The Health Hunt: Real Healing Journeys, Everyday Wellness & Expert Tips

Ep 28 - Full Body MRI: A Prenuvo Executive Explains the Data

• Sandi Magder and Daniel Schuman • Episode 28

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If you’ve ever wondered whether a full body MRI can actually detect cancer early, or just leave you more anxious than informed,this episode breaks down what these scans really show, what they miss, and how to make sense of the results without spiraling.

Full body MRI scans are exploding in popularity, but most people still don’t fully understand what they are, what they’re for, or how to interpret the results without going down a Google rabbit hole. In this episode, we sit down with Dr. Giuliana Zaccardelli, Chief of Staff at Prenuvo, to unpack the reality behind preventative imaging—what it can detect, what it can’t, and how it fits into the future of healthcare.

If you’ve listened to our recent episodes, you know we both went through the full body MRI experience ourselves, including the anxiety leading up to it and what it actually felt like inside the machine. Now, we’re going deeper with an expert to answer the big questions:

  •  What does a full body MRI actually detect? 
  •  How often do these scans find something serious? 
  •  What do terms like “nodules,” “cysts,” or “no evidence found” really mean? 
  •  And how do you interpret all of this without assuming the worst? 

Dr. Zaccardelli walks us through the concept of interpretive care,arguably the most important part of the process,helping you understand how to take your results and turn them into meaningful, real-life decisions about your health.

We also explore the bigger picture: the shift from reactive medicine (treating disease) to proactive, preventative care—and why patients are increasingly driving that change.

This conversation is equal parts practical, reassuring, and eye-opening, whether you’re considering a scan yourself or just trying to better understand how to stay ahead of your health.

🔍 What We Cover

  •  What a full body MRI scan is—and how it differs from diagnostic imaging 
  •  Why Prenuvo scans are screening tools, not replacements for tests like mammograms or colonoscopies 
  •  The difference between nodules vs. cysts (and why they’re often not scary) 
  •  What “no evidence found” actually means (and its limitations) 
  •  The role of the post-scan consult and why it matters more than the scan itself 
  •  How concerning findings are handled and communicated 
  •  The emotional side of preventative testing: anxiety, reassurance, and decision-making 
  •  The future of preventative health, wearables, and early detection 

Text us your thoughts, questions, or takeaways. We read every message.

All views, opinions, and commentary expressed on The Health Hunt Podcast are solely those of the hosts. They are shared in a personal capacity and do not represent the views, policies, or positions of any current or former employer, including any organizations with which the hosts may be professionally affiliated.

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Sandi Magder

Welcome

Intro: Why Full Body MRIs Are Gaining Attention

Sandi Magder

back to the Health Hunt. A human humble and sometimes slightly obsessive exploration of how to understand your health before something goes wrong. Today's episode is one we've been really excited about because we're talking about something that sits right at the intersection of curiosity, anxiety, and prevention. Full body MRI scanning and the growing shift towards earlier detection of medicine. If you've listened to the show recently, you know that Dan and I both went through the experience of getting full body scans of Renouvo. In episode 19 of this podcast, we shared the real and raw parts of how we felt leading up to the scan. And in episode 20, we recounted our experiences of what it's actually like inside the machine, including my MRI meltdown. We have also, since then, received our reports, and this information raised a lot of questions. Not just about what the scans show or don't show, but about the bigger picture. How does this fit into the future of healthcare? How should people think about preventative imaging? And how do you interpret all of that information without spiraling? So today we're joined by an expert who can help us answer those questions. Dr. Juliana Zaccardelli, Chief of Staff at Prenuvo Clinics. And we'll be chatting with her about the growth of the company, what they're actually seeing in those types of scans, how interpretive care works, and how people should think about this kind of testing in a practical, real-world way. But before we dive in, you know what I've got to do. The Health Hunt Podcast is for informational and entertainment purposes only. We are not medical professionals and nothing shared should be considered medical advice. Always consult your health care provider before making changes to your health. So, for those of you that haven't yet heard our previous episodes on Prenuvo, Prenouvo is a company focused on using whole body MRI imaging as a tool for proactive preventative health. And as the chief of staff for Prenou Clinics, Juliana leverages her expertise to drive innovation in preventative personalized health care. She previously co-founded a digital health company focused on women's health and worked as a health economics and outcomes research analyst and analysis group. Juliana holds an MD and an MBA from Northwestern University. Juliana, welcome to the Health Hunt. Thank you so much

Meet Dr. Giuliana Zaccardelli & What Prenuvo Does

Sandi Magder

for being here. Thank you. I'm so excited to be here. So Dan and I, from our background and careers, we're very nerdy about all things business. So we kind of wanted to start by getting into questions about the business side of PreNuve, because it's very interesting to us. During our visit to the Boca office, which is where we had our scans, we were kind of struck by how active the center was, which made us curious about the broader growth of the company. So we noticed that there were MRI machines running constantly when we were going in, when we were going out. And it made us curious about how many scans PreNuvo has completed to date across all of its locations and what the growth trajectory of the business looks like.

