For healthy people without a specifically elevated risk, a full-body MRI as a preventive examination has not been proven to be useful: clinical added value and cost-effectiveness are lacking, false-positive findings are frequent and can lead to unnecessary further investigations. For people with a hereditary elevated cancer risk, WB-MRI is recommended.
A full-body MRI (WB-MRI) sounds appealing as a preventive screening tool: one scan that maps the entire body. Yet there is currently no evidence that it is useful for healthy people without a specifically elevated risk. Clinical added value, test efficiency and cost-effectiveness have not been demonstrated for the general population (PMID 41792025).
The sheer volume of findings is overwhelming, but that is precisely the problem. A systematic review and meta-analysis of 12 studies (5,373 participants) found that approximately one third of healthy participants had critical or uncertain findings. A substantial proportion of those findings turned out to be false positives, however: the pooled false-positive rate was 16%, with an enormous confidence interval (1.9% to 65.8%). Long-term data of five years or more on the value of a negative result are entirely absent (PMID 30932247).
Another review of 12 studies (6,214 WB-MRI examinations) shows that virtually everyone, namely 95% of participants, has at least one abnormal finding on the scan. In 30% of cases further investigation was required. Ultimately, cancer was actually confirmed in only 1.1%. The studies are moreover too heterogeneous to allow firm conclusions about effectiveness (PMID 32393345).
A retrospective study of 576 asymptomatic adults presents a mixed picture. In just over 1 in 9 people (11.2%), the scan led to treatment. Cancers (2.6%) and cerebral aneurysms (4.8%) were detected. However, the scan also missed relevant findings: 2.8% had false-negative results, including five cancer patients. For the detection of colorectal, thyroid and breast cancer, the scan proved to have limited suitability. The researchers therefore regard WB-MRI as a supplementary tool, not as a replacement for existing screening programmes (PMID 33596499).
There is, however, a clear group for whom WB-MRI does offer added value: people with a proven hereditary elevated cancer risk (such as syndromes in which multiple cancer types occur within a family). There is broad consensus on this, and the recommendation applies to both adults and children with such a predisposition (PMID 34338948, 32393345). In specific known conditions such as multiple myeloma, WB-MRI is also a recognised and valuable diagnostic instrument, but that is an entirely different matter from preventive screening of the healthy population (PMID 34709161).
A small study (n=154) shows that participant satisfaction with the scan depends strongly on personality and expectations. Those who have high expectations of its usefulness are more satisfied; fear of claustrophobia lowers satisfaction. This says nothing about the medical added value, but it is relevant for understanding why people experience the scan as pleasant or worthwhile, even when the medical evidence does not (yet) support that (PMID 36148490).
Based on two systematic reviews and meta-analyses, one retrospective cohort study, and multiple guideline and review publications (totalling approximately 11,000+ scanned individuals in the quantitative studies). The studies are mutually heterogeneous and include no randomised controlled trials examining long-term health outcomes.