Physicians

MRI Innovation

Magnetic resonance imaging (MRI) was invented in the early 80s and has constantly improved ever since, making it possible to diagnose more diseases, more confidently with every passing year. Prenuvo is at the forefront of screening MRI, bringing new techniques that we believe make preventative, whole body imaging possible, safe, and effective.

Prenuvo’s Technology

Faster, more accurate imaging

Whole-body diagnostic quality MRI examinations on standard MRI machines, if possible, usually take 3-4 hours to complete and can cost upwards of $100,000. They are typically reserved for patients with cancer predisposition syndromes and, because of the time required to lie still in the machine, often involves the use of general anesthetic. Using proprietary protocols and unique software, a Prenuvo scan takes 60 minutes to capture up to x10 the images of a traditional MRI, for a fraction of the cost and in one sitting. The scanner allows the patient’s head to remain outside the machine for most of the scan and is wider and more comfortable than a standard machine.

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Increased coverage of conditions

New Functional Imaging Techniques

While most MRI scans rely on anatomical imaging, which simply shows organ structures, Prenuvo uses new clinically-proven techniques that make it possible to identify how the organ works. This technique is called functional imaging and it increases the ability of MRI to discriminate accurately many conditions that previously would be indeterminant. Most standard MRI machines are not capable of performing these functional sequences at an acceptable speed, image resolution and, signal homogeneity. We continue to develop our methods to expand the scope of conditions that a Prenuvo scan can cover.

Deeper analysis and greater accuracy

Increasing use of artificial Intelligence

Many research studies are showing that AI can play a pivotal role in imaging, either through making radiologists more efficient and make fewer mistakes, or in eventually replacing radiologists for some tasks. Because of this promise, Prenuvo invests heavily in AI. AI approaches are increasingly complementing our core clinical pipeline. Notably, we are excited about the power of AI to make imaging more quantitative and accurate which in turn could lead to earlier diagnoses and more successful interventions.

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Reporting Follow-Up

False-positive rates and incidentalomas

Higher Resolution

Physicians are notably concerned about whether whole-body screening can increase the rate of false positives and incidental findings, leading to unnecessary and time-consuming follow-ups. To explore this further it is important to understand how MRI has been advancing as a field, what distinguishes Prenuvo from other imaging approaches at a deeper level, and why we have been successful in finding support from hundreds of doctors. We run frequent zoom conferences where we discuss these key topics, among other questions. Reach out if you would like to attend.

Whole-body cancer screening exclusive to Prenuvo

Diffusion Weighted Imaging

At Prenuvo, the single biggest evolution in our rate of detection and accuracy of detection has been the mastering of 3D diffusion weighted imaging (DWI) for whole body scans. By expanding the use of DWI beyond brain and spinal scans, Prenuvo can identify smaller masses less than 1cm in size, as well as masses that are located in parts of the body that cannot be detected through manual screening.

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Can you tell me more about your false-positive rate?

A false positive in imaging is when a finding is reported to be present when it is not. For example, a test designed to detect cancer returns a positive result when the person does not have cancer. In one of our clinical studies, we had 4 false-positive findings out of 1000 patients. This was a single-site study and we are in the process of repeating that in a second site under an independent investigator. There is no perfect test, however we are committed to learning from any false positives that we do have to minimize the likelihood of them recurring in future studies.

Do you use contrast in your MRIs?

We never offer contrast on any of Prenuvo scans. We believe the combination of sequences that we take performs as well as contrast-enhanced MRI for tumor detection.

How are you different from other whole body MRI services?

There are so many differences between a Prenuvo scan and other whole body MRI services that we generally don't make comparisons. - Sequences and filters used – To make sure that there is a low false-positive rate, it is essential to image your body with multiple filters. Most other whole body providers do not use many filters in their screening protocol. In our protocol, this is the key to our low false-positive rate. - Quantity and quality of the images — We get up to 2000 high-quality images inside your body. The basic rule is that more images provide more details. We capture up to 10x more images than "WB MRI". - One-time scanning — We scan you from head to toe during one 60-75min scan. Other providers scan parts of the body and “glue” the parts together to create whole body scan. - Price – Our services are less expensive than our competitors.

