While celebrating the July Fourth holiday last year on a boat in Tyler, Texas, Dr. Julianne Santarosa received the results from her full-body MRI scan. What she saw put a damper on the festivities.
Radiologists at Prenuvo, which performed the scan, had identified a nodule in her lungs. Santarosa, who works as a spinal access surgeon in Dallas, could see the spot circled as she looked at the images from the patient portal on her phone.
“I was like, unless I swallowed a taco chip, that something should not be there,” she told CNBC in an interview.
Before paying $2,500 for the Prenuvo scan, Santarosa, who was 41 at the time, hadn’t felt any pain in and around her lungs and had no reason to suspect anything specific was wrong. Rather, she’d felt generally off since going through in vitro fertilization and had a gut feeling she should do the scan after seeing a Prenuvo ad on Facebook.
The day after seeing her Prenuvo results, Santarosa had a follow-up CT scan at a local hospital. The nodule was cancerous. She had it removed the following week.
Curious and concerned patients like Santarosa are flooding Prenuvo’s nine clinics in the U.S. and Canada. There’s so much demand that the 5-year-old Silicon Valley-based company has announced 11 more locations opening by 2024, including one in London and another in Sydney.
Kim Kardashian called Prenuvo a “life saving machine” in an August post on Instagram that’s generated more than 3.4 million likes. Actress and model Cindy Crawford is an investor, alongside Google ex-Chairman Eric Schmidt, 23andMe co-founder Anne Wojcicki and Nest Labs founder Tony Fadell. The company raised $70 million late last year in a funding round led by Felicis Ventures.
Prenuvo CEO Andrew Lacy said he wants to help customers understand what’s going on beneath their skin, which his company’s technology can do by identifying more than 500 conditions like cancer, multiple sclerosis and brain aneurysms. As of now, the scans have a limited audience because they aren’t covered by insurers, requiring patients to pay out of pocket.
For Santarosa, the imaging was worth every penny and more. Her cancer was detected early enough that she didn’t need to undergo treatments like chemotherapy or radiation. More importantly, it hadn’t spread to the point that it was life threatening.
“There’s no screening test for this,” Santarosa said. “I would’ve been stage 4. I would’ve figured this out when I was coughing up blood.”
An MRI, which stands for magnetic resonance imaging, is traditionally used when ordered by a doctor. Interpreting the images is a complex science, and the scan alone can take more than an hour, even if it covers just part of the body.
Prenuvo’s custom MRI machines, which received clearance from the U.S. Food and Drug Administration in 2018, can scan a person’s entire body in about an hour. Once a scan is complete, the images are reviewed by one of the company’s 30 licensed radiologists. Customers usually receive their results back within five to 10 business days.
Waitlists are long. According to Prenuvo’s website, the next available slot for a full-body scan in New York is in March. The same is true for the Los Angeles clinic. In the Dallas suburb of Irving, there’s availability starting in mid-December.
Lacy said the business has spiked as awareness in the past 12 months has grown “incredibly.”
“These days, when people ask me what I do, and I say I work at Prenuvo, it’s ‘Oh, I heard that on this podcast,’ or ‘That influencer talked about it,'” he said.
In addition to full-body scans, Prenuvo offers a head and torso scan for $1,800 and a scan of just the torso for $1,000.
‘Old-fashioned scaling’
Lacy said Prenuvo is working to bring prices down through “old-fashioned scaling.”
Some companies have started offering Prenuvo scans as a perk for employees, which has helped increase access to the technology. Lacy said it works for companies with self-funded insurance plans, because they’re able to customize their offerings while assuming the risks.
Traditional insurance companies are paying attention.
“Over time, that data helps inform insurance companies about whether this should be something that would be covered across the insurance plans that they offer,” Lacy said.
Prenuvo is looking for other ways to lower costs through artificial intelligence and by potentially reducing the durations of the scans even further. Lacy said the cost is directly correlated to the amount of time customers spend in the expensive machines.
Radiologists are at the core of Prenuvo’s business. That brings its own challenges.
Many radiologists are fighting burnout as an aging population has led to mounting caseloads. Emerging technologies like AI have also discouraged some young physicians from pursuing the practice. By 2034, the U.S. could see an estimated shortage of up to 35,600 radiologists and other specialists, according to a report from the Association of American Medical Colleges.
So far, it’s a problem Prenuvo has managed to avoid.
Lacy said Prenuvo has a backlog of radiologists who want to work for the company. In traditional medicine, radiologists are often diagnosing patients with serious and advanced diseases, so identifying conditions early can be a welcome change, he said.
“When you’re catching stage 1 cancer, what you’re doing will save lives,” Lacy said.
Prenuvo is still in its early days. Medical experts caution that, in addition to the steep price, full-body MRI scans won’t catch everything and aren’t meant to replace targeted screenings like colonoscopies and mammograms.
“It is a tool that your physician and you can use, but it does not replace a full diagnostic examination,” said Dr. Jasnit Makkar, an assistant professor of radiology at Columbia University Medical Center, in an interview. “It is a work in progress.”
Dr. Kimberly Amrami, vice chair of the department of radiology at Mayo Clinic Rochester, said that because of the limitations, patients’ expectations have to be set accordingly. She said it can be challenging to identify lesions in the lungs, for instance, and scanning different body parts like the knee, the pelvis, the breasts and the prostate all require different techniques.
“There’s always a wish to do an exam that’s going to answer every question,” Amrami said in an interview. “It’s just not really the way that it works with MRI in particular, because the way that you evaluate different body parts in different disease states is quite different.”
Prenuvo doesn’t use contrast, a heavy metal that’s injected into the blood vessels, when conducting its scans. Contrast can help radiologists visualize certain conditions better, but there’s controversy surrounding its use, and the company doesn’t want to deter people.
Lacy said Prenuvo’s hardware was designed to do “almost as good a job” as contrast by using other techniques.
“We believe that that’s the best possible solution for screening patients who are at normal risk and asymptomatic,” he said. “If we find something that’s very concerning, oftentimes, we will suggest that the patient gets some type of follow-up dedicated imaging that might involve contrast.”
Amrami said people should consult with their physicians to determine what kind of imaging works best for them.
“There is no one-size-fits-all for MRI,” Amrami said.
A look inside a Prenuvo clinic
Lacy said he was inspired to create Prenuvo after he started to wonder about how his high-stress lifestyle was affecting his body. He previously started an internet search company and helped found a gaming company, among other ventures.
He found a radiologist who was offering an early version of a full-body MRI scan. Lacy said he learned a lot from that experience.
“Although my lifestyle was impacting my health, there was nothing crazy going on,” Lacy said. “I remember just this incredible feeling of peace of mind.”
Prenuvo designed its experience for relaxation. Its New York location has the feel of a cross between a spa and a doctor’s office.
Upon arrival at the clinic, patients are led from a cozy waiting room to a private area where they can change into scrubs and remove their jewelry.
While lying down in the machine, patients are given a pair of headphones and can choose to listen to music or watch TV during the scan.
Dr. Eduardo Dolhun, a family physician in San Francisco, decided to get his first Prenuvo scan more than five years ago after Lacy stopped by his office. He said he was skeptical but intrigued by the technology, so he decided to fly to Vancouver, British Columbia, to try an early version of it.
After going through his results with a Prenuvo radiologist, Dolhun called one of his medical school peers at the Mayo Clinic.
“I think this is going to change medicine,'” Dolhun said, recalling the conversation.
Dolhun said he gets a scan every 18 months or so and recommends it to some of his patients. He still advises them to get screening exams like physicals and mammograms as well.
“Good science takes time,” he said.