THE ACCRESCENT™ PODCAST EPISODE 231

Leigh Ann Lindsey (00:01.24)
Well, Dr. Zaccardelli, welcome to the show. I’m so excited to have you.

Giuliana (00:06.122)
Thank you so much. I’m super excited to be here.

Leigh Ann Lindsey (00:08.908)
This has been a long time coming because we, know, our teams have been chatting back and forth for weeks now, getting you scheduled. And then I had my Prenuvo scan just last week. So those results came in. So the timing of all of this worked out really, really perfectly. And I’m excited to get into Prenuvo and also my results and how I’m already using those proactively. But before we jump into all that, can we just start a little bit with your origin story? What ultimately led you to Prenuvo?

Why are you so excited? If you’re there, it seems like it’s something you’re really excited about. So what led you there? What gets you excited about Prenuvo and what they’re doing?

Giuliana (00:49.108)
Yeah, so I think I’ll start with a little bit of my background. I went to medical school at Northwestern and I did my MD and my MBA there. And one of the things that really struck me when I was in medical school was that we learned a lot and we spent a lot of, there was a lot of emphasis on disease and how to treat disease. But I felt like we weren’t as focused on health and how to keep people healthy. And to me that felt like a gap in the

way health care approached.

patients and approach, you know, how we think about health and wellness. And so while I was still in medical school, I ended up starting a company in the fertility space. And the goal there was to get women and couples better access to fertility care earlier on in their journeys. So many people find out that they can’t have kids when they’re trying to have kids. And that limits their options and limits their ability to make informed decisions. And so that was really the goal of

Leigh Ann Lindsey (01:44.001)
and

Giuliana (01:51.24)
that company. And when I was trying to figure out what to do next, Prenuvo felt like such a natural next step because the mission is very similar.

What we’re trying to do at Prenuvo and what Prenuvo provides is giving patients access to information, to data, to an understanding about their health that they can’t get elsewhere in medicine. And that really allows them to make informed decisions, to think about how they want to live their lives, how they want to think about their health in a way that really empowers patients. And so that’s what drew me to Prenuvo. That’s what gets me excited every day about my work at Prenuvo.

And yeah, I’m really happy to be here.

Leigh Ann Lindsey (02:35.574)
I’m so excited. love that. So for someone who’s coming on or who’s listening, who’s never heard of Pranuvo, can you give us the overview of what is Prenuvo? What is their mission? What is their goal?

Giuliana (02:48.308)
Yeah, so at Prenuvo we provide, we are maybe the, we are the world leaders in whole body MRI. And what whole body MRI is, is it’s a screening test that takes pictures using MRI of your body from head to toe. And our scan is really optimized for that screening capacity. So to look across all of your organ systems and see what’s going on under the hood. And I think the unique thing about Prenuvo, I think there’s two really unique things.

about Prenuvo. One is that we are hyper focused on the patient and the patient experience and I think you lack that in a lot of the rest of healthcare. Everything from when you book your scan all the way through to the consultation that you have at the end is centered around the patient and giving the patient that information that they need and how they interpret that information and take it with them in their lives. And then I think the other really unique thing about Prenuvo is we’re providing a service that you

really get anywhere else. And from what I’ve seen as my time in medical school, as a physician, and now at Prenuvo, I think we provide information that is so much different and better than what you can get in a lot of the rest of health care. I really think there’s no substitute for kind of looking under the hood and seeing what’s going on in your body and being able to then make choices and decisions based on that.

Leigh Ann Lindsey (04:15.294)
Yeah, I want to, I want to get into how, cause people might go, okay, it’s an MRI. I can get an MRI with my doctor. We’re going to get into why it might not be that simple and also how Prenuvo goes so far beyond that. But this is where I think the conversation comes into that proactive ability. And I think for any of us in the integrative medicine world, we understand that it’s not, it’s not as easy.

as just being like, hey, doc, I’d like to have a preventative scan. Can we do that? What most of us understand is you have to be having some kind of symptom, and in reality, some kind of severe symptom, to be able to get a traditional conventional doctor to order some kind of scan. So let’s talk about this for a sec.

why that factor is so important. But then I also want to talk about how the information you’re giving might also go beyond conventional MRI results.

Giuliana (05:16.234)
Yeah, I mean, I think when you look at traditional healthcare.

so much is founded on insurance, on what insurance will cover, and a lot of times that’s a procedure or a diagnostic that is based on a disease or a symptom that someone has. We do have screenings, right? We have mammograms, we have colonoscopies, but those tend to be for very specific things. You oftentimes can’t get them unless you’re a certain age or you have certain risk, and we don’t do broad screening across

the population for your whole body that just doesn’t exist outside of Prenuvo. And one of the things that I think is really empowering about Prenuvo is giving patients the option, if this is something that they think is valuable, if this is something that they want to know about themselves, we allow patients to do that and we give them this option that they really don’t have elsewhere. And what we’re seeing is that people really want this information. We’ve scanned over

We’ve done over 150,000 scans. And so that speaks to just the gap that patients are having when they’re looking at what’s available to them in a traditional system.

Leigh Ann Lindsey (06:31.854)
Who is this for? Who is the ideal person? And I know there’s probably a hundred ways to answer that, but who is this for? When might someone consider doing something like this? I obviously have my opinions. I’m 30. I did a Prenuvo scan because I want that baseline, but I’d love to hear your two cents on who is this for? When might someone consider doing a preventative scan like this?

