Prevalence of and risk factors for failure of fetal magnetic resonance imaging due to maternal claustrophobia or malaise.

OBJECTIVE: To evaluate the prevalence of and risk factors for failure of fetal magnetic resonance imaging (MRI) due to maternal claustrophobia or malaise. METHODS: This retrospective cohort study included pregnant women who underwent fetal MRI for clinical indications or research purposes between January 2012 and December 2019 at a single center. One group included patients who completed the entire examination and the other group inlcuded patients who interrupted their MRI examination due to claustrophobia/malaise. We estimated the rate of MRI failure due to maternal claustrophobia/malaise and compared maternal and clinical variables between the two groups. Multiple logistic regression analysis was performed to identify independent risk factors for claustrophobia/malaise during MRI examination in pregnancy. RESULTS: Among 3413 patients who agreed to undergo fetal MRI, the prevalence of failure because of claustrophobia or malaise was 2.1%. The rate of claustrophobia/malaise in patients who underwent MRI for a clinical indication was lower compared to that in patients who underwent MRI for research purposes only (0.6% (4/696) vs 2.4% (65/2678); P = 0.003). Fetal MRI performed for research purposes only (adjusted odds ratio (aOR), 0.05 (95% CI, 0.01-0.48); P = 0.003), higher maternal age (aOR, 1.07 (95% CI, 1.02-1.12); P = 0.003) and later gestational age at the time of fetal MRI (aOR, 1.46 (95% CI, 1.16-2.04); P = 0.008) were independent risk factors for claustrophobia/malaise. Shorter fetal MRI duration (aOR, 0.77 (95% CI, 0.63-0.88); P = 0.001) was also associated with claustrophobia/malaise during the procedure. Body mass index, ethnic origin, multiple pregnancy, being parous and size of the magnetic bore were not associated with MRI failure due to claustrophobia/malaise. CONCLUSION: The rate of fetal MRI failure due to claustrophobia or malaise was found to be low, particularly when the examination was performed for a clinical indication, and should not be considered a common problem in the pregnant population. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

Does Structured Informational Care Reduce Anxiety In Patients Undergoing MRI? A Quasi-Experimental Study.

Objectives: To assess the anxiety level in patients undergoing magnetic resonance imaging, and to see if structured informational care reduces anxiety compared to conventional approach. METHODS: The quasi-experimental study was conducted Dow Institute of Radiology, Dow University of Health Sciences Karachi, Pakistan from January 2020 to June 2021, and comprised adult patients of either gender undergoing magnetic resonance imaging of brain / cervical spine for the first time. They were divided into S-arm group exposed to structured information with pictures, recordings and videos, and C23 arm group exposed to conventional information. The primary outcome was anxiety, measured by Beck Anxiety Inventory. Data was analysed using SPSS 11. RESULTS: Of the 280 subjects, 140(50%) were in the S-arm; 65(46.4%) males and 75(53.6%) females with mean age 41.1±15.2 years. The C-arm had 140(50%) subjects; 78(55.7%) males and 62(44.3%) females with mean age 44.2±13.9 years (p>0.05). The pre-procedure anxiety score of C-arm was 11.3±7.7 compared to 9.6±7.7 in S-arm (p=0.062. Post-procedure anxiety score in S-arm was 9.8±9.0 compared to 1.49±4.5 in C-armB (p<0.001). CONCLUSIONS: Structured informational care aimed at familiarising the patient to the magnetic resonance imagaing machine and describing the relaxing manoeuvres during examinationI was found to be a cost-effective and simple method to alleviate anxiety in patients.

Patient preferences for development in MRI scanner design: a survey of claustrophobic patients in a randomized study.

