THE PROMISE OF EARLY DETECTION
Roberta Kline MD
Despite the promise of early detection, women have had a long history of underdiagnosis of health issues. Having practiced as a board-certified OB-GYN for 15 years, I know firsthand the importance of early detection for some of the most common women’s health issues, including cancer. After all, basic bloodwork, pap smears, and mammograms are routine parts of women’s health care. However, these only address a small fraction of the diseases and health issues that women can face throughout their lives.
The failure of early detection can be due to many reasons, including a lack of effective screening tests, lack of support for the widespread use of current screening technologies, or lack of access to these services. Some diseases, such as endometriosis, ovarian and pancreatic cancer, and Alzheimer’s disease, have had no effective screening tests and are often not diagnosed until much later in the disease process. Others, such as brain or aortic aneurysms, uterine fibroids, gallstones, and cancers of the bone, liver, or kidney can be detected by currently available imaging, but these are not part of the standard recommendations.
In a healthcare system that generally prioritizes disease diagnosis over disease prevention, this failure to adopt a proactive approach is not surprising. While enabling early intervention through prevention and early detection strategies is often cost-effective in the long run, it is often more resource-intensive in the short run. Changing this on a global level requires a different mindset and reorganization of resources. It also requires innovative ways of thinking and creating potential solutions.
INNOVATIVE APPROACHES TO PROACTIVE HEALTH
In my endless pursuit for answers to help women better understand the “why” of their health and disease, I have spent the past 15 years seeking cutting-edge approaches to detecting potential issues early rather than waiting until they cause symptoms or disease. What I find continues to inspire me and compels me to share this information and make a difference through research and education.
These advances now make it possible to evaluate predispositions to health issues and create a customized plan for proactive health for each woman. An equally important part of this strategy is regularly assessing how well these strategies are working. Advancements in lab technologies have made it possible to do in-depth analyses of most aspects of our genetics, epigenetics, biochemistry, and molecular functioning.
However, this “micro” view doesn’t tell everything. We also need to take a “macro” view to screen for masses or other structural abnormalities. Imaging is designed to do just that, and we now have advanced technologies that have expanded our capabilities to see inside our bodies in incredible detail. But, as with lab tests, the conventional model of waiting until someone has symptoms and then only evaluating that specific body part has limited their use for early detection screening. In part, this is due to concerns over unnecessary radiation exposure. Ultrasound and MRI have no radiation and thus are safer options for repeated whole-body screenings. But neither of these was a viable option until recently.
MY EXPERIENCE WITH PRENUVO
Highly detailed diagnostic MRI's are designed to scan specific body parts. To be feasible for scanning the whole body, they needed to be redesigned with this different goal in mind. Recent progress made in imaging technology and AI-assisted interpretation has enabled innovators to create the right balance in detection and accuracy.
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At this point, Prenuvo states it can detect hundreds of conditions in the early stages. This includes many cancers, as well as diseases and other abnormalities that cannot be detected on routine bloodwork or yearly physical exams. This is a potentially powerful tool for helping women be proactive in their health, and I recently had the opportunity to experience a full-body MRI scan with Prenuvo.
Diagnostic MRI scans are not necessarily the most comfortable and can often induce anxiety both in the anticipation and in the actual experience. I was curious to see how Prenuvo compared and was pleasantly surprised.
Having practiced in many different settings, including the military, a large conventional group, and a cash-based practice, I’ve seen how the right patient experience can facilitate health and healing. Prenuvo clearly understands this as well, and it was evident in every part of my experience.
The online registration process included a lengthy health questionnaire. I had not anticipated this and so was not prepared. When I realized there were more questions than I could answer in the time I had allotted for this, I was afraid I would have to start all over again. I was relieved to find that all my answers were autosaved and that I could complete the form over more than one login session. As a point of improvement, it would have been helpful to have received some initial instructions on what information I would need and the approximate time for completion.
I received regular reminders of my progress through the registration process and instructions for my upcoming appointment. They also anticipated many questions I had and answered them proactively in these communications, helping me to feel well-prepared. This also conveyed that I was important to them, not just a number.
March 5, 2024 - On the day of my MRI, the reception area was warm and well-lit - a beautiful contrast to the gray winter day outside. The atmosphere was more like that of a spa than a medical office, and the staff was very courteous, friendly, and attentive. I was brought to the changing room which was beautifully designed and appointed to anticipate my every need. This attention to detail again spoke to how Prenuvo is not just a place to get an MRI, but also values supporting wellness overall.