Giuliana (06:58.942)
Yeah, so I think it’s a really personal decision. And I think that…

If you’re thinking about a Prenuvo scan, you wanna think about why you would want to get it, what you’re looking to get out of it, and people will make that choice for themselves about how they wanna spend their dollars, because this is not covered by insurance, on something like a scan versus maybe other sort of things that they can do to improve their health. But generally, I think people come to Pernuvo for one of three main reasons.

One is people who want to be proactive. So someone like yourself, you are, you turn a certain age, maybe you want to understand and have that baseline. We will see people sometimes who maybe they just had a kid and they want to make sure that they’re healthy. Maybe they’re getting a little bit older and they want to maintain their level of fitness and activity. Maybe they’re interested in seeing how their brain is aging because they want to stay at that peak performance level. And so that’s one bucket of people who generally tend to come to Prenuvo.

Another bucket would be people who maybe have symptoms that they don’t have a solution for elsewhere in the healthcare system. So maybe they’ve seen other doctors, maybe they haven’t gotten the testing they’ve been looking for, maybe their symptoms have been underappreciated or unexplained. And so they’re coming to Prenuvo to see, is there really something going on that has been missed? Is there an explanation for these symptoms that I’m having?

And then I think the third is people who either have a family history or higher risk or a personal connection to someone who had a serious illness like cancer or an aneurysm. Maybe they have a family history of cancer. Maybe someone they knew had a cancer that had it been caught earlier, they might have lived. We also have a large cohort of people who have high risk jobs like firefighters, right, where they’re at higher risk.

Leigh Ann Lindsey (09:00.938)
Yeah, totally.

Giuliana (09:03.0)
And so I think that’s another big cohort is people who have a personal reason that they really want to better understand their risk. But what it really comes down to is what are your goals? What are the things that are bothering you or you’re concerned about in your health? And how do you want to engage with your health? Because Prenuvo is not going to magically make you healthy, right? You kind of take that information and it’s how you’re going to then incorporate it into your life, the choices that you make and how you go forward with that.

Leigh Ann Lindsey (09:30.326)
Yeah, something I think worth saying is I interviewed Dr. Varshali Shukla. She is the founder of Vincere Cancer Center in Arizona. They work with firefighters. She does a ton of work with firefighters. And she said something that was so powerful, which is about 95 % of the patients that come in for screening who end up having cancer had zero symptoms.

And that’s not meant to scare anyone, but I think what we need to understand here is by the time symptoms are showing up, it’s been brewing for a long time. So this isn’t meant to stir up fear. It’s meant to go, the reality is, and she said this in our interview, when we catch cancer at stage zero, stage one or two, it is a completely different ball game. We can actually get in there and address it quite quickly.

and with far less interventions, and it really isn’t quite as scary versus if something’s showing up and getting caught at a three or a four. And that was really, it was so profound for me to hear that so, I mean, such a large number, 95 % of her patients had no symptoms. They came in for preventative screening, something was found, and then they were able to address it at stage, you know, zero one two.

Giuliana (10:45.281)
Yeah.

And think that’s really the power of screening and the power of that information. And cancer is, I think, obviously something that a lot of people are concerned about. It’s a huge buzzword, but what I’ve seen at Prenuvo is it goes way beyond cancer. have, like, I’ll talk to my own personal experience. I got my Prenuvo scan last year and it shows signs of tech neck or spinal degeneration in my neck. And when I was having my consult with the provider after, we started

Leigh Ann Lindsey (11:00.93)
Totally.

Giuliana (11:16.064)
talking about this and I realized that I actually was having some symptoms. Like I hadn’t really thought anything of them but I was getting headaches at the end of the day or my neck, I would wake up with a bit of neck pain and I kind of had blown it off. I didn’t really think much of it but now that I had this imaging I was able to make changes in how I sit, in the exercises I was doing, making like a real conscious effort not to look down at my phone like this and when I got my scan again this year

Leigh Ann Lindsey (11:32.141)
Mm-hmm.

Giuliana (11:46.457)
not only had it not gotten worse, I don’t have symptoms anymore. That’s just a small example. We see this a lot of times too with things like fatty liver disease, which is extremely common. You don’t often catch it on labs because the cells have some damage. You can actually pick up on it on MRI much sooner before those cells get damaged. When people have early fatty liver disease on MRI, they can then take that and

Leigh Ann Lindsey (11:50.519)
Mm-hmm.

Leigh Ann Lindsey (12:09.742)
Mm-hmm.

Giuliana (12:15.9)
and say, okay, I’m gonna change how I eat. I’m gonna cut back on alcohol. I’m gonna do these exercises. And we can see signs of that reversing when they come back. And so I think for cancer, for things like aneurysms, super important to catch things early. But it even goes beyond that to like, how do I wanna age? How do I want my health? How do I want my body to feel as I get older? What are the things I can do today to set myself up for success long-term?

Leigh Ann Lindsey (12:43.022)
100%. I think you guys probably have so many great stories of individuals coming in who almost just did it for fun, did it to get a baseline, and actually did find something really serious that they wouldn’t have found otherwise. And I’d love to hear some of those stories, but to your point, and I think this is the bucket I land in, it’s I want a baseline.

