> Once you include the complicated math of quality-adjusted life years, it's almost never worth it.

This is an actuarial argument, that applies is you want to have the most efficient overall healthcare system. In other words, if you have to ration the access to MRIs and to followup tests.

Now suppose that you are not limited by scarcity. It would absolutely make sense to use the minimally invasive procedures, but perhaps weigh the results a bit less heavily for followup tests.