I was surprised at how comfortable the MRI was. I have had conventional MRIs in the past, and they have felt small and cramped, even a bit claustrophobic. This MRI bed was a little larger, and that made a big difference. It was well-padded, and the technician spent time making sure I was comfortable. She also checked in with me throughout the scan to ensure I was still doing ok. The choice of music or videos was appreciated, and the automated instructions throughout the MRI were clear and very helpful in knowing what was coming next – including how long to hold my breath for some parts of it.
After my MRI was completed, I was not rushed out to make room for the next patient. Instead, snacks and drinks were available, and I was encouraged to take my time to replenish after having fasted for several hours. I left there feeling well taken care of. While I was informed that I would be getting my results through my personal dashboard, the process to set this up could be improved by handling this as part of the preparation or in automated emails in the day or two following the MRI.
As a first-time user, once I had figured out how to access my dashboard, I found it easy to navigate. It provided helpful education about the report and images, and it was easy to share these with others by having them sign up for an account. This is very easy and convenient, especially for healthcare providers who are forward-thinking and are used to this type of platform. However, it can pose a challenge if they don’t feel comfortable or are not able to create an account for a variety of reasons. Prenuvo does anticipate this by enabling downloading the report and image files, although this solution can have its own challenges.
One challenge I encountered was how to share these images with a local radiology facility, as they typically facilitate this process by reaching out to other imaging centers directly through standard channels. While their security processes prevented them from creating an account with Prenuvo or uploading the images from a portable USB, we eventually did find a workaround through a secure online file-sharing method.
I appreciated the opportunity to review my scans and results with their designated radiologist. While it’s more accessible to do this as a physician myself, it’s also a level of service available to anyone who gets a Prenuvo MRI scan. This is another element that speaks to a well-thought-out process designed to help people feel knowledgeable and empowered. I think that this is especially valuable for people who don’t have a healthcare provider who is familiar with the whole-body MRI concept or want to be able to have a more personalized experience.
FINDING HIDDEN RISKS CAN SAVE YOUR LIFE
I was amazed at the level of detail and amount of information provided in the report. Not only was it interesting to learn more about my body in a way that I hadn’t been able to access before, but it also revealed things I could act on. This reflects the very essence of proactive healthcare.
Any time someone undergoes any testing, there is always an element of fear of the unknown for what might be detected. We all experience this to some extent, but for some people, it prevents them from taking action. It’s important to understand that ignorance is not bliss. These things are going on in your body, whether you are aware of them or not. Being able to reframe this fear into self-empowerment is important. It doesn’t mean your fear goes away; it just means you can move through it and take action anyway. And that action may very well save your life.
For those who want to be proactive in their health, I see the full-body Prenuvo MRI as a great addition to existing tools for early detection. It fills a much-needed gap for learning more about one’s body and catching any potential issues while they are still easily addressed.
DR. ROBERTA KLINE is an ObGyn physician, an award-winning author, an educational advocate, and an inspirational speaker for the professional and women’s communities. She holds a combined mission to upgrade how we approach health and deliver healthcare for women through education, globalized communication, research, and advocacy. Dr. Kline develops and teaches CME programs, consults on gene expression project designs, and leads collaborative projects designed to advance the direction of women’s health. She is also a clinical advisor in integrative medicine and functional genomics to many health organizations including the Integrative Health Research Center. In addition to her mentorship programs for women physicians, Dr. Kline is Director of Educational Programs for the Women's Health Collaborative, Editor of the Women’s Health Digest, and on faculty at the University of Western States.
TECH TALK: PRENUVO'S UNIQUE APPROACH TO WB-MRI
MRI technology has now matured over the past 20-years where we can actually effectively perform diagnostic-quality WB-MRI. Via careful MRI protocol design and optimization, we have developed a specialized WB-MRI focused screening service that has been of significant clinical utility to our patients and referring-clinician colleagues.
Our approach to whole-body MRI imaging is one that is geared for early detection, fast yet comprehensive, safe and comfortable. Our standard Prenuvo screening protocol is a comprehensive multiparametric Whole-Body MRI study (anatomically covering the head, neck, chest, abdomen, pelvis, whole-spine, and lower-extremities through the ankles) that takes under 1 hour without compromising diagnostic quality. This technique is effective to detect, localize, characterize, and even stage a very wide-spectrum of pathology (ranging from solid-tumors even at small early/localized stages, to benign cysts, to brain aneurysms, and many other diverse pathologies) with a very high-level of sensitivity and specificity for a screening evaluation. We do this without undesirable radiation or contrast.