I really, I’ve never had full body imaging done ever. And I was a competitive soccer player, played professionally in Spain. I’ve had so many head injuries, it’s insane. And yet have never had full body. I had stage zero breast cancer. So I’ve had imaging of certain parts throughout my life, but never that full body.

And so I wanted to do it for those two main reasons. One is I think it’s so powerful to have a baseline where I now know like, here’s what everything looked like in 2026. So in 2030 or 2040, if something shows up, we can at least come back to the baseline and go, well, it wasn’t there then. So this has shown up sometime since then. And I’ll probably do that more regularly than every 10 years, but you get the point. But also to that end,

Giuliana (13:35.286)
Yeah, exactly.

Leigh Ann Lindsey (13:54.639)
truly being proactive. Some of the things that came up in mind that really shocked me were I have like early disc degeneration in some of my lower vertebrae. And that honestly kind of surprised me. It doesn’t stir up fear though, because I have an amazing team of integrative practitioners and doctors. And so I took it to my chiropractor who’s also like a functional medicine doctor. And he was like, great, like this is, you know,

Competitive athletes don’t often realize how much their bodies deteriorate with what they do. And there’s so much we can do for this now, now that we have this. And that I feel honestly so grateful to my 30 year old self for deciding to do that scan and so grateful to Prenuvo for enabling me to do that. Because I know now like when I’m 40 and 50 and 60, my life is going to be better because of this.

Giuliana (14:49.736)
Exactly, and if you didn’t know, if you don’t have symptoms, like…

You may not have done things about it, right? And that, then think about where you could have been at 40 or 50. Now you’re having back pain. Your options are so much more limited. Maybe you have to take medication or you have to have surgery and it just changes your whole life to be able to make these interventions earlier and prevent it from getting to the point where you ever have symptoms. And so I think that’s what’s so powerful about Prenuvo. It’s really giving you that information to allow people like yourself to make those decisions on how they want to live their life, to keep themselves healthy.

Leigh Ann Lindsey (15:23.715)
Yeah, we covered some of this already, but can you go into, just for the listener who’s still kind of like, okay, so what information can I get out of this scan? And there’s an immense amount. We’re not gonna be able to list every single potential piece, but can you give us a little bit of a broader sense of what might be some information or insights they can get from this?

Giuliana (15:44.087)
Yeah, so I think the best way to explain that is, if you don’t mind, I’m going to go on a little bit of a tangent and talk about the Pernuvo experience. Because I think when you think about how we’ve set Pernuvo up, it’s really about how we get that information to the patient. And so it starts at the very beginning when you book a scan. We ask patients to fill out a pretty detailed, you probably did this, medical history. And that gives us information about your medical conditions,

Leigh Ann Lindsey (15:51.981)
Totally.

Leigh Ann Lindsey (16:09.391)
Mm-hmm.

Giuliana (16:14.14)
why you’re getting a scan, your lifestyle, and that all goes to our radiologist as well as our provider who does the consult on the backend to help them interpret the scan, interpret the images, and then interpret the report.

When you get a prenuvo scan, you’re in the scanner for anywhere from like 40 to 75 minutes, depending on which scan you get. And we take thousands of images from your head to your toe. We go, we’d use different sequences, which are different ways of taking the MRI pictures for different parts of your body. And, and all those images come together and in, in, in, the, into the MRI. Those then get sent to the radiologist.

And one of the things that’s really unique about Pranuvo is we have over a hundred board certified radiologists who are all focused and trained on reading whole body MRI. And I think that’s so important because it’s very different from reading like an MRI of your brain because you had a symptom or from reading a mammogram where you know, you’re looking for this one type of thing. We’re looking for everything. And you often don’t know what you’re looking for. And so.

Leigh Ann Lindsey (17:22.861)
Right? Yeah.

Giuliana (17:28.676)
So having radiologists who are trained, who are specialized, who really know how to interpret these scans, I think gives patients that deeper level of insight than they may be able to get elsewhere.

And then you have our report. You got your report, so you probably know what I’m about to say. Our reports are, so when you look at other parts of healthcare, normally you have like a doctor is gonna order maybe a chest CT. You’re gonna get your chest CT, the radiologist is gonna read it, the radiologist is gonna write a report. That report is not for you as the patient. That report is for the doctor who ordered the chest CT. And so,

Leigh Ann Lindsey (17:44.567)
it’s so fun.

Leigh Ann Lindsey (18:03.097)
Mm-hmm.

Giuliana (18:08.671)
It’s only going to talk about, it’s not going to talk about everything. It’s maybe written in medical jargon. It’s not going to go into a lot of detail. Prenuvo reports are written for the patient. They’re the complete opposite. We go through system by system, organ system by organ system from head to toe. Any findings that you have, they’re going to be written and then they’re going to be explained to you. So what does that mean? Maybe what next steps should you take? Do you need any follow up on this? They’re also color coded in order

Leigh Ann Lindsey (18:38.381)
Yeah.

Giuliana (18:38.635)
of severity, informational finding, nothing to do, this needs this kind of follow-up.

And if there is, if you do have some, a system where there is no finding, the radiologist will tell you that so you don’t have to guess. and so super detailed. and then the console, I think is, like I said before, so important because that’s where the provider will go through the report with you, go through your symptoms, go through your lifestyle and, and talk about what changes you can make and, and, and, and what that means for you. So in terms of kinds of information, it can be anything.

Leigh Ann Lindsey (18:52.003)
break.

