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Comment by GTP | Hacker News Reader

I find the technology side intriguing and worth a deeper dive.

But I'm not convinced about their view of having people casually going to a spa every week and getting a full body scan. AFAIK, some doctors tend to avoid full-body scans. The reason is that each body is different and has its own quirks. If you do a scan for no reason other than "I can do it fast", chances are that the scan will show something unusual. But, at the same time, it is likely that it isn't a problem. And now, you will be stressed about the chance of having some health condition and spend time and money digging into a rabbit hole of what the issue could be, only to find out it was nothing.

They also don't say anything about the price of such a machine. If they really envision a future where everyone can easily get a scan, this is a crucial factor.

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Why can't we do full body scans, learn about these "quirks", and document them in the wider science literature?

I understand there are many benign tumors that doctors prefer to ignore in people, but eventually when scanning becomes portable and safe enough having regular access to scans could really help a lot of conditions.

I think we may be looking at a very large, if not potentially infinite, set of quirks. And there's the risk of worrying people for nothing. So, if this is the plan, at the very least, it should take the form of a large medical study and not a shiny machine for fancy spas.

Isn’t that a similar argument against AI?

Sorry, I don't get your point.

Because if a "condition" doesn't impact you, will it help to be aware of it? Over treatment can be a real problem. You dont want to take medisine you dont need, or spend much time in a hospital if there is no net positive outcome.

> Because if a "condition" doesn't impact you, will it help to be aware of it?

Fast and cheap full body scans could provide the data necessary to tune out the noise.

For me?

If I could have daily full 3d body scans, and time lapse healing, track injury progress, visualize and correlate food and exercise.

And all I have to do is chill out about known benign cysts and tumors.

Yes I think it will help. I would take that trade off.

I already can feel a few cysts that have been with me for a long time, docs said I was fine, so I've already been through the stressful initiation of benign lumps.

And for what? Is it just morbid curiosity or is there something you plan to do with that information.

It’s right there in their second line

You won’t know they are benign unless you plan on a biopsy or surgery for every finding. It’s exactly this reason why we only regularly scan people that have say, known cancer.

They'll know whether they're getting bigger or not. Pretty much the same for if you have a lump just under your skin that you can see and feel but this would allow you to see the ones further inside. So you just have to take the same attitude and advice towards them that a doctor would give you about the surface level lumps. What's the difference?

But from what this says, it's not accurate enough to determine benign vs cancerous lumps

Just to add to this. My heart pumps blood in a known but different way than normal. I know because, to practice sports in my home country, it is required to undergo a specific checkup that includes an ECG. However, despite doing that visit many times, only two doctors ever mentioned this condition. The reason is that it causes no issue at all, so they just don't want to worry people for nothing by telling them their heart is pumping in a different way than most other people.

I would rather know that than have the information hidden from me. It's also not hard to imagine a scenario where such quirks are harmless on their own, but might be relevant in the future or for reasons the doctor is missing. I guess it's true some people would panic at any sort of quirk they find, but I find that frustrating as someone that doesn't think that way.

Further, as someone that has spent far too much time and money trying to find the root cause of a particular issue (with absurdly frustrating inefficiencies in terms of being bounced around, insurance nonsense, etc), I am generally in favor of improving our ability to find a lot of information in a manner like this. Doctors are generally good at finding very common issues they see all the time, much worse at anything uncommon. This can be a real problem. I think it could help the world a lot if we had something like this to improve our understanding of more outlier cases, we might find a lot of issues that were hard to catch without that scale of information. I also think preemptive scanning would catch a lot of issues that go otherwise unnoticed for much longer than they should go, something that also happened to me, but is mostly an issue of systemic inefficiencies in our current healthcare system rather than something that this technology is required to solve. In my case, doing some simple checks that they felt weren't necessary because I seemed healthy would've caught it much earlier.