OBJECTIVE: To investigate which magnetic resonance imaging (MRI) scanner designs claustrophobic patients prefer. MATERIAL/METHODS: We analyzed questionnaires completed by 160 patients at high risk for claustrophobia directly after a scan in either a short-bore or open panoramic scanner as part of a prospective randomized trial Enders et al (BMC Med Imaging 11:4, 2011). Scanner preferences were judged based on schematic drawings of four scanners. Information on the diagnostic performance of the depicted scanners was provided, too. RESULTS: A majority of patients suggested upright open (59/160, 36.9%) and open panoramic (53/160, 33.1%) before short-bore designs (26/160, 16.3%, for all p < 0.001) for future development. When asked about patients' preferred scanner choice for an upcoming examination, information about a better diagnostic performance of a short-bore scanner significantly improved its preference rates (from 6/160 to 49/160 or 3.8 to 30.5%, p < 0.001). Patients with a claustrophobic event preferred open designs significantly more often than patients without a claustrophobic event (p = 0.047). Patients scanned in a short-bore scanner in our trial preferred this design significantly more often (p = 0.003). Noise reduction (51/160, 31.9%), more space over the head (44/160, 27.5%), and overall more space (33/160, 20.6%) were the commonest suggested areas of improvement. CONCLUSION: Patients at high risk for claustrophobia visually prefer open- over short-bore MRI designs for further development. Education about a better diagnostic performance of a visually less-attractive scanner can increase its acceptance. Noise and space were of most concern for claustrophobic patients. This information can guide individual referral of claustrophobic patients to scanners and future scanner development. KEY POINTS: • Patients at high risk for claustrophobia visually favor the further development of open scanners as opposed to short- and closed-bore scanner designs. • Educating claustrophobic patients about a higher diagnostic performance of a short-bore scanner can significantly increase their acceptance of this otherwise visually less-attractive design. • A medical history of earlier claustrophobic events in a given MRI scanner type and focusing on the features "more space" and "noise reduction" can help to guide referral of patients who are at high risk for claustrophobia.

Anxiety sensitivity, disgust sensitivity and aversive reactions to four stimuli.

BACKGROUND: Prior theory and research has implicated disgust as relevant to some, but not all phobias. AIMS: The current study examined whether anxiety sensitivity is more relevant to certain specific phobias and whether disgust sensitivity is more relevant to other specific phobias. METHOD: Participants (n = 201) completed measures of anxiety sensitivity, disgust sensitivity and measures of aversive reactions in the presence of two fear-relevant stimuli (i.e. heights and small, enclosed spaces) and two disgust-relevant stimuli (i.e. spiders and blood/injury). RESULTS: Results of multiple linear regression analyses revealed that disgust sensitivity showed significant associations with aversive reactions in all four stimulus domains after controlling for anxiety sensitivity. After controlling for disgust sensitivity, anxiety sensitivity showed associations with the two fear-relevant phobias but not with the two disgust-relevant phobias included in this study. Anxiety sensitivity also showed an association with variance specific to one of the two fear-relevant specific phobias included in the study. Disgust sensitivity also showed associations with variance specific to both of the disgust-relevant phobias included in the study but not with variance specific to either of the fear-relevant specific phobias. CONCLUSIONS: These results provide evidence that the distinction between fear-relevant and disgust-relevant specific phobias is meaningful and also implicate disgust sensitivity as relevant to aversive reactions to all stimuli included in this study.

Modified technique for imaging the wrist and elbow in obese and claustrophobic patients using a non-open standard MRI scanner.

OBJECTIVE: It is challenging to image extremely obese and claustrophobic patients using a standard, non-open, magnetic resonance imaging (MRI) scanner. On the other hand, installing an additional upright or open MRI scanner may not be cost-effective for most practices. Our technique with a patient in a sitting or standing position behind the standard MRI scanner may be helpful in the MR examination of the wrist/elbow in these patients using a standard wrist/elbow coil. MATERIAL AND METHODS: We performed wrist and elbow MRI of extremely obese and claustrophobic patients by using our modified technique with the patient sitting or standing outside the standard non-open MRI scanner. A total number of 20 cases with the following diagnosis were examined: triquetral and scaphoid bone contusions and fractures, scapholunate ligament tears, triangular fibrocartilage complex tear, and biceps tear. RESULTS: Comparison of image quality for diagnostic information between the standard technique and our technique showed no significant difference, which is necessary for making the diagnosis. CONCLUSIONS: Our technique enables wrist and elbow imaging of extremely obese and claustrophobic patients who cannot otherwise be imaged using a standard MRI scanner without compromising the image quality that is essential for making a diagnosis.