Inside Prenuvo: Growth, Locations & Demand

Giuliana Zaccardelli

Yeah, so um we've done over 170,000 scans to date, and we're looking to bring Pranuvo to as many people as possible. Right now we have 26 clinics operating across North America, Australia, and Europe. Um, and we'll see where we go next.

Sandi Magder

I saw some interesting locations. I think Canada, maybe somewhere in Toronto. I'm from Toronto originally, so I'm always interested about how the people back home can get this kind of treatment.

Giuliana Zaccardelli

Yeah, actually, our initial location was in Vancouver and we still operate there. Toronto has very strict rules around getting MRIs into the province. So we actually have a mobile trailer across the border in Buffalo to help service that market.

Sandi Magder

Well, that's actually very interesting. I didn't know anything about that. I've been in Florida since 2003. So I don't know if things have changed, but that's really interesting.

Dan Schuman

Julia, I'm curious, how do you pick um your locations and other state-by-state regulations regarding how MRIs can be used in each of those locations?

Giuliana Zaccardelli

There are. So I am not personally super involved in how we choose locations, but if you look at our map of where we are, right, you'll see most of the major cities in the US and Canada, Vancouver. But there are state by state regulations that sometimes make it difficult for us to enter a state. So a lot of states have something called a certificate of need law, where you have to prove that you need that there's a need for another machine. And so you have to get essentially a license from the state government to bring a new MRI machine into that state. And so those states, it's very hard to enter. Um and so a lot of times we're not in those states because they have these additional regulations.

Sandi Magder

That is very interesting because that seems like a place where maybe regulation needs to change to keep up with what's happening in the medical world. Thank you for sharing that. So I'm also curious about with respect to sort of the marketing that you do, is that more forward-facing to the clients, or is it also geared towards doctors and understanding the need for these preventative scans?

Giuliana Zaccardelli

It's definitely a mix of both. Um, so one of the so we definitely want patients and and people uh across the country to know about pronounvo, know what we do and understand our scan and what the value of our scan is. Um, and so a lot of our marketing is geared towards patients and towards prospective patients, so to really help them understand what prenuve is, because it's very different and new for most people coming to see us. But it's also different and new for a lot of people in the healthcare system. And so we have programs where we are radiologists, our preventative medicine doctors will do educational sessions and information for providers so they can also understand the value of a prenuo scan, whether it's potentially sharing that information with a patient who's interested in getting a scan, or after the scan, if they see a report, how they interpret that report and how they kind of help the patient figure out what the next steps are. So there's definitely a mix of both because prenuo is new for a lot of people.

Sandi Magder

Yeah, I mean, we love that it's sort of helping to change the landscape of how people think about health. It's something we talk about a lot here. So this was something that kind of really came to mind, especially when we were going into the scans, because we saw a lot of that marketing. So we're just curious, like of the scans that were performed so far, are there statistics that you can share about how often something significant or potentially life-saving is discovered?

What Do Scans Actually Find? (Life-Saving Stats)

Giuliana Zaccardelli

Yeah. So based on our internal data, about 5% or 1 in 20 PRNUVO scans have helped detect a potentially life-saving condition. And this reflects generally things that look cancerous or precancerous or brain aneurysms in our screening practice. But there are also other findings that we see that maybe wouldn't be kind of classified as life-saving, but that have huge impacts on patients' health and how they approach their care. And so another great example is fatty liver disease, where we can quantify that very accurately and help people understand if they have fatty liver and then they can kind of go take that back to their provider or make other changes in their life to hopefully help reduce or change that.

Sandi Magder

Yeah, I actually, I mean, I always knew the liver was important, but I actually I think eudaimonia, which is where we met one of your representatives. Um, it's a conference here in South Florida, health conference. And so I they I get a newsletter from them, and they just did a whole article about the liver health and fatty liver. And so that's interesting that that can be detected so well in the scans. Okay, so the only other one that I have right now would be are there any other patient stories that really stand out, individual patient stories? I mean, obviously no names, but where early detection truly changed the outcome of somebody's life.

Giuliana Zaccardelli

Yeah, so there are tons of stories of everything from finding an aneurysm that could have otherwise gone undetected and caused a stroke to finding a kidney cancer in a father of two who was able to have that removed and didn't have any symptoms. But I actually like to talk about a slightly different story because I think it showcases a little bit of a different side of PRNU. Um, we have a patient who I've gotten to know, and her and her husband both came in to get Prenuo scans. And on his scan, we found a late-stage pancreatic cancer. He didn't have any symptoms, and pancreatic cancer is very deadly. Um, and he chose not to undergo treatment because of the stage of his cancer. But the way she talks about it was how powerful that information was for them to be able to make choices and to live the end of his life the way they really wanted to. Um, he didn't have any symptoms until the last three weeks of his life. And she talks about how different their life would have been if they had to make all of these decisions kind of under pressure in the last three weeks. And so I think that story is really powerful to me because we talk a lot at Purdue about the life-saving findings. Um, we talk a lot about the health optimal optimization findings that we can help patients with. But that one is has always stuck with me as a lot of times that somebody in the healthcare system may look at a patient like that and say, Well, you didn't really change anything that that patient still ended up having the same trajectory of care. But she talks about how that knowledge was so powerful for them. And I think that's really what we provide at Prenovo is giving people the knowledge to make their own choices about their health.