> I think it could help the world a lot if we had something like this to improve our understanding of more outlier cases

Was this presented as an opportunity for researchers to be able to run more large scale studies involving full scans I woukd have a different take. This is however presented as a shiny toy to be put in a spa, that gives you images you don't know how to interpret anyway, or at best gives you some AI-powered report.

The rest that you're saying points more to issues of you country's Healthcare system, and it isn't clear if and how this technology would improve that.

> Over treatment can be a real problem.

Indeed, but having more data might be able to solve that? The whole problem seems to be that benign conditions sometimes look scary because we're currently not able to predict well enough whether it's something that will eventually cause problems.

Because a lot of things showing up in scans you wont know what is until you cut them out or do a biopsy. And even then you might never know if that thing would have progressed to become a problem. Scanning more will not solve that.

Realistically this data is going to be used to train a closed source model, not to contribute to the scientific literature.

We can and do full body scans. Typically in the context of research, or for focus/metastasis search in current clinical settings.

The problem is that, in clinical practice, with every imaging technology there are trade-offs. Just because we see something out of the ordinary in a scan doesn't immediately tell us whether it's pathology, pathology worth investigating/treating, or if it's just a normal physiological variation.

Which means that, when "something" is seen on a scan, we must do further testing, either increasingly invasive, or increasingly time consuming and expensive.

I agree with the sentiment that if we had a way cheap, fast, and harmless way to scan an entire body we would unlock many new research areas and that it would further our medical understanding, and eventually ripen for clinical use.

However currently, I do not see any benefit in giving access to the population to such a technology, because we neither have the resources to chase down every single region of interest in a scan, nor do we have efficacious treatments for everything we might come across on a scan. Which is why we've settled on scanning things if there are other signs of disease, and only treating something when it significantly impairs life quality and/or expectancy.

Should such a quick and easy scan be in every hospital and research center? Yes. Should it be a spa for people to go to whenever they feel like? No.

"the people can't be trusted with knowledge" is a bad argument

we don't need to do much differently to take advantage of this data anyway. doctors already ask patients what changed recently

collect data passively. when a medical condition arises, you have a data source to correlate against the onset of the condition

currently we have almost no data, so doctors need to run multiple tests to identify possible causes

> we don't need to do much differently to take advantage of this data anyway. doctors already ask patients what changed recently

So your take is we just do the testing and ignore it's outputs entirely, until something comes up? And that is somehow different and better than current imaging processes?

> currently we have almost no data

This is absolute fucking nonsense.

my take is simply three points

1/ telemetry is operationally useful in systems engineering 2/ the human body is a system 3/ this is a step towards telemetry for the human body

> currently we have almost no data

this is accurate. ordinary people might get blood drawn once per year. that is almost no data, relative to a monthly or weekly full-body ultrasound

It's not that I don't believe people can't be trusted with information. I regularly introduce basic diagnostic/statistical concepts to patients to explain why a certain test is needed, and why another would be wasted time and anxiety.

Tools are only effective in their purpose when one knows when and how to use them. Most things are imperfect, or a game of balancing benefits vs. shortcomings.

If a patient learns the potential pitfalls and strengths of a testing method, then I would trust them to apply it judiciously. But a biweekly medical scan you can go to as easily as a spa is not that.

Similarly: data matters, sure, but the quality of the data matters just as much. If the signal to noise ratio is too low then what's the point of gathering it?

I understand the argument but imagine if it were applied to other nascent technologies like the microscope, which incidentally was also viewed with suspicion by doctors who (accurately) cited flaws in early models such as chromatic and spherical aberration. Thankfully, many people persisted in developing it including non-medical polymaths like Robert Hooke. I recognize this may cause some headaches for doctors dealing with insistent patients but I doubt it will be a permanent problem as the technology develops further and becomes more widespread.

Good question!

Full body scanning is expensive, and in some cases not that higher resolution. CT full body scans are cheap and high resolution, but you are being blasted with Xrays for long periods. So there is a not inconsiderable health implication.

