The increasing popularity of whole-body MRI (WB-MRI) scans in private health clinics across the USA was addressed in this New York Times article, singling out Prenuvo for its use of celebrity endorsement on social media to promote their offering of hour-long WB-MRIs.
Prenuvo made claims like “1 in 20 scans result in a potentially life-changing diagnosis”, which directly contradicted the prevailing medical advice from the American College of Radiology (ACR).
In response, the ACR released a statement saying: “There is no documented evidence that total body screening is cost-efficient or effective in prolonging life”. The medical society also raised concern regarding “nonspecific findings” that require extensive, expensive follow-ups that are not without their risks to patient’s health.
Whilst we deeply believe in preventative healthcare at Compound, and we strongly encourage people to be more proactive in their healthcare, WB-MRI is not the panacea that clinics, like Prenuvo, proclaim it to be.
There has been a sharp rise in incidentalomas (incidental findings on radiological scans) detected in routine imaging scans today. Associate Professor Tom Sutherland, Director of Medical Imaging at St Vincent’s Hospital in Melbourne told The Age that “the rate of incidental findings had more than doubled in his 21-year career”, pointing to increasing use of scans, and higher sensitivity of images as the main driver of this trend [1].
Staggeringly, only 1% of these incidentalomas were serious enough to require medical treatment. So-called 'preventative' WB-MRI scans will only increase the incidence of incidentalomas and demand for follow-up diagnostic procedures like biopsies, blood tests and even surgeries.
Risk vs reward for whole-body MRI scans
“Surely it is worthwhile if even 1 scan detects a potentially life-threatening condition?” I hear you asking.
Well, that may not be the case. Investigating these incidentalomas is not without its risks and often comes at significant costs to the public health system or self-funding private patients. Painful biopsies can result in infection, bleeding, pneumothorax (a collapsed lung) or in extreme cases, the removal of part or all of an organ or tissue that is later found to be unnecessary.
Professor Ian Scott told The Age of one such example, detailing the experience of a patient who had major surgery to remove their pancreas after a mass was an incidental finding on an abdominal CT scan.
The patient developed diabetes and malabsorption syndrome post-operatively and had poor outcomes, only to find the mass was not cancerous weeks later.
Importantly, we cannot underestimate the positive impacts of the good news stories that form a strong counterargument to this ethical dilemma. This, in combination with clinicians’ citing a fear of litigation and patients' natural preference to investigate all incidental findings, ultimately drives the growing trend of investigating incidentalomas.
Whilst this “better safe than sorry” sentiment is unquestionably driving an increase in the uptake of private WB-MRIs, you have to question if these private operators are less likely to report the adverse results of their patients who go on to investigate benign masses and come to harm in the process.
At Compound, we are excited about advancements in diagnostic technologies and use cases within progressive models of healthcare. However, diagnostics must always remain rigorous, evidence-based, and patient-centric, avoiding unnecessary harm, or potential harm wherever possible.
It’s reasonable to assume with improvements in machine-learning imaging that the specificity of WB-MRIs for early detection will improve in time, however, they are simply not there yet and we have chosen not to include WB-MRIs in our diagnostics until they improve.
What about DEXA scans used in Compound’s program?
At Compound, we use DEXA body composition scans to answer specific questions about lean muscle mass, body fat, visceral fat, and bone mineral density given the importance of these metrics to everyday performance, cardio-metabolic health, and overall longevity.
However, these metrics must be reviewed alongside other indicators (e.g. blood biomarkers, diet, exercise, etc.) to form more powerful insights on areas for improvement and the actionable levers to focus on during our structured programming.
How does the DEXA influence Compound’s program?
Having a precise view of a member’s body composition helps identify key gaps to address and enables the coaching team to provide more personalised insights and recommendations across the Compound program.
DEXA scans provide precise metrics that are key inputs into specific parts of our program:
- Lean muscle mass provides key inputs to personalise daily protein targets and support improved strength and overall metabolic health.
- Body fat percentage — rather than relying on crude measures like BMI — enables us to modify your personal strength, conditioning, and nutritional program and informs clinical decision-making around the appropriateness of adjunct therapies where intervention is required.
- Visceral Adipose Tissue (VAT) is the amount of fat around your organs and is a strong indicator of cardio-metabolic risk that only a DEXA can accurately measure. Tighter nutritional and glycemic control and more emphasis on zone 2 cardio are key levers to address elevated VAT.
Demonstrating significant improvements in body composition — body fat percentage, VAT, and lean mass — at the end of each quarterly program cycle, provides Compound members with objective evidence of how their body has responded to lifestyle changes.
It’s our vision to help men adopt high-ROI lifestyle changes that drive quarterly improvements to measurable metrics — DEXA being one example — and establish a positive feedback loop that compounds consistency in healthy habits into more energy, everyday performance, and longevity.
At Compound we focus on diagnostics that provide accurate insights and inform actionable plans.
This post contains general information about health and wellness practices. It is not intended as medical advice and should not be treated as such. Please consult with a healthcare professional before starting any new health regimen. This information is provided without any representations or warranties, express or implied.