Giuliana (19:15.539)
from like I have an extra vertebrae for example. They told me that. don’t this doesn’t really impact my life but if I ever have spine surgery it’s good to know. But so is anything from an informational finding like that to things like I talked about spinal degeneration, fatty liver disease. We do really great women’s like pelvic imaging so we can look at your ovaries, your uterus, see if there’s signs of endometriosis.

Leigh Ann Lindsey (19:20.588)
huh.

Leigh Ann Lindsey (19:25.881)
Mm-hmm.

Giuliana (19:45.449)
or fibroids. We look at your brain and can look for aneurysms. So it’s kind of a mix of everything, but those are just some examples.

Leigh Ann Lindsey (19:56.437)
Yeah, you’re getting to look at all the systems. I want to go back to something you said, because I think it was actually really important for the audience to understand. And I’ve heard patients talk about this, where a lot of radiologists, it’s to your point, they’re having head symptoms. So we’re doing a scan on the head, and I’m looking at this one particular part to find this one particular thing. Or there’s something going on with the breast, so we’re just looking in the right breast for this.

And I’ve had patients come in who go, I did an MRI six months ago. And yes, they found the spot on my breast, but they didn’t even mention that there were these spots on my lungs. And I think a part of that is that radiologist is just looking where they’re being told to look for the symptom that’s presenting. They’re not necessarily observing the whole scan. And I hear stories like that.

all the time. But I think to your point, it’s a really special skill to be able to go, we don’t know what might be going on. Obviously you have the patient’s intake form, so you know if there are some things that have been noted, but they have to look at those images in a completely different way. Not like we know something’s here, so we’re going to look at that. It’s could something be here? We have to look so much more intentionally.

Giuliana (21:19.519)
Mm-hmm. Yeah. And this might be a little bit too much detail for the listeners, but the way our radiologists read the reports, we kind of…

Leigh Ann Lindsey (21:19.81)
at every part of this imaging.

Leigh Ann Lindsey (21:27.543)
or we love it.

Giuliana (21:34.717)
set them up to do that, right? So like the software that we’ve created is intentionally built to really guide the radiologists through that system by system, finding by finding. And so the whole process is set up to really optimize for this vast screening imaging. And I think that’s really unique.

Leigh Ann Lindsey (21:56.501)
Mm-hmm. To your point about the reports then that you get, what I love is you do provide the full medical report. You provide all the images, which is really powerful because if someone does want to take some of this to a different medical provider, they have access to all that raw information. But you’re providing it in a patient-friendly way as well that could not be any easier. It’s basically all these different tabs of the different systems.

And you can see right away, you there were three findings in the nervous system, one moderate, one minor, you know, one minor finding in the vertebrae or all these different things. So it’s so straightforward. It’s so easy to work through. You provide it in terms that are really easy to understand. Now I haven’t done the console yet.

And then I also want to talk about the blood draw because my ex from a few years ago when we were together, he did a Prenuvo. But I don’t know that you guys were offering blood draws then, or he maybe just didn’t do it. OK.

Giuliana (23:01.111)
We weren’t. We started offering blood draws last year. Yeah. Yes.

Leigh Ann Lindsey (23:04.887)
Okay. And so that say a little bit more about that. Is that standard with every, every type of scan you offer, or is that an add on people can do?

Giuliana (23:15.743)
So.

Currently, we offer the blood draws as part of our enhanced package, includes our whole body MRI, it includes labs, and then also some AI analysis of your body composition and your brain. And we’re looking to expand blood draws to incorporate it in more offerings. Because what we’ve seen from patients and from our providers who are doing the consultations is that there’s really this one plus one equals three effect of the labs plus

the imaging, I guess it would be like two plus one plus one plus one equals four, plus with the medical history, right? There’s this additive effect of being able to take what the patient is saying and what their background is, all of this really rich data on the imaging, and then when you bring the blood into it, you have another layer, another way of looking at the body. And so it can help you get more focused on, you know,

certain findings that may be in the labs or in the imaging. It can help contextualize certain things that we see on imaging. And we found that it’s really powerful for patients and for.

our providers when they’re doing the consults. And one of the things that I love about the labs that we do is they’re very comprehensive. And, you know, when you go to your doctor, maybe for your annual physical, they’re going to check CBC, they’re going to do a, sorry, they’re going to do like a blood count, a thyroid test, maybe a diabetes test and your cholesterol, right? But we kind of go beyond that because it gets back to what we’re trying to do at Pernuvo, which is give you that full body

Giuliana (25:00.781)
picture. And so, yeah, I’m really excited about that. And more to come on our lab offerings, I think.

Leigh Ann Lindsey (25:09.641)
Yeah, I was so impressed. mean, you guys, the person came to my office, did the blood draw. I didn’t have to go anywhere. I know there was an option to do it there at Pranuvo on the day of the scan too, but it, I mean, it just was so seamless. It was so effortless on my part. So I want to talk a little bit more about the consults, the value of that for the patient. And then I’d love to hear some.

like client stories on all the different sides of this spectrum. But could say a little bit more about that console. What is entailed in that? I’m already surprised that you’re saying it involves some, some recommendations of, here’s what’s going on. Here’s some shifts you might want to make that already surprises me. Cause I would have thought it was just the doctor going, here’s what all this means. now

have a nice day, go talk to your other doctors about it. And I would have been really happy with that. great, thank you so much for sitting down with me and explaining this. I will go now take this to my team. It sounds like it’s a little more comprehensive than that.

