan has the ability to detect cancer and diseases such as aneurysms in its earliest stages, before symptoms arise… It has really saved some of my friends lives and I just wanted to share #NotAnAd.”

Her post marked the inflection point in a trend that had been building on the platform for months. Miranda Kerr had shared her visit in January of last year, Ian Somerhalder in February, Christina Milian in March, Elsa Hosk in April, Tamra Judge in May, and Jenna Dewan in June. In the weeks and months following Kardanshian’s August post, Tia Mowry, Carole Radziwill, and many, many more flooded users’ feeds with Prenuvo pics.

Most reported no significant findings, if they chose to disclose their results at all. But for television host Maria Menounos, the full-body scan found a 3.9-centimeter mass — previously undetected on a recent CT scan — which turned out to be pancreatic cancer. She had surgery to remove it, and required no further treatment aside from annual follow-up scans. She credits Prenuvo for catching the tumor before it had a chance to spread.

That’s the promise of consumer-facing companies like Prenuvo: to return agency to patients in a broken health care system, which too often dismisses their concerns.

It’s certainly why I sought out a scan, but I passed on the photo opp. I’m here to see inside myself, not to be seen.

Founded in 2018, Prenuvo is a venture-backed startup that offers radiation-free, full-body MRIs. The company aims to make scans available to the general public and assist in catching conditions that often go undetected, from breast cancer to thyroid inflammation. Prenuvo promises its machine can screen for more than 500 conditions, all without the use of ionizing radiation or contrast agents. The dream is that one day, we’ll all be getting regular full-body scans much like we do mammograms.

Unlike mammograms, Prenuvo’s scans currently aren’t covered by insurance, and cost roughly $999 to $2,499 out of pocket depending on the type of scan. It isn’t just a one-shot deal, either: Prenuvo recommends patients receive a scan every year or two, which allows both continued monitoring and the promise of increasing accuracy (the best way to assess a scan is to compare it to an old scan).

But, if you can afford one, there’s no one to stop you from getting it.

In the past two years, I’ve had doctors order an MRI of my cervical spine, two of my brain, and an MR enterography to image my intestines, all seeking answers for my collection of vaguely autoimmune-related conditions. I’ve been to state-of-the-art facilities and run-down ones, exam rooms with views of Central Park and offices hidden in fluorescent-lit basements.

About a year ago, one of those brain MRIs found “a solitary punctate focus of T2 prolongation in the right frontal-subcortical white matter.” I thought maybe I was dying, but at least I’d found the cause of my mysterious numbness, tingling, and double vision.

My neurologist thought otherwise. He said it was irrelevant. My rheumatologist phrased the finding in another way: “When you start looking around, you’re going to start finding things,” she said. The problem is that most of the things don’t matter.

This is one of the dangers of Prenovo and similar direct-to-consumer companies that run parallel to the health care system: The patient is empowered to go looking for things, especially if they see others online doing the same.

Doctors are the experts of The Human Body; patients are the experts of their own bodies. Who should decide when it’s right to look?

Prenuvo’s waiting room is staged with small, spare stacks of books, petite succulents, and unlit candles. When my name is called, I’m ushered into a spa-like changing room, where a clean set of scrubs and a sports bra await me. I’m told to leave my belongings there. The entire room will lock behind me.

A woman in a black business suit guides me to the inner sanctum. I’m always in awe of the MRI machine, a great, gleaming tube placed in the center of a large, purpose-built room, almost like an altar. How many devices do you encounter in your day-to-day life that deal in the quantum mechanical properties of atoms? Proton alignment, magnetic fields, radiofrequency pulses.

After I decline the photo, I’m strapped into a gurney-like bed. The woman places weighted equipment on top of me, fits headphones and goggles on me that’ll allow me to watch TV for the duration of my hour-long scan, and slides me into the tube.

Some struggle with claustrophobia as they’re backed into the machine’s throat, slowly swallowed whole. But I find small spaces comforting. Even the banging and beeping have a rhythmic, calming effect.

So far, this is standard procedure — but what I am struck by is the care.

Not only has the suited woman clearly read my file, but never before have I been able to watch TV while in the machine, let alone choose my own programming from Netflix. (I went with Beckham, and watched Posh and Becks be hounded by flashing cameras while the technician in the other room imaged my entire body.) Post-scan, I was left to peruse a selection of free snacks and beverages.

It’s a marked difference from other health procedures I’ve had or physicians I’ve seen. My doctors usually appear exhausted and in a terrible rush. The nurses, too, have bags under their eyes. They’re all victims of the insurance system, which demands that typical appointments last just 15 minutes. In the widely understaffed, post-COVID health care system, any individual who finds the time to treat patients like humans is a saint.

The difference at Prenuvo is that I’m not just the patient; though my appointment was comped, I’m the customer.

The difference at Prenuvo is that I’m not just the patient; though my appointment was comped, I’m the customer.

