Below we give you an objective overview of the advantages and drawbacks of various suitable and available methods of examination.
The primary purpose of screening (also called ‘preventive examination’) is to trace an illness in the early stage, so that effective measures can be taken in time.
As a rule, illnesses are easier to treat if they are discovered in the early stage. Screening is done when people without complaints undergo an examination to find out if they might have a disease that is in the early stage. A good example of early detection is the population screening for breast cancer, in which every woman over 50 years is examined on a regular basis. This examination is generally known, but is limited to the breasts only.
A Total Body Scan gives insight into a large part of your body. During this examination it is standard that the vital organs and blood vessels are examined by means of an MRI (Magnetic Resonance Imaging) and a cardiac screening to look at your heart is included.
Our MRI consists of a four part scan which includes the skull and brain, arteries of the neck, upper abdomen and lower abdomen. We would only see an overview of the Lumbar spine (lower back). The focus of the MRI scan as part of the Total Body Scan is on the organs and arteries and not on the joints.
In the areas that we examine with an MRI scanner there is much to be diagnosed. Some organs, such as the stomach and intestines do not always give a clear picture. To be able to give a good diagnosis of the stomach and intestinal tract a supplementary examination is necessary. For more information about organs that can be diagnosed less specifically, read the section 'supplementary examinations and other important information' in this document.
The MRI scan is not the best means for an accurate examination of the heart, therefore a resting ECG and an Echocardiogram of the heart is recommended. An ECG measures the electrical activity of the heart and the echocardiogram is a film of the heart (ultrasound of the heart). An exercise stress test can be added which would show the electrical activity of your heart while under exertion.
It can occur that the doctor (on basis of risk factors) gives advice during the first consultation to make some changes in the standard examination program.
The latest developments in the field of Magnetic Resonance Imaging and CT-scanning make it possible to examine larger parts of the body. Even an examination of the complete body is possible. Current relevant (scientific) examinations have shown that an MRI-scan has absolutely no side effects, making this type of scan most suitable for screening. An MRI scan, makes use of harmless magnetic fields instead of X-radiation.
In certain clinics a contrast agent is used during the examination, to obtain an even clearer picture. This is administered by means of an infusion in your arm. This special MRI contrast fluid is currently used a lot. Side effects (such as skin allergies) are seldom. Serious reactions to contrast fluid are very rare (approximately 1: 8.000.000). It is important not to compare MRI contrast agent with the dangerous X-ray contrast medium. Because contrast fluid is excreted via the kidneys, no contrast fluid will be used if you have a serious renal dysfunction.
An echocardiogram is done by means of sound waves. This makes it possible to trace diseases and disorders that bring about structural changes in a part of the body.
Sound waves penetrate the tissue. During an echo the doctor moves a probe over heart area. The probe transmits sound waves with a very high frequency (2,6 to 10 MHz) which the human ear cannot hear (ultra sound). The sound waves are bounced back (echo) by the different tissues in the body, back to the echograph which in turn converts the sound into moving pictures.
Supplementary examinations and other important information
CT-scan of heart and lungs
Because a CT scan makes use of X-rays (although the scans are carried out with an extremely low dose) the doctors set a limit of two very important organs, the heart and the lungs. The CT scan will only be carried out if there are certain risk factors present. By means of the CT scan of the heart the calcified plaques, responsible for any clogging of the coronary arteries, is detected. This examination has a risk indication of a heart infarct in the oncoming 5-10 years. The CT scan of the heart can be carried out if one is older than 40 years and there are risk factors present, such as high blood pressure, high cholesterol, overweight, diabetes, illnesses in the family and/or smoking.
The second examination is the CT-scan of the lungs. Recent research results have shown that the number of deaths with heavy smokers decreases strongly if one undergoes a CT scan each year. 80% survived instead of the normal 20%. To participate in this research there are requirements that must be met. One must be over the age 40 years and have smoked at least 20 cigarettes per day for more than 20 years. If one has stopped, it is then advisable to be scanned up to 15 years from the time that you stopped smoking. A CT scan of the lungs can also be performed when one has persistent lung complaints, such as coughing, airway complaints, coughing up blood, a hereditary lung disorder/s and when there has been exposure to asbestos in the past. If one does not meet the criteria for a CT scan of the lungs, then one can have an MRI scan of the lungs.
Breast examinations are not a standard part of the Total Body Scan. There are a number of reasons for this. First of all, women in the UK above the age of 50 years are screened for breast cancer every 2 years. As breast diagnostics is very precise, the strength of this specific examination is in the comparison of current images to previous images. Time has shown that undergoing a mammography once only, does not provide a reliable diagnosis. Also a mammography does emit x-rays and our radiologists want to limit x-rays as much as possible to protect your body. Purely making an MRI scan of the breasts at the moment gives such a high percentage of error-positive results, so that the MRI scan for clients without symptoms/heredity do not have preference. A mammography in combination with ultrasound (or MRI) of the breasts is still the most reliable (and most cost effective). It is possible to have a supplementary examination of the breasts at most clinics that we work with. After studying the risk factors, such as heredity and complaints, the doctor will, in consultation with you determine which examination is best for you. The doctors will be somewhat careful with the use of X-rays and it may be that initially only a tactile examination and ultra sound will be done.