Giuliana (26:12.895)
Yeah, and so.

You know, the consult really depends on who you are, what you want to get out of it, and also what your findings are. Like if you have a serious finding, your consult is going to be focused on that, right? We’re going to explain the finding to you. We’re going to explain what it means, what it possibly could be, what next steps you need to take. Do you want us to send this to your primary care doctor? Do you want us to send this report somewhere else? So, you know, in the people that have an urgent finding, it is truly focused on that generally.

Leigh Ann Lindsey (26:26.649)
Mm.

Giuliana (26:44.793)
But we do go through the rest of the report if the patient really wants us to. But for the majority of people who don’t have what we would classify as an urgent finding, something that needs pretty timely follow-up, the consult is really about taking the information that we get from the report and contextualizing that in your life. And so I can talk a little bit about my consult. I did an enhanced scan last fall. And my body composition,

I had a higher than normal percentage of visceral fat. And that’s the fat that’s around your organs. And there are lots of studies that link visceral fat to…

less than good outcomes long term in terms of your brain health and your aging and things like that. And I was surprised because I eat healthy. I am pretty slim person. So I was very surprised to see that. And so we ended up spending a lot of time talking about that. You know, what is my family history? Do do does this run in my family? Are there things I can do? What does my diet look like? Can are there things we can optimize there? I talked a lot about what kind of exercises I

Leigh Ann Lindsey (27:29.167)
Mmm.

Giuliana (27:56.935)
should be focusing on. I love to go to the gym pretty regularly, but are there should I be doing strength training? Should I be doing more cardio? Like what should I be focused on? We also talked about supplements I could potentially take to hope to help build muscle, build more muscle mass. So we’re not going to prescribe anything in that console. Like, you know, we’re not your doctor. You still need to go back to your provider to get a prescription. If you need follow up imaging, if you need to

to PT, but a lot of that consult is really taking what we see on the report and then asking those questions about what you’re doing in your daily life, what do you want to focus on out of this report, and what are some things that you could think about to make those changes.

Leigh Ann Lindsey (28:44.695)
Yeah. And it sounds like that, that doctor’s able to go, yes, there’s lots of findings. Let’s talk through that. Here’s some that you might want to start discussing with your primary care provider. And I think that’s important because, and I think this is actually a good place to bring this up. And I’m excited to hear your input because I’ve heard doctors on different podcasts kind of throw shade at

Giuliana (28:58.059)
Thanks for watching.

Leigh Ann Lindsey (29:10.275)
companies like Pranuvo for offering these preventative scans. I think their argument is it’s causing people undo fear. It’s causing people to intervene too dramatically before it’s really necessary. And that might be true for some people, but I don’t think the solution then is to just go, well, yes, let’s just not offer proactive imaging like this. think the solution is to educate patients on, you know, here’s what’s going on.

this isn’t 911 and that’s good so we don’t need to like go go off and biopsy this or go off and have surgery on that but if we do want to be

intentionally proactive, like for me with my early disc degeneration, but I’m not freaking out. I’m not running around like a chicken with my head cut off, but I am going to my doctor saying, great, what can we do to halt this? Maybe even reverse this? What do I need to know about my posture, my sitting habits, my exercise styles, et cetera, so that we can start to improve this.

But it sounds like that console is really important for that, for patients to be able to get that insight of, hey, this is, you know, here’s some things we don’t think you need to look into some of these deeper. It’s just good to have this noted. Here’s some things we think you might want to start talking about, but they’re not red flags and or here are some things that you really need to get on with.

Giuliana (30:38.559)
Yeah, I have a lot to say about this topic around anxiety. I think that, I wanna say this diplomatically, I think it’s a little bit of a fallacy to say that what we’re doing at Prenuvo is causing patients undo anxiety for a couple of reasons. First of all, I think that,

Leigh Ann Lindsey (30:41.347)
Okay, good, I love it.

Giuliana (31:04.447)
The way we’ve kind of approached traditional healthcare tends to be very top down, tends to be a little bit paternalistic. And I don’t think that gives the patient enough credit. I think patients are looking for these answers. They are interested in knowing more and…

And I think we should be able to, as a system, as a healthcare system, as a society, figure out how to incorporate that information in a way that’s beneficial for the patient. So I…

The console is a huge piece of that because that allows us to do it. And I know that a lot of primary care doctors, have 10 minutes with their patient. They might not have time to go through all the Pranuvvo results. That is a systematic problem. But saying that giving patients information is causing them anxiety, I just don’t think that’s true. And I have a couple reasons for that, if I can go in detail. So we did a study of about 1,000 Prenuvo patients asking

Leigh Ann Lindsey (31:59.907)
Yeah, I’d love it.

Giuliana (32:08.407)
about anxiety and we asked them 12 months later, did their Peruvian scan cause anxiety? And less than 1%, I think it was actually like 0.5 % said that there was unnecessary testing that caused them anxiety after their scan. So that’s one signal. Another signal comes from just my own experiences talking to Peruvian patients and talking to

and when they speak to how they took this information and what they did with it. And there’s one in particular who really sticks out to me. I’ve gotten to know her quite well. And she has, I think, such a unique story that I want to share.

So this woman, she brought her husband in to get a Prenuvo scan. Her husband had a family member who had passed from an aggressive type of cancer. And when he got his Prenuvo scan, it showed that he had that same type of aggressive cancer. It was not early enough stage where they decided to intervene.