Sandi Magder

That is such a beautiful story. I really appreciate you sharing that perspective. Because as you were talking, I was having like a wow moment because

Real Patient Stories & The Power of Knowing

Sandi Magder

it's like sometimes you want to know that you have limited time if that's the real outcome and you can do the things that maybe you would have put off. So that's that's very profound.

Dan Schuman

I'll just jump in there. That um story sits very close to me because I lost my dad with a stage four pancreatic cancer. Um, and it was six to eight weeks from diagnosis to death. And it was um, you know, it was just a lot. And uh um I I can tie in very much with that. And so I mean, and actually um one of the moderate findings on my prenovo scan was a three millimeter or less cyst on my pancreas, which um, although not incredibly serious, um, will be followed up aggressively with my care team uh because of the past of my father and because just wanting to monitor the potential growth of that. So um thank you for sharing that and it definitely hits home.

Giuliana Zaccardelli

Yeah, I think it's I the thing that I think we give patients really is that agency over their health, right? Whether it's we find something that is life-saving and can be intervened earlier, whether it's we're giving people reassurance or we find things that help them optimize their health, or in rare cases like like this couple, to be able to make those choices about their how they wanted to live the rest of his life. Like, I just think that's so powerful for people.

Sandi Magder

I think also the inverse of that, sometimes knowing that maybe something we're concerned about is fine. Yeah. I know that Dan had an experience that we talked about like that, where he had been thinking it was one thing and then and the scan came back clean. So that also allows you to release some of that anxiety. So I think it's a really comprehensive result that you're getting.

Giuliana Zaccardelli

Yeah, I think either way, right, you you have that knowledge now. And so you're able to really, whether it's reassurance and you're able to not worry about that, whether it's something that you had no idea about, but that you're gonna kind of change. Like I have um, I have spinal degeneration in in my neck. I have tech neck basically. And I didn't really know notice any symptoms. But after my skin, I was like, oh yeah, I do get headaches. I do have a little bit of neck pain. And so now I make, I'm, I'm making changes in a concerted effort not to look like this all day and to do exercises to strengthen it so that hopefully down the road I don't, I I'm able to avoid things like painkillers or surgery. But I would have never done that if I hadn't seen that on my scan.

Dan Schuman

Yeah, my neck is a hot mess. And so it's just Premnobo just confirmed what I already knew. But I will tell you that um the game changer for me has been osteopillo. That when I wake up in the morning, that this new osteopillo I use, there's no headaches. Um, it really kind of kicks me off to a good start of the day and allows my neck to kind of not be as severe during the day as uh usual. So just you know, hey, cool. Late person pro tip. Check that out. Yeah.

Sandi Magder

And we're we're not sponsored by osteopillow. I don't even, I don't even know what that is. So just so you know that it's not a plug.

Dan Schuman

I'm breaking new things up. Um all right. Let's we'll switch topics here. Um thank you for all that useful information. Great story. Preventative medicine, something that we love. Um, it's a core theme of the podcast, metrics, people being proactive about their health. Where do you see preventive medicine heading over the next five to 10 years? We're seeing so much with the full-body MRIs. We're seeing biomarkers. You know, people are testing the whole gamut of biomarkers with certain entities and wearables. How does this all fit into like an ecosystem of what's going to happen in the next five to 10 years, in your opinion?

The Future of Preventative Medicine

Giuliana Zaccardelli

I think we're in a very interesting time right now. Um, one of the reasons that I'm at Prenevo and I don't practice medicine is when I was in medical school, I was really struck by we learned a lot about disease and how to treat disease, but there was not really any emphasis on health and how to keep people healthy. And I think what we're seeing is patients and people looking for that information in things like prenuvo and things like wearables and things like lab testing, because the traditional way we've approached this in healthcare is not giving them what they need. And so I do think there is this switch now where more and more people, both in and outside of the healthcare system, are recognizing how important that is. So I am really hopeful that this change is going to become more, I would, I would call it more mainstream or more uh the way we approach health rather than it kind of being something that people have to go off and do on their own. But I think it's really powerful that it is coming from consumers who are looking for those insights because it's really showing us that there's a there has been a gap historically and how we approach health. And so I'm I'm hopeful that kind of the rest of the healthcare system and the more traditional healthcare system will start to catch up. And you are seeing this, right? There are health systems that big names that have um longevity clinics or that are doing research around longevity, you're seeing more uptake of things like preventative imaging. So I definitely think um it's moving in the right direction, but we still have a long way to go. And the healthcare system is built to be very reactive, right? Everything from how insurance pays out to, you know, how hospital systems are set up. So I do think it's going to take some time, but we're really seeing this shift, I think, right now, where where people are really driving that and the healthcare system is catching up.