To get good data, ideally you need to have a longitudinal study, as in you measure people monthly/weekly and then correlate that to life outcomes. The ethical issue is that you'll see lots of lumps and bumps growing, and this could lead to lots of invasive checks. You can't not check because that's not fair "here is something that looks like cancer, if we grab it now it will stop you needing chemo. But it could just be a cyst."

So, its really really expensive to have 100k people getting monthly full body MRIs for 10+ years. Even more expensive to get them at the right resolution.

I think, that if these scanners are good and that is _Very much_ not proven. Then having a long term study would be good. I however have deep misgivings about how effective field array ultrasonic scans are, also safety.

I also do not trust midjourney, a company that exists through large scale copyright infringement to handle that data safely, ethically or in a way that would allow decent science to be done from it.

The entire point of this machine seems to be to do non-invasive scans that don't have the type of side effects that constant CT scans would have and which are vastly cheaper and easier to do than MRI so that you can collect longitudinal data on any/all individuals.

Finding "lumps and bumps" or incidentalomas may be much less of a problem if you can keep a close eye on them without using CT or MRI, maybe your doctor would want a follow up MRI as a closer look but if it seems likely benign they could easily recommend you to just keep scanning with this ultrasound machine and only get another MRI or biopsy if it seems to develop in a malignant way.

The mistrust of private individuals and companies is a harmful belief when it comes to the development of new medical technology. Many groundbreaking devices were developed through the efforts of individuals, including the MRI.

> The mistrust of private individuals and companies is a harmful belief

the full body MRI was developed in the NHS/university along with CT scanners. But let us not pretend that modern companies have been acting in a way that is ethical. OR that there exists a legal framework that fights for the rights of normal people.

> incidentalomas may be much less of a problem if you can keep a close eye on them without using CT or MRI

They are a problem because we have no real data on cancer incidents that don't develop. (https://ima.org.uk/24626/making-sense-of-cancer-with-profess... buried in this article)

Biopsies are not risk free. General anaesthetic carries a risk. You'll be on antibiotics, the wound will have an infection risk. Also the build up of scar tissue is a real issue.

This is the ethical issue. Because suspicious lumps will need investigation, no ethics board is going to allow not investigating.

This also fucks up the data.

Its not impossible, but it needs sensible thought, thought from actual medical professionals, rather than a company who is at best operating in a legal grey zone.

Overdiagnosis can be a problem. On the flip side, I wonder if adding the time dimension to the data (i.e., you could realistically have scans from every few weeks over the course of years) could significantly change that.

Instead of looking at a single snapshot of a person, you're now looking at trends over time. We probably don't have the analytical tools to effectively evaluate medical imaging with that time dimension at such scale (because I assume it would be rare for someone to get MRIs so frequently), but maybe with more data and study, we'll be able to more definitively distinguish benign quirks from real concerns.

Rather than a human comparing a couple of scans five years apart, you're talking about computationally identifying outlying regions in the data (a motion picture of the entire body) that are trending towards areas of concern.

This seems like something MLB teams would install in their locker rooms if it works.

I agree, hopefully it becomes just like any other cheap and easy measurement like blood pressure. Most of the time, small changes and variations will be determined to be normal but having a record and a measurement allows you to determine what is abnormal or a symptom of a disease. It's the difference between having a measurement and having nothing at all (if you never got a scan with CT or MRI).

If this becomes cheap and widespread, there'll likely be an initial iatrogenic spike, of course--but how could you think that having an enormous amount of precise, quantifiable data about a lot of bodies, and the ability to analyze all that data, is a bad thing in the long run?

I thought the same. There are papers analyzing data about that.

https://www.wiserhealthcare.org.au/too-much-of-a-good-thing-...