So he ended up, he and she ended up, they made a choice, he made a choice not to pursue chemotherapy, not to pursue aggressive treatment, and he lived for 10 months. And some people would say, what did you do for that patient? Their cancer was too late to operate on. What value did you provide? But what his wife says is,

Leigh Ann Lindsey (33:44.835)
Hmm.

Giuliana (33:54.333)
That knowledge was the best gift that I’ve ever received. I like, get chills talking about this because it’s just such an incredible story. She said, she talks about how they had 10 months together where they were able to do things that they might not have otherwise done, where they were able to plan, where they were able to make these conscious choices and how beneficial that was for the both of them in those last 10 months of his life. Like he didn’t have any symptoms until the last three weeks. And so she talks about how

different that experience would have been if they found out three weeks before he passed. And so I think that like,

Leigh Ann Lindsey (34:29.985)
right.

Giuliana (34:33.907)
Having that knowledge and having the choices is so empowering for patients because this person was able to make a decision, I don’t want to pursue aggressive treatment. Other people might make a different choice. And I think that that is so important to give patients the ability to make those decisions.

Leigh Ann Lindsey (34:54.783)
Mm-hmm. Absolutely. I’m so glad because I think there’s also a little bit of this, well, it might cause people anxiety, so let’s just not do it. And that’s a part of the problem here is we’re not equipping or empowering people to be able to deal with information in a proactive way. We’re just disabling them and going, well, it might cause anxiety, so just don’t do it at all.

And I think that’s a bigger part of the problem. But also to that point, I imagine most of the people pursuing imaging like this are ones who understand and are wanting to be proactive and aren’t jumping the gun on some of these things, if that makes sense.

Giuliana (35:41.547)
Yeah, and I think, you know, I think it’s…

I think it’s a combination of things. think it’s people who want to know or have good, who have reason that they want to know. I think it’s how we provide that information to the patient, how we explain it in the report, how we explain it in the consultation, how we help them understand what something means and what they should do about it. And then I also think it’s a little bit of the healthcare system. Like when you take something back, you know, having

that real conversation with the patient of do you need this biopsy or do you need to do this thing or like you talked with your chiropractor about like here are all the things that you can do proactively. But I think that they’re that that really it’s like a three step process and we control sort of two of them. But the last step is really outside of pernivo. You know, I have a thyroid nodule on my pernivo skin. I had no symptoms. I got it ultrasound and it’s technically technically a

Leigh Ann Lindsey (36:32.431)
Mm-hmm.

Giuliana (36:44.697)
should be biopsied. But it only should be biopsied because of its size. It doesn’t have any other characteristics that make it likely to be cancer. And so I made a decision with my primary care doctor that I’m not getting it biopsied. I’m going to just watch it. I’m going to get more ultrasounds. I’m going to get my pernumeral scans in between. And that was the decision that we made together. And so I think that it’s about

know, making that shared decision making and also giving the patients the tools they need to really understand their risk, understand the next steps that they could take and then allowing them to make that choice for themselves.

Leigh Ann Lindsey (37:23.951)
Yeah. And just having that power and option to be able to do that. remember in 2020, um, 20, actually late 2019, I, I like woke up with a horrible pain in my right breast and went to my primary care and she was like, you know, it’s probably just your gallbladder. You’re young. And I was like, I’m pretty sure that’s not referred pain from my God. Like I’m pretty sure I know where that pain is coming from. Um,

And at 20 then 24 made the decision to go, you know, opt to have an ultrasound that I paid for out of pocket that she wasn’t going to refer me to because I was too young and I didn’t all these things. And that’s when we found this very, very small mass. But I look back on that and go. If I had just let.

traditional medicine guide me through that, they would have been like, no, there’s no, no, you’re too young. You don’t need any imaging. It doesn’t make sense. You know, come back in 10 years. And if I had waited that long, would I have had to have a mastectomy? Would I have had to go on chemo or radiation? Who knows? Maybe not, but I don’t want to gamble. I don’t want to play that game. So to have caught something so early,

is incredibly, incredibly powerful. And to the point we made earlier in the conversation, the interventions we might want to do, whether that’s for me right now with my back, just different exercises and different posture, or with that early stage breast cancer, know, ultimately just a lumpectomy to remove that. It’s so powerful to be able to have the decision to do minor interventions like that, rather than when things are caught so late.

You don’t have a lot of options at that point.

Giuliana (39:10.153)
Exactly. And I think that goes back to your earlier point about the physician who you said with the screening, right? With the firefighters. Like finding things gives you optionality. If you don’t know, you can’t do anything about it. And so I think that that knowledge is so powerful. It’s empowering for patients. It helps them make decisions and it sets them up for success in health long term. And I just I don’t think that there’s a substitute for being able to know that that information.

about yourself. I think about like the rise of wearables as kind of a comparator, right? Like people are looking for this data. They wear their oar rings, they wear their Fitbits. They want to know like what’s going on with them and how can they optimize and what can they do to keep themselves healthy? And back like it’s just, it’s a gap that in our healthcare system today that that Pernouvo is filling. And I just think it’s so powerful for patients to have that information.