Sandi Magder

Yeah, you know, Dan. So we had just interviewed a doctor and he said something along the lines of what you said that really had struck me. And it was that medical schools are following along with what they know is going to be on the exams. And the exams are about disease. And so that's what they teach you. And so that's, I think, you know, obviously where a gap is. So and I think too, people are probably becoming a little bit more educated. Like our theme here, and one of the themes is to be your own advocate and to do your own research. And I think as people are doing that, that's where they're starting to understand that they don't have to wait until something catastrophic happens. They can look for ways to prevent it or at least learn about it earlier.

Giuliana Zaccardelli

Yeah, and I think the way I sometimes describe traditional healthcare like the Catholic Church. Like they're always, you know, a hundred years. The Catholic Church's always like a hundred years behind. Like healthcare is not a hundred years behind, but uh but a bit behind, right? And there's a lot of uh ingrained training, ingrained the way this is how things are done. And then there are a lot of systemic factors that oftentimes prevent change from being from happening too quickly in traditional healthcare. And that's not necessarily a bad thing, right? You don't just want to throw experimental treatments at people or something like that. But so I understand where some of that hesitancy comes from. But I think in the preventative health space, it has sort of kept people from getting what they want and what they're looking for. And and I think you're totally right, Sandy, that like people now do have this sense of agency and feel this sense of agency around their health that is new and different. And I think we we as a healthcare system, like we need to catch up.

Dan Schuman

I'm just curious. I know obviously ProNova does a really good job of front-facing marketing to the consumer. Really, really good job. Do they have any education pieces or are they doing any education like on the back end of this to actual physicians to how to like to see these reports, how to understand these reports?

Giuliana Zaccardelli

We do. Uh physicians can come to Pranuvo and get an educational scan where we give them educational information and and they could experience it for themselves. And then we also do things like webinars and other materials that we provide to physicians to help them understand both whether this is for them because they're interested in maybe sending patients to Pranubo or the patients have asked about PRNUVO, and then also how they kind of take that report, interpret it, contextualize it for the patient, their additional findings and tests that have to come out of that.

Sandi Magder

Yeah, that's I think that's very important because imagine somebody, you know, hears about the scans and they're sort of on board and then they decide to talk to their doctor about it, but the doctor's not educated. So they don't necessarily even confirm that that's a good thing to do. So I think it's definitely has to be coming from both sides, and that education is highly important.

Dan Schuman

I'll tell you what's also kind of wild is that, and this is not just Pernova, this is like an MRI thing, is that the the they give you physical CDs. Um, I've brought these into other doctors and neurologists, and I've said, can you read this for me? They're like, well, we don't have a CD player. I'm like, well, how can we like actually get information to each other in a bit in a more streamlined, like less archaic way? And this, I mean, I'm sure you're aware. I think this is very bad. Talk about 100 years. I mean, you know.

Giuliana Zaccardelli

Fax machines also, hospitals are a big fan of those. Yeah, it's uh it's crazy. And we I could we hate having to burn CDs, but to get those images to a lot of different doctors, that's how you have to do it. And part of the reason is just how fragmented the healthcare system is. Lots of hospitals, they have different imaging softwares that they use, they have different viewing platforms, they have different medical record systems. Your doctor down the street may have something totally different from the hospital that's across town. And so unfortunately, CDs are kind of anyone can use them as long as they have a CD player and then they can upload the images to their own viewing software. But um, it's just one aspect, I think, of how fragmented the healthcare system is because you can't just digitally transfer those images. It's it it is it is ridiculous.

Dan Schuman

Yeah. There you go. Being confirmed. Yeah.

Sandi Magder

This is just a side note, but just so you know, pre-nuvo ruined me because I almost like I am very claustrophobic. And I thought I was fine the morning of, and they put me in and I quickly yelled, take me out. And it took me a second time before I got through it. But once I like got used to the visor and I really focused on, you know, the movie and everything like that, it was significantly better. So now in my brain, I could never go into an MRI machine that doesn't have that technology because that just was life safe. I thought I was gonna be on here. I was telling the board tech, we're doing a podcast, and I'm gonna say I didn't do it. But anyway, I did do it. I just wanted to share that with you.

Dan Schuman

Well, I was a little bit nervous because Sandy went in 10 minutes before me, and I got out and she was she was out 10 minutes after me. I'm like, oh boy, something's going down.

Sandi Magder

But yeah, it was the machine also reset when I went back in the second time. So I had to come out not by my own choice. So it's like a lot of things. But again, I made it through and you're and the technology was great, and the texts were amazing. Amazing.

Dan Schuman

Um absolutely amazing.

What Is Interpretive Care? (And Why It Matters Most)

Dan Schuman

Capital A on the amazing. Let's shift gears. Uh, very important term, interpretive care. Can you define interpretive care for our audience? What does it mean for someone who's coming in getting a baseline scan or maybe like pressing reset on their health? Um, just what what's that concept defined as?