[The Italian version of the "Claustrophobia Questionnaire": validation study and perspectives of use for the occupational physician.] / La versione italiana del "Claustrophobia Questionnaire": studio di validazione e prospettive di utilizzo per il medico del lavoro.

OBJECTIVES: Aim of our study was to adapt the Claustrophobia Questionnaire (CLQ) to the Italian context. METHODS: In our study, a sample of 50 claustrophobic patients was compared to 50 healthy people (control group). All of them answered the Claustrophobia Questionnaire and the Stait-Trait Anxiety Inventory Form Y1 and Y2, as well as demographic questions. RESULTS: As it was theoretically expected, our results confirmed the two-factor structure and showed that the Italian version of the CLQ has good psychometric properties. Indeed, it was observed that claustrophobic patients scored higher in claustrophobia than those from the control group. CONCLUSIONS: In conclusion, the Italian version of the CLQ is a reliable and valid instrument to assess claustrophobic fear.

Effect of team training on improving MRI study completion rates and no-show rates.

PURPOSE: Magnetic resonance imaging (MRI) is a high-cost imaging modality, and an optimized encounter ideally provides high-quality care, patient satisfaction, and capacity utilization. Our purpose was to assess the effectiveness of team training and its impact on patient show-up and completion rates for their MRI examinations. MATERIALS AND METHODS: A total of 97,712 patient visits from three tertiary academic medical centers over 1-year intervals were evaluated, totaling 49,733 visits at baseline and 47,979 after training. Each center's MRI team received team training skill training including advanced communication and team training techniques training. This training included onsite instruction including case simulation with scenarios requiring appropriate behavioral and communicative interventions. Orientation and training also utilized customized online tools and proctoring. The study completion rate and patient show-up rate during consecutive year-long intervals before and after team training were compared to assess its effectiveness. Two-sided chi-square tests for proportions using were applied at a 0.05 significance level. RESULTS: Despite differing no-show rates (5-22.2%) and study incompletion rates (0.7-3.7%) at the three academic centers, the combined patients' data showed significant (P < 0.0001) improvement in the patients' no-show rates (combined decreases from 11.2% to 8.7%) and incompletion rates (combined decreases from 2.3% to 1.4%). CONCLUSION: Our preliminary results suggest training of the imaging team can improve the no-show and incompletion rates of the MRI service, positively affecting throughput and utilization. Team training can be readily implemented and may help address the needs of the current cost-conscious and consumer-sensitive healthcare environment. J. MAGN. RESON. IMAGING 2016;44:1040-1047.

Taphophobia and 'life preserving coffins' in the nineteenth century.

In 1891 the Italian psychiatrist Enrico Morselli (1852-1929) described taphophobia, defining it as an extreme condition of claustrophobia due to the fear of being buried alive. This rare psychopathological phenomenon reflects an ancient fear, and its origin is not known. Taphophobia is closely linked to the problem of apparent death and premature burial. In the nineteenth century, scientists and authors paid particular attention to the issue of apparent death, and special devices (safety coffins) were invented to ensure that premature burial was avoided. Nowadays taphophobia is quite a rare psychiatric disorder; different forms of social anxiety disorders are much more widespread. Its modern equivalent could be the fear of organs harvested from a patient who is still alive.

Safety of hyperbaric medicine in clinical scenarios.

Hyperbaric therapy is generally considered a safe therapy for the treatment of wounds, mucormycosis, and orthopedic injuries. It is fraught with complications such as barotrauma, pulmonary toxicity, fire hazards, and claustrophobia. This article discusses the safety protocols and preventive aspects on usefulness of this new emerging therapy.

Résumé La thérapie hyperbare est généralement considérée comme une thérapie sûre pour le traitement des plaies, de la mucormycose et des blessures orthopédiques. Elle entraîne de nombreuses complications telles que le barotraumatisme, la toxicité pulmonaire, les risques d'incendie et la claustrophobie. Cet article traite des protocoles de sécurité et des aspects préventifs sur l'utilité de cette nouvelle thérapie émergente. Mots-clés: Claustrophobie, médecine hyperbare, sécurité.