What makes our approach different from traditional MRI approaches, which typically rely primarily on more anatomically-focused imaging, is that we also combine this with an important specialized functional-focused MRI-technique known as Diffusion-Weighted-Imaging (DWI) covering the whole body. DWI has been clinically-demonstrated to play a very valuable role particularly in oncological-imaging; and, in the screening setting DWI significantly enhances our ability to discriminate oncologically-concerning lesions from benign lesions. DWI can be thought of as an MRI-analogue to PET-imaging (whereas PET highlights hypermetabolism of cancerous tissue, DWI highlights hypercellular-density or “tissue hardness” characteristic of cancerous tissue).
Our DWI technique, in conjunction with the multiple other well established multiplanar multiparametric MRI sequences in our protocol, afford us the requisite level of sensitivity and specificity needed to provide clinical value in the context of desired proactive screening. Most standard MRI systems are not capable of performing these specialized WB-MRI sequences at an acceptable speed, image resolution, and similar multiparametric comprehensiveness.
MRI SCREENING vs HOSPITAL CONVENTION- Prenuvo scans capture 2000 images in 28 areas in under an hour at diagnostic quality, with 1B+ data points acquired, compared to the 4-5 hours it would take through conventional MRI. Conventional MRIs also use pre-programmed protocols that are not optimized for whole-body speed capture without compromising diagnostic quality. We've taken a different approach and verticalized our hardware and designed software acquisition protocols for whole-body diagnostic yield in under one hour. |
THE FULL-BODY STRATEGY FOR CANCER SCANNING
In simplistic terms, having a full-body access comports to the fact that everything is connected in one way or another. Tumor cells start somewhere, but they can spread almost anywhere they want. If we find a cancer in stage one (which usually means confined to the organ of origin) what happens afterwards is to ask if it is IN FACT confined to that organ, or if it has spread somewhere else. This is called staging.After a cancer is detected, patients often go into a panic asking "What stage is it? ... Is it metastatic?" Working with the conventional MRI or CT of the past, they would have to wait to get a brain MRI, then a chest, abdomen, pelvis study and a bone scan etc. With our technology, we already have all that. We've routinely found people with stage one cancer as part of early detection. This is a good basis where you want to find it. From here, searching 'full body' is the best next step to make sure that it's not anywhere else in the body. Using an MRI with diffusion, we can see it all.
"COUSIN SAL" GOES WHOLE-BODY MRI
8/8/2023- Ret. FDNY Sal Banchitta signs in to experience his Whole Body MRI from Prenuvo, NYC- a state of the art imaging company founded out of Vancouver, Canada. As one of the founding cancer awareness producers of NYCRA (NY Cancer Resource Alliance0 and F.A.C.E.S. (Firefighters Against Cancers & Exposures), Mr. Banchitta gladly accepted the invitation to receive this complete body scan as part of his pursuits of a base line for future scans and a preventative measure against cancer. "My mission alongside my fellow advocates is to learn about the latest modalities in diagnostics and treatment to bring awareness about cancer resources to the rescue community", says Sal. Prenuvo’s cutting-edge whole-body scans are based on 10+ years of clinical work while curating the biggest data set of whole-body MRI scans in the world. Unlike conventional MRIs, which take hours and often involve contrast injections, Prenuvo scans for 500+ conditions, including most solid tumors which can be detected as early as stage 1, in addition to aneurysms, cysts, and more –- all without radiation, in under an hour.
CANCER ADVOCACY IN THE NEWS!
3/27/2024- 23 years later, those exposed to 9/11 continue to feel the health repercussions of toxin and toxicants from the historical urban disaster. More than the 343 firefighters who perished during that fated time, we continue to find cases in the rescue and responder service, contracting the many types of illnesses from this horrendous response call. 13x Emmy Award winning reporter Marvin Scott covers the EARLY DETECTION program as he interviews Dr. Robert Bard (Cancer Imaging Radiologist) and Ret. FF and 9/11 responder Sal Banchitta. Dr. Bard presents his state-of-the-art imaging innovations to provide firefighters with some of the most advanced scanning solutions. "There are many tools out there that patients should know about. I'm pretty fortunate to have access to Dr. Bard and his program for advanced screening and I tell all my fellow firefighters about 'Getting Checked NOW!"
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