Giuliana Zaccardelli

I would think of it as kind of taking your results and contextualizing them and then and then being able to act on them. And so one of the great things, I think, I don't know what your guys' experience was like, but I think one of the best parts of the Pretty Bo experience is the consult afterwards because it takes those findings and you're able to go through them with a provider. You're able to talk about your own life, your own health, your own goals, and really understand those findings and what the next steps are. And so I find that being able to contextualize that and then make those like lifestyle changes or whatever it might be is the most useful part, right? A scan one time is gonna give you some information. It's gonna give you a baseline, and that's so important. But you have to then go make those decisions on your own to impact your health. A scan is not in and of itself going to impact your health. And so whether it's you have mild fatty liver disease and you want to make dietary and exercise changes to try to reduce that, whether it's your spine is all messed up and you need to do exercises, it's really about taking those findings and contextualizing them and then bringing that back to your life.

Sandi Magder

All right. So now that we've covered the broader themes around preventative health and imaging, we're gonna shift to some more practical questions that we kind of had as we went through the experience. And these are questions that are meant to help people better. Better understand how to think about full body imaging and what the results mean in sort of an actionable and practical sense. And these are the kind of things that our listeners are always really asking us about. It's like, what does the report actually mean? What can they actually see on the scan? What happens when you get the results? Kind of you talked about, you know, that consult that you have. And so this next segment is going to be really about helping people understand how to think about the full body imaging in a more practical way.

Dan Schuman

This is one I'm personally super curious about and you know, excited to hear more information about this and our listeners as well is what is the difference? I'm my assumption, and it could be wrong, is that PRNOV, the scan is a surveillance scan. It's a screening, and that you get this, and it's kind of like walking through a metal detector. It will tell you some of the high-level things that you it will point out some things, you know, in in in most circumstances that could be interesting to know, informational, immediate, moderate, uh, and so on and so forth. And then beyond that, you go for a diagnostic MRI that would maybe be more detailed. Is that am I seeing that right? Or is there am I in error in that that's

Screening vs Diagnostic MRI: What’s the Difference?

Dan Schuman

true?

Giuliana Zaccardelli

You're on the right track. So our scan is optimized to look across your whole body in under an hour, and we don't use contrast, and we MRIs don't use radiation. And so our scans are set up differently than if you were to go to the doctor to get an MRI of your liver. You can think of MRI images as a stack of pictures, and so you're taking slices through your body. And so the slices, how thick those slices are or how close they are to each other. Oftentimes diagnostic imaging, they'll be closer together because you're looking at a more targeted area. Oftentimes diagnostic imaging will use contrast or other techniques, and so they are they are different. Preneuvo scan does not play replace diagnostic imaging. So if your doctor told you to go get an MRI of your liver, a prunebo scan is not going to be right for you because it's our scan is not set up to look at your liver in the same way that a liver MRI is. We're really there to give a survey across the whole body and to look across all the different organs and look across your entire body in a way that is, again, as fast as possible without using contrast and still getting that imaging that we need.

Sandi Magder

Yeah, it was interesting. During my consult, and I just want to share this for listeners, I was told that the scan doesn't replace a mammogram, obviously for the reasons that you just said, but I didn't understand it until you explained it just now.

Giuliana Zaccardelli

Yeah, and mammogram is a great example. Mammogram is very specific for picking up breast uh cancer. And there are other MRIs like breast MRI that are also really great at at detecting breast cancer, but we don't use the coils. So you need like a the, you remember the things that went on top of you, right, when you were in the scan. That's right. For the listeners, they're they're uh how do I describe it?

Sandi Magder

Are you talking about yes, but the the big blanket thing? The blanket type thing. Okay, that she called it a weighted blanket, but I realized that that was a euphemism for it being something else. But yes.

Giuliana Zaccardelli

Yeah. So it's uh it's called an MRI coil, right? And so those go on top of your body when you're in the scan. But if you're gonna do breast MRI, you there's a specific breast coil, for example. So that's one way that our scan is a little bit different from a breast MRI scan. Breast MRI also uses contrast. We don't use contrast, so it just changes the sensitivity of how of what the scan can pick up.

Sandi Magder

But so in the example of breast, would it pick up some sort of uh growth of some sort of?

Giuliana Zaccardelli

It can. Okay. It depends on the size and the characteristics of that growth, but we're not optimized for looking for breast cancer the same way a breast MRI or a mammogram is optimized for looking for breast cancer. So that's why it wouldn't replace that. It can also tell you if you have dense breast tissue, which can make breast cancer harder to find on mammogram. And so it can give you that information so you can make those informed decisions, but we're not a replacement for something like mammogram. We're not a replacement for colonoscopy because a colonoscopy, you undergo the prep, your colon is clear, the doc the doctor is directly visualizing the nodules. They can also take the polyps out and then test them, right? So we're not a replacement for other screening tests, we're more of a compliment. Got it. That's helpful.