> As well as being unlikely to be beneficial, full body general health checks in asymptomatic people can potentially be harmful. The main harms are overdiagnosis, detrimental psychological effects, negative effects on health behaviours (for example, failure to quit smoking due to reassurance of good health), complications related to follow-up tests, and unnecessary treatments.

those scans are one-off events, these scans are regular

the signal is improved by focusing on differences over time, instead of looking for insight from a single snapshot

in a production system, I look at the change log around incident start as one high signal way to diagnose the problem

I want the same ability with my own body. new pain? look for recent scan deltas, in conjunction with modern medical intuition

We already have had that for millennia. Moles. Benign cysts. Unusual body shapes. Doctors have learned to say more than “just pretend that’s not there”. They have learned what’s important and what’s not and how to explain such things.

Why can’t learning more about unusual things we can’t see with the naked eye be the same?

“Bury your head in the sand to avoid harm” does not seem to be the right path.

Scans like this will have short term difficulties while we better figure out what’s important and what’s not but will only help long term.

MedLifeCrisis the youtube channel has a great video [1] on why you shouldn't full body scan. He's a consultant (highest level of doctor) in the NHS in England (and has done a PhD and research as is common in the UK medical system).

[1]: https://youtu.be/BJ9soFmzYO8

> chances are that the scan will show something unusual

Something unusual in a single one-off scan vs something unusual and changing over the course of multiple scans give two different views.

The main potential of this technology is that it's easy and fast, unlike classic MRIs. So someone could do a scan a month without a problem.

I learned this from watching House. I am certain that it's true, but I also kind of wonder how much backpressure there is against this kind of thing because the scanners are also insanely expensive to run per minute.

This backpressure is even with cheaper devices such as x-rays etc.

The backpressure on x-rays is because dosing yourself with radiation on a regular basis is a really great way to generate health problems in the course of trying to find some. There's a reason x-ray operators and anyone in the room with the patient get given lead lined aprons to wear while the machine is active.

"We shouldn't collect information because we don't know how to fit it into our care playbook" might be rational for a single patient, but it's a policy that will lock you into your current playbook.

Our medical industry is set up to only evolve via highly centralized research that fully situates a diagnostic within a particular treatment path. This approach makes it more and more expensive to improve care for narrower and narrower populations - driving medicine towards being a luxury good.

I'd like to see midjourney say more about price, but I love the idea of starting some new diagnostic pathways with different principles. There are probably all sorts of low hanging fruit to be found about new treatment strategies... It just takes some faith that nature hasn't hidden all of her secrets in the one place we already know how to look.

I understand your point, and I might even agree to some extent. However, the issue is that this isn't presented as an opportunity to do research, but as commoditizing a clinical test that, when it isn't done for medical reasons (i.e., investigating some existing symptoms), can lead to a lot of false positives.

This is exactly why it's a bad idea. I agree that if this technology comes to fruition, it should be in every clinical and research setting as a tool for us to further our understanding.

It shouldn't be a commodified test anyone can do at any time they feel like it. There are so many examples this leading to over or misdiagnosing already. I've seen patients who thought they had diabetes because they got a CGM over the counter and it showed a blood sugar spike during exercise (as in, their body doing exactly what it was supposed to do). He also now avoids oatmeal because "it spikes my blood sugar". Surprise: reddit and tiktok are awash with such stories as well.

I've seen a patient who on a whim decided to get 24hr blood pressure monitoring done, and thought they have severe hypertension because their systolic reached 170 when they were climbing stairs and during a football match because they were cheering and shouting.

In a similar vein, there are shady practicians who offer full body MRI scans, and fMRI brain scans to the well-to-do as a way of diagnosing things, when in fact neither are specific enough to actually diagnose something on their own.

23andme tests sending patients into clinics because they found a specific SNP that may be associated with worse outcomes for a disease.

We have neither the resources nor a specific enough technology (scan shows something: not specific enough to tell us what it is, but it sure is something) to unleash these for the general population to use.