Leigh Ann Lindsey (40:09.163)
Yeah, absolutely. Can you give us some of your favorite client patient stories, maybe across all the spectrums, right? People who came in just proactively, maybe there weren’t massive findings, but it led to some real lifestyle shifts for them. And then maybe some of those more intense where something big was caught early and it completely changed the game for them.

Giuliana (40:31.455)
Yeah, so I’ll start with the latter. We had a patient who came in, she was in her 40s. She was having some perimenopause symptoms, so she wanted to just get a baseline of her health. And she came in to get a Prenuvo scan. And…

It turned out that she had a mass about the size of a walnut in her brain. And now we couldn’t tell what that was from the scan, but she took that information, she went to a neurosurgeon and had the mass removed. And she talks about how the neurosurgeon said,

I can’t believe you had no symptoms. I can’t believe you haven’t had seizures. Like this was pushing on your hippocampus. It could have caused seizures. And yet she had no symptoms.

And then after they did the pathology on it, it turned out that it was a grade three brain tumor. But because she was able to catch it early, she’s also like an oncology nutritionist. She made some changes in her diet and her lifestyle. She has no evidence of disease and her surgeon thinks she’s going to be completely fine. And that’s just one example of the power of catching things early before there are symptoms. If she hadn’t found

out until the mass had continued to grow, who’s to say what could have happened? Would they have been able to take the whole thing out? Would she have had a seizure that had caused issues? Like, we just don’t know. And so I think that’s a great example of how something very serious was only picked up because she chose to get this scan. On the kind of less serious side of things, I think

Leigh Ann Lindsey (42:14.745)
Mm-hmm.

Giuliana (42:22.389)
I don’t have like a specific patient story about this, but I think pretty much every day there are people who come to Prenuvo and they find something like you and your back, like me and my neck, like the fatty liver disease patients that I’ve talked about. One of the beautiful things about Prenuvo that we haven’t really touched on so much is like the ability to get that baseline, but then also follow up on it over time. And so you can come back in a year or a few years and you can see, did your back get better or was it at least stable or did it get

worse. I can look at my neck and see the same thing. People who have fatty liver can come back and often we’ll see that their liver has gotten better. There’s less signs of or no signs of fatty liver on on their MRI. And so I think for people who have those less serious things but still things that they need to follow up on, one of the great things about the scan is getting that data over time and being able to track those things and see I’m doing better on this. I’m

I need to keep working on these other things. So I’m excited to see next year if my visceral fat has gotten any better.

Leigh Ann Lindsey (43:26.867)
Yeah, absolutely. mean, same the back stuff, I will say again, not that it didn’t cause a panic, but I just was like, I wasn’t expecting that, especially having had an early brush with cancer. It’s hard not to have some thoughts in your head of like, is there going to be a mass that’s found somewhere else that kind of so that’s where my head goes. I wasn’t even thinking about discs and spine and some of these different things, but.

It actually made sense with symptoms and I’ve actually had low back issues since I was a young, young kid playing competitive sports. So it might’ve been something that’s been going on for quite some time, but I’m really excited to be able to do some comparative scans, in that work and see what’s shifting and have that power to do that.

Giuliana (44:13.353)
Exactly. And I think that, you know, also as we get more sophisticated, there’s so much more like data that we can that we can give patients. So the enhanced scan, which is the scan that has the blood that you did, we launched that last year. And one of the things that we included in that scan was it’s a

quantitative measurement of your brain and it looks at how different regions of your brain are the size and how that compares to within your own brain and then with other people of your age and gender. And it can help look at things like is your brain aging faster or slower? Are you potentially, do you have signals that would potentially make you at a higher risk of something like dementia? And that data is valuable in and of itself, but what’s really valuable is to see

okay, two years, five years, 10 years down the line, what does my brain look like today? Am I able to keep my brain looking close to how it looked when I was 30 years old? Or is it kind of accelerating in how it’s aging and what do need to do to change that?

Leigh Ann Lindsey (45:22.507)
Mm-hmm, absolutely. I love that. Is that information I get in the console?

Giuliana (45:28.182)
Yes, it’s like a supplemental report. If you go onto your portal on your web portal, you should be able to see it, but it’s not part of the normal like pernubo report. So if you’re in your app, I go on the web portal. Yeah. Yeah. Yeah, that’ll be on the website.

Leigh Ann Lindsey (45:31.192)
Okay.

Leigh Ann Lindsey (45:34.904)
Okay.

Leigh Ann Lindsey (45:40.375)
got it, got it. OK. Yeah, because I think I just saw the imaging report. So I’m like, I want to make sure I would get that one too and check into it. anything we didn’t cover that feels actually what I will say is, you walk us through what are the different options people can book? How someone might make the decision of where they want to start with that. Let’s make sure we cover that. And then if there’s anything else we didn’t cover.

Giuliana (45:57.185)
sure.

Giuliana (46:07.383)
Can we take a quick time out on this? Is Grace here?

Leigh Ann Lindsey (46:09.111)
Yeah, totally.

Leigh Ann Lindsey (46:13.967)
Yeah, she should be. I see her. You can pop in the chat, Grace. Yeah.

Giuliana (46:20.055)
Should I talk about the products that we have today or the products that we are moving towards?

Leigh Ann Lindsey (46:30.649)
just today.

Giuliana (46:31.777)
Just today. Okay, perfect.

Leigh Ann Lindsey (46:33.519)
I made a note, so we’ll cut that. worry. Yeah.

Giuliana (46:35.625)
Okay, thank you. Okay, so we offer three kind of types of scans today at most of our clinics.