Dan Schuman

Yeah, that's really important for people to manage expectations and understand what they're doing. And I mean, it's extremely effective, but just um thank you for calling that out. And it was a really great explanation. We um our listeners will appreciate that for sure. Uh switching again, kind of just taking a little deeper dive into this. I think there's a lot that comes at you in these reports for the interpretative side. And uh I would be curious um if you could define nodules and cysts. I think they're kind of scary words for people. And maybe because of the size or what actually, if you define them, they're that people can not be as scared or intimidated by those words.

Nodules, Cysts & “No Evidence”: What Results Really Mean

Giuliana Zaccardelli

Sure. So a nodule or an a cyst are both growths inside your body. A nodule is a small solid lesion, whereas a cyst is a fluid-filled lesion. They are very common. And so you like I have cysts that we found on my whole body scan. That doesn't mean that there's anything cancerous about them. There are other characteristics, a nodule or a cyst in and of itself can be totally benign. There are other characteristics sometimes that we look at or that will show up on MRI, depending on the size or how it looks, that may make it more or less likely to be cancer. And one of the things that our radiologists do is they scale these nodules or cysts on a rating scale and on how likelihood it is likely it is to be cancer. And so when you got your report, also those rate, that rating scale that the radiologist uses also kind of tracks back to the report. And you can see, like, I don't know if you remember on your report, it would say mild finding, moderate finding, severe finding, informational finding. And so we try to classify that for the patient so they understand what what that means. Um, just like if they see the word nodule, it does, it's not scary if it's a benign-looking nodule. It would kind of show up, you know, on the report as mild potentially in that case.

Dan Schuman

Got it. Which some beasts, so you're talking about statuses there. Um a lot of my statuses were assessed in green. And then they'd use verbiage such as no evidence, not detected. Should one who's reading that think that they're kind of in the clear, or is it just that is there some type of nuance there with that, those definitions?

Giuliana Zaccardelli

So the absence of something on imaging does not necessarily mean that that thing is not there. Um, nodules, for example, show up better when they are larger. They also show up better in certain tissues, if depending on the characteristics of the tissue. Um, for example, lung tissue, because there's a lot of air in the lungs, it can be harder to detect nodules in the lung on MRI because of the air that's in the lungs. It kind of makes them, it doesn't make them stand out as much. And so when a radiologist is saying no evidence of, it means they didn't see it. But that doesn't mean that it's not there and it's really tiny, or that the characteristics of it made it hard to see. Or because we are set up for screening, if you got dedicated imaging of that organ, that they might find something that we did not see on the on the exam. So that's kind of how the radiologist describes it. Now, generally, if they say if there is no evidence of things, I would say that is a very reassuring thing, right? And so if there is no evidence, um I think people can take that as reassurance, but that doesn't mean necessarily that it's 100% not there.

Sandi Magder

So you had mentioned already that there is a consult that comes after you get your results. So for us, we got our results. Um, we got an email about it. We logged in, we were able to see the whole report. So we had asked the women at the front desk. We we didn't know about how the process works. So after our scans, we were all curious and nerdy. So we asked them and they explained to us, we get the report, and then you know, you schedule this consultation. So we got our report. I think I got the email within the same day about scheduling it, and it was very quick. I scheduled it within a day or two. I know people are interested to know what happens. Can you kind of walk us through what that appointment is like and what the clinician is going through with the patient?

The Consult: What Happens After Your Scan

Giuliana Zaccardelli

Sure. Yeah, I think the consult is part of almost the most important part of the whole process because it's where we take the imaging and the findings and the report and we explain that to you, but also contextualize that for you. Um, so we ask very detailed medical history questions when patients come to PRNUVO. And sometimes patients are wondering why we do that. It's very important for the radiologist. It helps them contextualize the findings when they're reading the scan. And then it also really helps the provider who's giving the consult to interpret those findings based on some of the information that you've given us. And so that that consult, they will walk you through your report, but they'll also ask you questions about your lifestyle and your health goals. And if you have something like fatty liver, they may talk about things that you can do or how you might want to approach that. Um, if you have a more serious finding, they can help answer those questions and figure, help direct you to what the next step should be in your care. And I think the amount of information that people get out of Purdue is amazing, but I think it can also be overwhelming for the first time somebody comes in, like it's a lot of information that you're getting about yourself. And so the console is a really great way to understand what's important, what you should focus on, how you think about some of what some of these things mean. Um, and and I just think it's like the the best part of the whole experience.

Sandi Magder

Yeah, I mean, it definitely makes things that may have been terrifying less scary because they're given context and you're given some sort of reassurance that, okay, here's maybe something you can look into, but also you're not dying, which we all want to hear. So is there anything that sort of falls outside of the scope of that consult?

Giuliana Zaccardelli

So the provider who's giving you a consult is not your medical doctor, right? So they don't have that ongoing relationship with you that maybe your primary care doctor does. So they're going to contextualize the findings, maybe ask you some questions, make some recommendations, but we're not going to prescribe medication. We're not going to write a referral for additional imaging. That's really the patient needs to take that back to their provider and and get that because that person has that ongoing relationship with them and can kind of um help them make those decisions.