The increasing popularity of whole-body MRI (WB-MRI) scans in private health clinics across the USA was addressed in this New York Times article, singling out Prenuvo for its use of celebrity endorsement on social media to promote their offering of hour-long WB-MRIs.
Prenuvo made claims like “1 in 20 scans result in a potentially life-changing diagnosis”, which directly contradicted the prevailing medical advice from the American College of Radiology (ACR).
In response, the ACR released a statement saying: “There is no documented evidence that total body screening is cost-efficient or effective in prolonging life”. The medical society also raised concern regarding “nonspecific findings” that require extensive, expensive follow-ups that are not without their risks to patient’s health.
Whilst we deeply believe in preventative healthcare at Compound, and we strongly encourage people to be more proactive in their healthcare, WB-MRI is not the panacea that clinics, like Prenuvo, proclaim it to be.
There has been a sharp rise in incidentalomas (incidental findings on radiological scans) detected in routine imaging scans today. Associate Professor Tom Sutherland, Director of Medical Imaging at St Vincent’s Hospital in Melbourne told The Age that “the rate of incidental findings had more than doubled in his 21-year career”, pointing to increasing use of scans, and higher sensitivity of images as the main driver of this trend [1].
Staggeringly, only 1% of these incidentalomas were serious enough to require medical treatment. So-called 'preventative' WB-MRI scans will only increase the incidence of incidentalomas and demand for follow-up diagnostic procedures like biopsies, blood tests and even surgeries.
Risk vs reward for whole-body MRI scans
“Surely it is worthwhile if even 1 scan detects a potentially life-threatening condition?” I hear you asking.
Well, that may not be the case. Investigating these incidentalomas is not without its risks and often comes at significant costs to the public health system or self-funding private patients. Painful biopsies can result in infection, bleeding, pneumothorax (a collapsed lung) or in extreme cases, the removal of part or all of an organ or tissue that is later found to be unnecessary.
Professor Ian Scott told The Age of one such example, detailing the experience of a patient who had major surgery to remove their pancreas after a mass was an incidental finding on an abdominal CT scan.
The patient developed diabetes and malabsorption syndrome post-operatively and had poor outcomes, only to find the mass was not cancerous weeks later.
Importantly, we cannot underestimate the positive impacts of the good news stories that form a strong counterargument to this ethical dilemma. This, in combination with clinicians’ citing a fear of litigation and patients' natural preference to investigate all incidental findings, ultimately drives the growing trend of investigating incidentalomas.
Whilst this “better safe than sorry” sentiment is unquestionably driving an increase in the uptake of private WB-MRIs, you have to question if these private operators are less likely to report the adverse results of their patients who go on to investigate benign masses and come to harm in the process.
At Compound, we are excited about advancements in diagnostic technologies and use cases within progressive models of healthcare. However, diagnostics must always remain rigorous, evidence-based, and patient-centric, avoiding unnecessary harm, or potential harm wherever possible.
It’s reasonable to assume with improvements in machine-learning imaging that the specificity of WB-MRIs for early detection will improve in time, however, they are simply not there yet and we have chosen not to include WB-MRIs in our diagnostics until they improve.
What about DEXA scans used in Compound’s program?
At Compound, we use DEXA body composition scans to answer specific questions about lean muscle mass, body fat, visceral fat, and bone mineral density given the importance of these metrics to everyday performance, cardio-metabolic health, and overall longevity.
However, these metrics must be reviewed alongside other indicators (e.g. blood biomarkers, diet, exercise, etc.) to form more powerful insights on areas for improvement and the actionable levers to focus on during our structured programming.
How does the DEXA influence Compound’s program?
Having a precise view of a member’s body composition helps identify key gaps to address and enables the coaching team to provide more personalised insights and recommendations across the Compound program.
DEXA scans provide precise metrics that are key inputs into specific parts of our program:
- Lean muscle mass provides key inputs to personalise daily protein targets and support improved strength and overall metabolic health.
- Body fat percentage — rather than relying on crude measures like BMI — enables us to modify your personal strength, conditioning, and nutritional program and informs clinical decision-making around the appropriateness of adjunct therapies where intervention is required.
- Visceral Adipose Tissue (VAT) is the amount of fat around your organs and is a strong indicator of cardio-metabolic risk that only a DEXA can accurately measure. Tighter nutritional and glycemic control and more emphasis on zone 2 cardio are key levers to address elevated VAT.
Demonstrating significant improvements in body composition — body fat percentage, VAT, and lean mass — at the end of each quarterly program cycle, provides Compound members with objective evidence of how their body has responded to lifestyle changes.
It’s our vision to help men adopt high-ROI lifestyle changes that drive quarterly improvements to measurable metrics — DEXA being one example — and establish a positive feedback loop that compounds consistency in healthy habits into more energy, everyday performance, and longevity.
At Compound we focus on diagnostics that provide accurate insights and inform actionable plans.
This post contains general information about health and wellness practices. It is not intended as medical advice and should not be treated as such. Please consult with a healthcare professional before starting any new health regimen. This information is provided without any representations or warranties, express or implied.
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