Understood; these are the failure modes of cheap, weak tests in a system designed for expensive, high signal tests. I get that it is causing a real pain when these are introduced willy-nilly -- so is there a way for the medical system to evolve into making productive use of such signals?

Because the status quo is not working for a lot of folks in managing their own health, and just saying "it has to be this way" --while every other aspect of their life takes advantage of a wider range of options -- leaves them careening into MAHA style crazyness .

This is a tough problem for sure, and I resonate with your sentiment that something has to be done with it.

In my personal (fully anecdotal) view, I think clinicians desperately need to get better at communication, as well as meta-communication. Right now the rift between the patient and practitioner is enormous, because Drs do not take the time to dutifully explain things and processes, and what pitfalls there may be, and like you said, just boil it down to "it has to be this way" and shrug.

Some of this is down to systems design, i.e. not enough time per patient;insufficient support staff (simple example is no nurse being present to take down history concurrently as you spend time with the patient, or no dictation facilities available so you have to manually type everything down during the consult, eating away what precious time you have w/ the patient); a specialist getting bombarded with things a generalist should have treated w/ no referral needed; jurisdictions where violence towards healthcare workers is prevalent and so on..

But I would wager that compassionate listening and communication is the lion's share in why there's this huge rift. We currently do not teach effective communication in medical school, students just see how their attending treats a patient, and they copy their style. Which is funny, because the first thing we were taught in preliminary internal medicine was that 80% of making a diagnosis (any diagnosis) is down to history taking and communication.

As for how exactly we would get institutions to take communication seriously, I have no idea.

>> But I'm not convinced about their view of having people casually going to a spa every week and getting a full body scan.

People are already doing this monthly with DEXA scans!

Another reason is that we don't actually know what negative effects regular "scans" might have.

Actually in some cases we do know. Regular xrays are harmful, for example.

As crude as it sounds, you don't know until you try.

Agreed, If you look for issues, you'll find them.

Anecdote: My wife had a high risk pregnancy. They did more than the usual scans and tests, and at one point we were told to go immediately to the NICU, spent 48h there , more tests. None of the tests really showed anything other than she was different than the normal pregnancy (I won't get into the specifics).

In the end, we have a healthy child but it was a lot of pain just going through test after test just because things were out of bands (my words).

I'm grateful that modern science can monitor and predict such issues, even if in the end there's no problem. The alternative, as we know for thousands of years without modern health care, is far worse for women giving birth.

I'm in full favour of learning better and better tests. Over time we'll have enough data to know what's urgent and what's preventative. Losing friends and family to avoidable health issues is too heartbreaking.

Sure, but in this case, there was a good reason for the additional tests: a high-risk pregnancy. And still, the outcome was stress for nothing. Now, imagine thousands of perfectly healthy people doing full-body scans every week just because they can. This actually carries the risk of jamming real health care, because those perfectly healthy people will undergo additional clinical tests for nothing.

Imagine all the data that gets us towards those scans actually being meaningful. Don't treat them like scans to find problems but scans to learn from, collectively.

As I wrote in replies to other similar comments, this would be the case if this technology was presented as an opportunity for researchers to run more large-scale studies. This isn't however the case, it is instead presented as a shiny toy for fancy spas.

SOTA ultrasound devices are still very expensive, with e.g. a custom 3D probe with a few hundred piezo elements costing well over 10k. IF they want to use MEMS probe instead of piezo (which is implied by them saying that they will use a chirp), that's going to be even more expensive, considering the lack of manufacturing know-how. When sufficiently scaled, I wouldn't say it is an exorbitant price for large research hospitals, but I am a little skeptical of rolling these out as a health checkup "spa" service outside of areas with extreme wealth concentration (e.g., Silicon Valley? Sure. London? Yeah; Minneapolis? not so sure.)

I know you are right but it just sounds so dumb. In theory it should be possible to do a scan and then realize most things you find are likely not a problem and don't worry about them.

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