Sandi Magder

Okay. So do they recommend if they find something? Well, let me ask this question first because I'm just, I was curious how this happened. So if the scan shows something that is concerning in some way, how does prenouble handle the timing of sending the report? Do they still send the report out in advance or do they schedule the consult at the same time? Because I can't imagine what it's like if you got something that says you have brain tumor.

What Happens If Something Serious Is Found?

unknown

Yeah.

Giuliana Zaccardelli

Yes. So we we do have a different process. We have a classification framework. And if something falls into one of those higher tiers, we do some, we do it a little bit differently. We will have team members who reach out to the patient to schedule that consult. And we're a little bit more aggressive about getting that consult scheduled because we do really want to talk to you about that. And then we will release the report in advance of the consult happening, but once that consult is scheduled. And we do that because we've tested over the court history of Purdue, we've tested different ways of doing this. What we found that was patients who were had had the consult, had the report before the consult, were able to come prepared with questions in a way that they weren't if we were just giving them that information live during the consult. But we do kind of wait until that gets scheduled before we release the report. Now, there are patients who never respond to us, in which case we have a cadence at which we will release the report after, you know, after we've tried to contact them a few times. But the goal uh for people who have those more urgent findings is really to get them on the phone, explain the finding to them, explain what what it what it means and and what their next steps should be.

Sandi Magder

Okay. I'm glad that didn't happen to us, but also that's very helpful to know. Yeah. Yeah. So just for context, Dan got his results, I don't know, I want to say a day or so. He texted me. He's like, the results are in. And I looked and I didn't have mine. And so immediately my brain went to, oh my God, there's something terrible. Nobody wants to tell me. And again, I realize that's not a thing, but that's, you know, that little disconnect was a little interesting thing for us to go through.

Giuliana Zaccardelli

Yeah, I we generally read the reports in there, there's a like a queue, right? Of the reports. Um, and so if the technologist notices something urgent on the scan, that gets bumped to the top of the queue. But uh the otherwise the radiologist kind of picked them up on the the way that they came in. So maybe because you had 10 extra minutes in the scanner, you were uh behind Dan in the queue. Probably.

Sandi Magder

That actually answered a question, Dan. I know you had about that. He he came out wondering about this.

Dan Schuman

Yeah, I um by the way, um, when I my Netflix was uh James Bond, it's no time to die. I didn't I didn't I'm just letting you know, I just thought of that and um kind of I'm gonna interest the theme. Yeah, but um I always wonder when they are undoing you like all of the plates or the the weighted blankets and they're looking at you and they've just seen your scan, which they've seen many scans. Like, do they know something and they're not telling me? And so that was what I that was kind of the conversation I had with Sandy as we were walking in. I'm like, God, do they know something? Like, you know, do they know that like and so I don't know about you uh you may not have any opinion on that, but I just was thinking of that.

Giuliana Zaccardelli

Yeah, I mean the technologists are generally very good, right? They look at these images all day, they've been trained, and so they are able oftentimes if something really serious, if they see something really odd or really serious, they they do pick that up a lot of the times. And and again, that kind of gets bumped up to the cue for the radiologists, but they are not radiologists, so there are some limitations there as well.

Rapid Fire: Food, Music, Wellness Habits

Giuliana Zaccardelli

So this is the fun stuff, I guess, if this is fun for anybody.

Sandi Magder

So we're gonna ask you a series of questions. This kind of give us like the first thing that comes to mind. So, what is your favorite food or go-to restaurant?

Giuliana Zaccardelli

I am uh food is very important to me. I grew up, my parents have a restaurant. I, my grandparents are from Italy. We grew up cooking all the time. So it's very hard for me to pick a favorite food, but I will pick two. One is my my Nona's pasta and meatballs. It's amazing. I have tried to replicate it, and I cannot make the meatballs the same way as her. She is still alive. And every time she tells me the recipe, she tells me something different. I think she's keeping a secret intentionally, so that I can't make them as good as her. And then my other favorite food is is sushi. I I love sushi.

Sandi Magder

I love me too. But a funny story. I think the first guest that we had on her favorite food was also meatballs. So maybe there's a theme. Okay. A TV show you swear that everyone should watch. So I'm also we're curious. Well, let's do that one first. This is a two-part question.

Giuliana Zaccardelli

Uh the TV show that everyone should watch. Yeah. I don't really watch a lot of TV. Yeah. But I am watching the pit right now. And if you ever want to see the way traditional healthcare, like reactive healthcare system exists, the pit is dramatic but fairly accurate depiction of the emergency room. And so for the theme of this podcast, I would say go watch that because it's kind of the complete opposite of how we approach healthcare at Prenouve.

Sandi Magder

Oh, I love that. Okay. And also the second part is what did you watch in your prenouve scan?

