The first question about imaging is what the indication is

People ask me about full-body MRI a lot. It usually runs $2,000 to $3,000, and most people walk out with a list of findings. In a review of 12 studies covering about 6,200 scans in people without symptoms, around 30 percent had something that needed more workup, and cancer was suspected in under 2 percent. For that small group the scan can be extremely valuable. For most others it means more appointments and some worry over something harmless. What I'd rather see is a clear reason behind any imaging. Take a 40-year-old and a CT angiogram, which shows both soft and hard plaque in the heart's arteries. Traditional guidelines would usually say that's too young without symptoms. Now add a high Lp(a), prediabetes, a lot of visceral fat and a family history of heart disease. From a proactive standpoint that scan makes a lot of sense, since the result could change the whole plan. So the first question I ask is what the indication is. If someone has the disposable income and understands what might come back, a scan can be a reasonable choice. For most people, though, being deliberate about when and why to image is more valuable than imaging everything.