Situational anxiety in head and neck cancer: Rates, patterns and clinical management interventions in a regional cancer setting.

INTRODUCTION: Research indicates that the immobilisation mask required for radiation therapy (RT) for head and neck cancers can provoke intense anxiety. However, little is known about the rates of this anxiety, whether it changes over a course of treatment and how it is managed in clinical practice. This study aimed to describe the rates and patterns of situational anxiety in patients undergoing RT for head and neck cancer and the use of anxiety management interventions in current clinical practice in a major regional cancer setting in New South Wales, Australia. METHODS: Situational anxiety rates and patterns were assessed at five time points using the State-Trait Anxiety Inventory prior to treatment planning (SIM), the first three treatment sessions (Tx 1, Tx 2 and Tx 3) and treatment 20 (Tx 20). Sessions were observed to record the use of general supportive interventions (music and support person) and anxiety-specific interventions (break from the mask, relaxation techniques and anxiolytic medication). Sociodemographic and clinical information was extracted from the medical record. RESULTS: One hundred and one patients were recruited. One-third had clinically significant anxiety at any of the first three time points (33.3-40%), and a quarter at Tx 3 (26.4%) and Tx 20 (23.4%). Of the sample, 55.4% had available data for categorisation into one of four pattern groups: 'No Anxiety' (46.4%); 'Decreasing Anxiety' (35.7%); 'Increasing Anxiety' (7.1%); and 'Stable High Anxiety' (10.7%). Most participants had social support present at SIM (53.5%) and listened to music during treatment (86.7-92.9%). Few participants received relaxation techniques alone (1.2-2.3%). Anxiolytic medication was provided for 10% of patients at some stage during the treatment journey and 5% required a break from the mask at SIM, with frequency decreasing throughout the treatment course. CONCLUSIONS: In this regional cancer setting, situational anxiety was common, but generally decreased throughout treatment. Some patients experience persistent or increasing anxiety, with up to 10% of patients receiving specific anxiety management interventions.

Harnessing ChatGPT dialogues to address claustrophobia in MRI - A radiographers' education perspective.

INTRODUCTION: The healthcare sector invests significantly in communication skills training, but not always with satisfactory results. Recently, generative Large Language Models, have shown promising results in medical education. This study aims to use ChatGPT to simulate radiographer-patient conversations about the critical moment of claustrophobia management during MRI, exploring how Artificial Intelligence can improve radiographers' communication skills. METHODS: This study exploits specifically designed prompts on ChatGPT-3.5 and ChatGPT-4 to generate simulated conversations between virtual claustrophobic patients and six radiographers with varying levels of work experience focusing on their differences in model size and language generation capabilities. Success rates and responses were analysed. The methods of radiographers in convincing virtual patients to undergo MRI despite claustrophobia were also evaluated. RESULTS: A total of 60 simulations were conducted, achieving a success rate of 96.7% (58/60). ChatGPT-3.5 exhibited errors in 40% (12/30) of the simulations, while ChatGPT-4 showed no errors. In terms of radiographers' communication during the simulations, out of 164 responses, 70.2% (115/164) were categorized as "Supportive Instructions," followed by "Music Therapy" at 18.3% (30/164). Experts mainly used "Supportive Instructions" (82.2%, 51/62) and "Breathing Techniques" (9.7%, 6/62). Intermediate participants favoured "Music Therapy" (26%, 13/50), while Beginner participants frequently utilized "Mild Sedation" (15.4%, 8/52). CONCLUSION: The simulation of clinical scenarios via ChatGPT proves valuable in assessing and testing radiographers' communication skills, especially in managing claustrophobic patients during MRI. This pilot study highlights the potential of ChatGPT in preclinical training, recognizing different training needs at different levels of professional experience. IMPLICATIONS FOR PRACTICE: This study is relevant in radiography practice, where AI is increasingly widespread, as it explores a new way to improve the training of radiographers.

Effects of psychological nursing in Parkinson's related depression patients undergoing functional magnetic resonance imaging: A randomized controlled trial.