Stomach and gastro intestinal tract (incl. oesophagus)
The gastro intestinal tract (including oesophagus) can best be examined internally by means of so called endoscope (= a flexible tube with light and camera). The MRI scan is not suitable for this. Tumours can be concealed in mucus, may be confused with faeces or other irregularities and the intestine is moving continuously. To detect possible tumours in this track the most commonly used method of examination is the gastro- or colonoscopy. This viewing technique gives immediate sight into the inner side of the intestines and at the same time can take little tissue samples and/or remove polyps for further examination. In our Total Body Scan a stool test is done, which detects if there is blood in the faeces. This examination is somewhat less reliable, but it is an alternative for people who do not want a gastro-intestinal examination.
Throat area (including larynx, vocal cords)
This requires internal inspection by an ENT doctor using a so-called laryngoscope (a thin flexible fibre scope) the most reliable method of examination. The MRI scan is not suitable for this. Prescan does not offer this examination.
The echo technique, laboratory tests and scintigraphy are the best methods for this examination and/or a specific MRI scan of the soft tissue in the neck area. The MRI part of the Total Body Scan with the emphasis on the arteries of the neck. This is a so-called MRA and is focused on the arteries. For complaints in the neck area a supplementary MRI of the soft tissue of the neck can be included. This scan, however, does have its limitations and a consultation with an internist may be a better option.
Bladder, prostate (men)
In an MRI scan it can happen that small tumours in the bladder and prostate remain concealed. In the scope of preventive examination of the prostate a supplementary blood test by means of a PSA level check is recommended (this PSA level check is a standard part of the extensive laboratory tests that Prescan offers.
Bladder, ovaries, uterus (women)
With an MRI scan it is sometimes possible that small tumours in the bladder and ovaries remain concealed. The MRI examination of the female pelvis is not a substitute for the regular preventive gynaecological examinations (cervical smear).
A scan shows the anatomy of organs and blood vessels, but does not provide any information about the quality of your blood and the functioning of your organs such as liver, kidney and thyroid. Furthermore, latent risk factors can be traced from the blood, for example a heart infarct or a stroke. This is why the laboratory research an essential complement to the Total Body Scan. In addition to blood, also urine and faeces being tested there are, among other diagnostics for colorectal cancer and the presence of diabetes.
With the standard Total Body Scan one looks in the body. The skin is not diagnosed. Do you have moles, fair skin, have you been exposed to UV radiation from the sun or a tanning bed or do you have little places on your skin that you do not trust, then we advise a skin scan. With this scan a dermatologist inspects the noticeable places and evaluates them.
Enlarged lymph nodes are in the abdominal cavity and possibly can be seen clearly in the lungs. The nature of an enlargement, however, is less well defined and there may be a puncture/biopsy necessary in order to get clarity. This also applies to diagnostics of lymph node cancer, Hodgkin's disease and Non-Hodgkin's. Often lymph node enlargements are not specific to lymph node cancer. Also the laboratory test results (blood) of these diseases do not always indicate abnormalities. We therefore always recommend that if the lymph nodes are enlarged and there are persistent complaints, to contact your G.P. and if necessary ask for a biopsy of the lymph nodes.
Certainty and results
In some cases it can occur that the results do not give a definite diagnosis. In cases like this the follow-up examination, such as a check-up scan after a few months, can be necessary. Also, the doctors, despite very thorough investigation, cannot give a 100% guarantee about your health.
Incidentally it can occur that a suspicion of having a condition turns out to be nothing after having a supplementary examination. Here we speak about false-positive.
The medical report
A final GP consultation about examinations can either take place in the clinic or as a telephone consult.
The final conversation with the doctor and the report
In a personal conversation with the GP the outcome of the examination will be discussed with you in detail. The cardiologist will speak to you during the echo (while you are watching) and discuss the ECG later. You will receive the medical reports a week later.
Despite the fact that diseases often develop through the years, a preventive medical examination is always a snapshot and just shows the state of health at the time of examination. That is why it is advisable to regularly undergo a preventive examination and additionally, be aware of the alert signals from your body.
Depending on personal risk factors we recommend a total body examination every 1-3 years.
The examination program for a repeat client may differ in some parts from previous times. This may be for reasons of current medical knowledge, developments and/or personal health circumstances.
Because we do not have insight in your medical record it is important to indicate whether there were significant findings in the intake during your last examination (s). We ask you to always take your last report and CD-ROM images of the last examination, as the doctor might want to review it.
Prescan is duty-bound to select hospitals, clinics and doctors that they mediate for concerning quality and the required registrations. The responsibility and liability for the assessment, implementation and evaluation of the medical examinations lies with the hospitals, clinics and doctors with which Prescan has an agreement. The clinics and doctors are insured against possible "medical malpractice". Prescan is not liable for the actions of the medical staff of the clinic/hospital where the investigations take place, or from which damage can arise. Should a dispute arise Prescan may or may not mediate on behalf of the client.