How does your scan compare to 3T MRIs?

Bigger is not always better. A 3T MRI is a great option for a detailed brain study. Unfortunately, 3T performs poorly for whole body imaging due to wavelength interference (physics!) and imaging artifacts (more physics!). Additionally, a 3T MRI increases the body temperature too much. Therefore, for safety reasons they are used for single body parts. As we specialize in whole body imaging, we use a 1.5T MRI.

How effective is the Prenuvo scan for breast cancer versus mammography?

These screens work very well together. Mammography is capable of seeing small micro-calcifications in the breast that MRI does not see. Breast calcifications are well visualized on mammograms. Although breast calcifications are usually noncancerous (benign), certain patterns of calcifications — such as tight clusters with irregular shapes and fine appearances may indicate breast cancer or precancerous changes to breast tissue. Our MRI scan, on the other hand, is capable of seeing breast cancer more clearly through dense breast tissue which mammograms struggle to do.

Is a CT or MRI better at finding tumors?

MRI. A CT scan has a problem differentiating tumors. This is because a CT focuses on density. The density of a tumor is not greatly different from the density of a cyst but has a vastly different significance. A CT scan can miss many tumors and equally concerning, can more often lead to additional testing when it is unnecessary. Importantly, CT scans cannot accurately assess breast tumors or liver tumors.

Is your scan more accurate than a PET scan?

PET-CT (Positron Emission Tomography - Computed Tomography) is rarely used to screen for cancer. PET-CT is expensive and subjects you to both gamma and X-ray radiation. The PET portion of PET-CT uses gamma radiation to detect the metabolic activity of a tumor. The CT portion obtains many X-ray images which are overlaid on the PET images to assist in determining the exact location of the tumor in the body. PET has limited use in the kidneys, ureters, and bladder because the radioactive injection is excreted through the urinary system and is highly concentrated in these areas during the scan. The Prenuvo scan does not have these issues and is therefore, more sensitive than PET-CT for tumors of the urinary system.

What is the difference between a CT scan and an MRI?

A CT scan is great for showing densities in organs but is not useful for determining what these densities are. For example, CT scans can only report a "possible fibroid measuring 10mm", whereas an MRI can show more certainty in saying "a 0.8cm intramural fibroid". The MRI is more definitive on its composition and exact location. CT scans show densities such as coronary artery calcifications, and this is the main benefit from a CT over an MRI. The MRI shows more precise imaging for brain, brain arteries (which are not imaged at all on a non-contrast, enhanced CT), as well as every organ in the neck, breasts, abdomine, and pelvis. CT would be better for assessing the esophagus, lung, and stomach. The major downside of a CT scan is that it uses a high dose of radiation. For example, a CT scan uses up to 79.7mGy of radiation. This is the equivalent of 800 chest x-rays and 22 years of background radiation every time you go for a CT scan. With MRI, there is no ionizing radiation, making it a safe test that does not have a risk of causing leukemia or lymphoma.

What is the difference between an ultrasound and an MRI?

It is difficult to compare ultrasound to MRI. There are a few areas where ultrasound really shines — notably in confirming kidney stones because MRI is less able to see calcification. But it suffers from a poor field of vision (kind of like shining a light under the water, where the depth of field can be a bit murky) which means that it sometimes misses things. A good example was an ovarian cyst we found recently in a woman that received a normal ultrasound because the cyst was likely confused with a section of the bowel. An MRI is a completely different modality. It is three-dimensional so if you see something of interest, you know exactly what organ it is in. And we don't just take run-of-the-mill MRIs. We take many different tissue weightings which means, not only can we determine that "something is there" but we can distinguish if that something is a hematoma, cyst, abscess, or solid tumor.

What specific sequences do you use in the Prenuvo scans?

We perform a comprehensive set of protocols that image the entire body. These include brain quantification, arterial assessment, fat quantification as well as dedicated cancer and spinal screening. The exact techniques are part of our "special sauce" and are hence not freely given out. Rest assured, they are a combination of evidence-based and emerging technologies that offer the most comprehensive diagnostic imaging in a reasonable time frame. We currently utilize Siemens hardware in all locations.

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