Prenuvo is not the only company offering full-body scans to the public, but it is arguably the only one with name recognition, thanks in part to influencer marketing with folks like Kardashian and the media attention that’s accompanied it.

Around New York Fashion Week last fall, high-profile individuals like designer Zac Posen and model Lily Aldridge posted photos from inside Prenuvo, offering a discount code at the #LinkInBio. Cindy Crawford is an investor.

Sometimes, these de facto spokespeople share videos or photos from their own scans — which Prenuvo makes remarkably easy, with a few readymade assets provided to each patient via the company’s app. As more scan pics and photos alongside MRIs began to populate our feeds last fall, a rash of articles appeared heralding the full-body MRI as the elite’s new must-have (the New York Times: “The New Status Symbol Is a Full-Body M.R.I.”; Fast Company: “What is Prenuvo? How an MRI became a luxury status symbol”; Town & Country: “Why Everyone is Talking About Prenuvo: When did getting an MRI become a status symbol?”).

“Our strategy has been, just [make] a great clinical service, a great experience, and people will tell other people about it,” says Prenuvo founder and CEO Andrew Lacy, who says the company stumbled into this tactic by accident. “We were opening in LA, [and] some of the people that got told were people who had a massive voice, who also have friends with massive voices because they stick together,” he says. “You can say we've leaned into [that strategy], but it's not been deliberate in the sense that we don't go out there and sign contracts with people with influence to go and promote us.”

A couple of hours after my interview with Lacy, my husband shows me an Instagram ad he’s been served: a message from content coach Marzia Prince (20,000 followers), vouching for Prenuvo.

Lacy points to our health care system, which just about everyone will tell you is broken even if they don’t agree on why, and argues that preventative medicine is the answer.

Dr. Daniel Sodickson, M.D., Ph.D., director of NYU’s Bernard and Irene Schwartz Center for Biomedical Imaging, thinks so. He’s a believer — so much so that he joined Ezra, a Prenuvo competitor, as its chief of innovation. Ezra’s approach differs from Prenuvo’s in that it uses existing, third-party MRI facilities, rather than building its own. It seems a little less concerned with the experience than the results.

“The best way to make imaging accessible to people is to make it cheap, to make it fast, and to make it nevertheless fully capable of catching any of these diseases early,” Sodickson says.

The best part were the images. My whole body, bisected and laid bare for inspection.

Seven days after my visit to Prenuvo’s midtown clinic, I receive an email notification: My results are ready on the online portal. Greedily, I scan through all of the information. For a moment, I let myself wonder if I’ll finally find the One Diagnosis to Rule Them All.

I did not. As far as the scan could tell, I was generally fine, aside from some swelling in my ankles and hip joints, and a central disc herniation in my lumbar spine. Apparently my gallbladder was folded over and my breast tissue was dense, and apparently neither of those things mattered to my overall health. The best part were the images. My whole body, bisected and laid bare for inspection. It scratched a primal itch, to view what has been kept under wraps for almost all of human history. I understood why people felt the urge to post these on social media, an ecosystem where everything is skin-deep.

I had the option to meet virtually with a nurse practitioner to go over the whole thing, but I didn’t much see the point, as I was already in the care of a half-dozen specialists.

A couple of weeks later, I hop on an unrelated virtual appointment with one of my neurologists. It’s relatively uneventful, but as we’re wrapping up, I mention offhandedly that a Prenuvo scan had detected disc herniation.

He doesn’t even try to hide his exasperation. If you scan just about anyone’s spine, he says, you’re going to find something.

My instinct is that it’s better to know than not know. My disc herniation in particular seems meaningful, because my father has back issues in the same place; armed with this new knowledge, I can take preventative steps to stay limber.

But there are downsides, too. I’ll admit, I’ve been more aware of back pain in the past few months than ever before. Maybe I didn’t even have any before I saw that picture of my L5-S1. Now that image is embedded in my self-perception. Seeing is believing.

From a patient perspective, this may be the most salient issue: that instead of calming garden-variety hypochondria, Prenuvo may aggravate it with unimportant findings. Experts, however, worry about more concrete risks — and this gets a little jargon-heavy, but stick with me.

Neither the American College of Radiology (ACR) nor the American College of Preventive Medicine recommend preventative full-body scans. Nor does the American Cancer Society, or National Comprehensive Cancer Network.

As with so much of medicine, ACR spokesperson Shawn Farley explains, deciding whether or not to recommend preventative scans boils down to weighing benefits against potential risks. The benefits of the full-body MRI, of course, would be catching cancers or other diseases in early stages, when they’re easier to treat. The potential risks would come after the scan, through any follow-up procedures or tests ordered in the wake of a false positive.

Do the benefits outweigh the risks? “I don't think there's sufficient evidence either pointing toward it or against it,” says Joshua D. Trzasko, Ph.D., a Medical Physicist member of the radiology faculty at Mayo Clinic. “It's essentially an unknown.”