Giuliana Zaccardelli

So I told you I don't watch a lot of TV. I did watch um a I watched a show that I love, uh, which is Sex in the City. I wanted something that I was gonna be comfortable about. Comfortable with. Yeah. Okay. I was nervous I was gonna be claustrophobic. So I was like, I'm just gonna put on something that I know is gonna make me comfortable, but I was I was fine when I got in there.

Sandi Magder

Yeah. And I think it's probably because I had had an uh MRI before and I freaked out. That's when I probably learned I was claustrophobic. So I think it was in my head. But I I shared this before, but the one thing that really helped was when the movie was actually playing. The first time I went in, it was static. The second time I went, she turned it on. So that was a for anyone coming in, that's a good tip. Okay. A favorite musician or song that like always gets you revved up and excited.

Giuliana Zaccardelli

Um, I love electronic music. My favorite DJs are Odeza and Rufus de Soul. They're kind of like chill electronic music. That's what I listen to. Those are good choices.

Dan Schuman

I'm jumping in here. I used to spin house and trance music uh in law school. Oh nice. Rufus to Soul was my last show in Miami. They played 5,000 people at the Bayfront. And then the year after, at that show, they played 25,000 people. And now obviously they're and they're on tour this summer. So you are you're going after my heart.

Giuliana Zaccardelli

Yeah, they're coming to Chicago. I will I will be seeing them. I'm very excited about that.

Dan Schuman

Love it.

Sandi Magder

Okay, so the next question: a wellness habit that you generally love, even if it's weird and quirky.

Giuliana Zaccardelli

So it goes back to food for me. Um, I think that food is so important, and prioritizing what you eat makes a huge difference for me in my energy, in my mood, in just how I feel. Like if I go to a bar and I have fried food, I feel it the next day. I just don't feel great. So I make a huge effort to cook healthy meals. They don't have to be elaborate. They're like sometimes it's sometimes I'm making eggs and avocado toast, but like hot cooking things that are healthy is is to me makes the biggest difference. Yeah, I agree.

Sandi Magder

I actually I live off eggs and avocado. If that didn't exist, I don't know what I would eat every day, but yes. So we're on the same page. Okay, so one thing that you're currently personally working on in your own health journey.

Giuliana Zaccardelli

So I when I did my scan the last time, I did the uh enhanced scan, which includes advanced brain imaging and body composition. And I my body composition told me that I don't have a lot of muscle and I have a lot of visceral fat, which is the fat around your organs, which is very surprising to me because I am a very small person. Um and visceral fat has a lot of negative long-term, it's been linked to a lot of negative long-term health outcomes. So I'm trying to go to the gym more and I'm trying to build some muscle.

Sandi Magder

I need to take a page out of your book because I probably fall in the exact same category.

Giuliana Zaccardelli

I was shocked. Um, but I I I I'm not a big like weight lifter. I've never been, so I'm trying, trying to be better about that.

Sandi Magder

Okay. All right. So the last one, and it's kind of the opposite of all these questions, is a guilty pleasure retreat that makes you happy.

Giuliana Zaccardelli

I love ice cream. Like I love ice cream. I know that's boring, but it is my my favorite thing. I love it so much. And I also love to sleep, which is not a bad health habit, but I I do love to sleep. Those are my two.

Sandi Magder

Me too. Like all I think about is sleeping in. Anytime I can just knock it out of bed, it's just it's like glory to me. So I get it.

unknown

Yeah. Yeah.

Giuliana Zaccardelli

I am a big sleeper and a big ice cream eater.

Sandi Magder

Yeah. Okay, that's the end of the rapid fire.

Final Thoughts: Making Health Less Overwhelming

Dan Schuman

Juliana, this was such an informative, helpful conversation. One of the things we try to do on this podcast is help people feel less in the dark about their health. And I think this episode really did that as far as anyone in our listeners moving forward, current listeners who want to do a prenobo scan. So thank you so much for your time and insight.

Giuliana Zaccardelli

Thank you so much for having me.

Dan Schuman

Yeah, this was just delightful.

Sandi Magder

So thank you again for all of your time. We hope everyone out there enjoyed this conversation as much as we did. We love episodes like this because they take something that can feel really intimidating, like medical scans, reports, and all the unknowns that come with them and make them feel a little more understandable and a little less scary. And honestly, that's a big part of why we started this podcast in the first place. Because most of us are just trying to figure out how to stay healthy without falling down the ChatGPT rabbit hole at 3 a.m. And Dan and I are not always successful at that. So thank you, Juliana, for helping us and our listeners to make a little more sense of the world of preventative imaging and what these scans actually mean in real life. If you enjoyed this episode, make sure you're following the health hunt wherever you listen to podcasts. And if you haven't already, we'd really love it if you left us a rating and review. It helps more people find the show and it lets us keep having these conversations with people who are really interested in doing work in this health space. And if this episode sparked questions for you about scans, testing, prevention, or anything else that you want us to dig into, send them our way. A lot of our episodes start with something that one of you asked about, or something that made one of us spiral and decide we needed to investigate it on the microphone. So thanks for being here with us on the health hunt. Stay curious, stay skeptical, and we'll see you next time.