We have our traditional whole body scan that goes from head to toe. It looks at all your organ systems. It also includes an assessment of the major arteries of your brain to look at aneurysms. And that’s, if you’ve heard of Prenuvo, like that’s the Prenuvo scan. That’s the scan that you’ll be used to hearing about. Then we have a torso scan. So for some people, maybe they’re more concerned about what’s going on in their major organ

systems of their body. Maybe they’re not interested in learning about their brain or they want something that’s a little bit more accessible on a price point. And so that’s kind of our entry level scan. And then we have the enhanced scan, which is what you did. And that is the whole body scan with the addition of the AI brain analysis, the AI body comp analysis, and the labs, and kind of bringing that all together into one package.

Leigh Ann Lindsey (47:42.295)
I love that. And it’s pretty straightforward, but I’d love to have you walk us through what does it look like to book one of these scans? What’s the process? Give that to us one more time.

Giuliana (47:50.391)
Yeah?

Sure. So you can book the scans online. You can also call into our sales team if you have questions or you’re not sure which scan is right for you. And then after you book your scan, you’ll get access to our patient portal and that’s where you’ll fill out that medical history form that I was talking about. Once you fill out that form, that’s when we do the appropriateness review and the safety questions, safety check. So our nurses will review your medical intake form for

or why you’re getting the scan, any…

symptoms that you might be having and there are some things that Prenuvo is not great at. And if you flag that on your scan, we’ll kind of reach out and talk to you about that and make sure that the scan is right for you because we want to make sure that we’re meeting your needs. So we look at your large joints but because the small joints of your hands, your wrists are so detailed, our scan’s not really optimized for that. So if people have concerns about maybe their wrists

for example, will reach out and will explain, hey, this is a limitation of our scan because again, we want to make sure patients come to Prenuvo and that they’re satisfied. So we also do that. And then the safety check. Then you come into our our centers. You probably know this. It doesn’t really look like a traditional doctor’s office. I say it looks more like a spa. And we do that intentionally. We want patients to feel comfortable. We want them to to to not be nervous. So the person at the front desk

Leigh Ann Lindsey (49:16.168)
No. Yeah.

Giuliana (49:27.293)
checks you in, you get brought to your own private changing room, you change into scrubs, you have the option to watch Netflix or listen to Spotify or we also have something called Health Tunes which has been shown to reduce anxiety in the scanner. So some sort of entertainment while you’re in the scan. You get brought back, the MRI tech does another safety check, you lay down in the scanner and if you’ve never been in an MRI scanner,

like a big donut of the machine and then you kind of go in the center. We use large bore magnets so it’s a little bit further away from your face to reduce claustrophobia. The scan takes, like I said, 45 to 75 minutes. You come out, images go to the radiologist, they get read, and then you get that report on your app, on the website, and then you get your consult at the end. So the whole experience is really set up to

be supportive to you, to make patients feel comfortable, to make them feel supported during the Pernuvo journey, and that’s really what we’re there for.

Leigh Ann Lindsey (50:38.017)
Yeah, I was just really impressed that the whole patient experience wasn’t an afterthought. You could tell it was a primary part of everything you guys are taking into account. mean, from the moment, just from the ease of all of it, you can book online, you can see the schedule. Everything is so crystal clear. I got there, she hands me a tablet. She’s like, choose what you want to watch on Netflix. We’ll load exactly what you want.

I get out, there’s a snack bar. I can get a snack because I’ve been fasting all morning. So you guys have really considered every fast that I can think of of that patient experience to make it clear, easy, simple, literally even the MRI bed I was laying on. was like, this is more comfortable than my partner’s bed. Like I could, I’d rather lay on this.

Giuliana (51:25.119)
Yeah, I mean, we’ve made so many conscious decisions throughout the history of our company to put the patient first. And truly, I think that’s really what sets Prenuvo apart from how we run our MRI centers, the literal machines that we choose, how you get that report and how that information is conveyed to you and everybody who you interact with along the way. Like the goal is to really, to really put the patients first. And I’m so glad that you had that experience when you, when you got your scan, because that’s what’s, that’s what guides us every day.

Leigh Ann Lindsey (51:55.511)
Yeah, I love it. Anything we didn’t cover that you feel is really important for the audience to hear.

Giuliana (52:02.636)
I just, I think that, you know, I think that…

One of the things that I just like want to hit home and we touched on it a little bit is that there’s so many reasons why you might want to get a Prenuvo scan. think historically there has been a bit of a persona around who comes to Prenuvo. Maybe someone who’s a little bit more biohacky or interested in longevity. But we see patients come to Prenuvo and find so much value at Prenuvo from all ages, all walks of life, many different reasons why they come to us. And so I think if you’re considering getting a

Leigh Ann Lindsey (52:23.535)
Hmm.

Giuliana (52:40.217)
I think look into it and really think about like what am I trying to get out of this and is this information gonna help me? And yeah, I just think there’s so much value that that we can give people so I I come in and see us

Leigh Ann Lindsey (52:55.759)
I love it. And we’ll make sure that Prenuvo website, social media, it’s all linked in the show notes. So the audience will be able to find that really easily. Well, Dr. Zaccardelli, thank you so much for coming on. This was fantastic.

Giuliana (53:05.495)
amazing.

Giuliana (53:10.529)
Thank you. It was a pleasure.