Although MRIs have been around for some time, both public and private institutions have been working to make the machines more powerful (self-explanatory), smaller (in hopes they’ll become somewhat portable), and faster (less time for patients to move and mess up the scan; and the less time it lasts, the less it costs). To ensure that everyone’s advances are up to par, the National Institute of Standards and Technology (NIST) has stepped in to implement some universal standards — otherwise, how would anyone know whose technology was best, or if it even works?

AI is proving particularly helpful for increasing speed: Ezra’s proprietary Flash AI, which allows MRI machines to work faster while also creating clear images, was cleared by the FDA last June. This allowed it to launch the world’s first 30-minute full-body MRI scan, spine and lungs excluded. (To generate the data necessary for FDA clearance, the company used anonymized versions of the scans it’s been charging patients for since its 2019 launch.)

Prenuvo’s full-body scan is about three to four times faster than I’d find in a standard clinical setting, Lacy tells me. (This tracks: While my Prenuvo scan took an hour, my previous MRIs have taken 30 minutes or more to image much smaller portions of my body.) The company accomplishes this with a blend of custom-built machines and proprietary AI, which Prenuvo says is “currently in the research and investigational stage” and has not been cleared by the FDA.

We know that Prenuvo works sometimes, because of stories like Maria Menounos’. And we know it doesn’t work sometimes, because some patients have reported false positives, inaccurate reports, and poor communication about the scan’s findings. (Prenuvo says they are very confident in their techniques and rate of accuracy, and notes that their founding radiologist co-authored a set of standardization guidelines for full-body scans.)

How can Prenuvo be growing, planning to open locations in 11 more cities by the end of the year, if there is no FDA clearance of its algorithms, or explicit peer-reviewed evidence that it does what it says it does?

The answer likely lies with a certain category of products the FDA doesn’t regulate, which is meant to house low-risk devices like heart rate trackers or step counters. However, the category is broadening thanks to advancing technology, explains David A. Simon, Ph.D., a professor at Northeastern University and a former research fellow for the Diagnosing in the Home initiative at Harvard's Petrie-Flom Center. Today, it encompasses programs that claim to calm anxiety and depression, bracelets that track your vitals and spit back AI-powered analysis on your REM patterns. An app called Miiskin promises to track moles; Apple Watches can now perform ECGs.

A few weeks ago, I began experiencing chest pain. Against the express advice of the Apple Watch’s ECG feature, which is approved by the FDA for informational — not clinical — use and clearly states it cannot detect heart attacks, I used it in the hope it’d give me peace of mind. It did, for a while. But the next day, after urging from a virtual urgent care doctor, I went to the ER. The EKG they recorded was anything but normal. (Subsequent testing ruled out heart attack, but something really was wrong.)

Why did I think the Apple Watch could help me?

It’s increasingly hard for us non-doctors to tell the difference between a device that’s evidence-backed and those that just have evidence-backed vibes. “There have long been homeopathic practitioners, chiropractors, naturopaths, people who use supplements and other techniques that maybe don't have the same evidence base,” Simon says. “For a good portion of the history of modern medicine, that's always been an issue. What's different now is that the consumer has direct access to some of these things, whereas before, at least to some degree, they'd be mediated by a third party with purported expertise.”

Over the course of my own medical odyssey, evidence-based science has been my guiding light. I do my best to read all publicly available studies on a given treatment, and take care to note the methodology. I resist punching people who recommend I go on a juice cleanse, but can’t guarantee I won’t one day lose it.

When you fall through the cracks of established medicine, as my collection of vaguely autoimmune-related conditions and I do, you quickly find it’s up to you to determine the difference between a forward-thinking treatment and pure quackery. If you want, you can see increasingly fringe doctors and all manner of dubiously accredited “experts.” You can start on firm ground by resolving to eat more fruits and vegetables and quickly trip into a rabbit hole of wellness, piling on the med spa treatments and gulping down dubious supplements that may not even contain what they advertise. The line between medicine and wellness wavers, then recedes entirely.

The line between medicine and wellness wavers, then recedes entirely.

For those who like being in the driver’s seat, this can be a blessing. If you’re lucky enough to have some combination of decent health insurance and disposable income, and to live in an area with lots of doctors, you can direct your care. You can seek out second opinions and referrals until you find someone who will take your concerns seriously. The potential downsides? Just look at the people hospitalized during the pandemic for taking large doses of Ivermectin, erroneously believing that it would fight COVID-19.

Over the past two-ish years, I’ve often joked that I should just get a full-body MRI. It wasn’t just a joke, though. I really wanted one. My doctors assured me that nothing was wrong with me “structurally” — code for “whatever it is, it won’t show up on a scan” — but how could they be sure? Still, even as I craved the peace of mind such a scan would deliver, I knew no doctor would prescribe such an indulgent scan, and even if they would, my insurance surely wouldn’t cover it.

Prenuvo brushed aside the red tape and let me right in. I got to see myself, for myself. And the doctors were right: Nothing was structurally wrong with me.