BACKGROUND: Patients with Parkinson's disease (PD) often experience depression, and some may require magnetic resonance imaging (MRI) for diagnosis, which can lead to MRI failure due to claustrophobia. AIM: To explore the value of psychological interventions in successfully completing functional MRI scans of the brain for PD-related depression. METHODS: Ninety-six patients with PD were randomly divided into two groups. The control group (47 patients) received general care, and the experimental group (49 patients) received general care combined with psychological care. The Unified Parkinson's Disease Assessment Scale (UPDRS), Hamilton Depression Scale (HAMD), and Geriatric Depression Scale (GDS)-15 scores, heart rate, systolic blood pressure, and MRI-Anxiety Questionnaire (MRI-AQ) scores before and after the scan were recorded. The completion rate of magnetic resonance (MR) scanning, scanning duration, and image quality scores were recorded. RESULTS: Before scanning, no statistically significant difference was observed between the two groups in terms of heart rate, systolic blood pressure, and UPDRS, HAMD, GDS-15, and MRI-AQ scores. After scanning, systolic blood pressure, MRI-AQ score, and scan time in the experimental group were significantly lower than those in the control group, whereas the scan completion rate and image quality score were significantly higher than those in the control group. CONCLUSION: Psychological nursing interventions are helpful in alleviating PD-related depression and assessing MR depression scores and may be helpful in the successful completion of functional MRI scans of the patient's brain.

Cell-type-specific hypothalamic pathways to brainstem drive context-dependent strategies in response to stressors.

Adaptive behavioral responses to stressors are critical for survival. However, which brain areas orchestrate switching the appropriate stress responses to distinct contexts is an open question. This study aimed to identify the cell-type-specific brain circuitry governing the selection of distinct behavioral strategies in response to stressors. Through novel mouse behavior paradigms, we observed distinct stressor-evoked behaviors in two psycho-spatially distinct contexts characterized by stressors inside or outside the safe zone. The identification of brain regions activated in both conditions revealed the involvement of the dorsomedial hypothalamus (DMH). Further investigation using optogenetics, chemogenetics, and photometry revealed that glutamatergic projections from the DMH to periaqueductal gray (PAG) mediated responses to inside stressors, while GABAergic projections, particularly from tachykinin1-expressing neurons, played a crucial role in coping with outside stressors. These findings elucidate the role of cell-type-specific circuitry from the DMH to the PAG in shaping behavioral strategies in response to stressors. These findings have the potential to advance our understanding of fundamental neurobiological processes and inform the development of novel approaches for managing context-dependent and anxiety-associated pathological conditions such as agoraphobia and claustrophobia.

Investigation of distress during diffusion-weighted whole-body magnetic resonance imaging among women with breast cancer and the effectiveness of a new technology in alleviating patient's anxiety by approaching the human senses.

INTRODUCTION: Breast cancer is a common malignant tumor among women, and the effectiveness of diagnosing its metastasis and recurrence has been demonstrated using diffusion-weighted whole-body imaging with background body signal suppression (DWIBS). However, DWIBS causes distress to patients due to the unique circumstances of magnetic resonance imaging (MRI). This study aimed to investigate the various distress factors caused by DWIBS among women with breast cancer and assess the effectiveness of a new MRI system designed with an environment incorporating relaxing technology. METHODS: From May to September 2022, we conducted a questionnaire survey regarding DWIBS-related distress among women with breast cancer. The questionnaire was administered to participants who underwent DWIBS on a conventional MRI system (19 women) and on a new system (20 women) equipped with relaxing technology equipped features, including projection images, illumination, and sound. Participants rated the degree of various stress factors on a face-scale rating scale (0-10). The scores of both systems were compared using the Mann-Whitney U test. RESULTS: In the conventional system, women experienced distress due to MRI-specific situations, such as immobility in a confined space, noise, feeling trapped, and concerns about not moving. These results did not show a specific tendency among women with breast cancer undergoing DWIBS. For almost all distress parameters, the new system had significantly lower distress scores than the conventional system (p > 0.05). CONCLUSIONS: A comfortable environment using new and relaxing technology is effective in alleviating patient's anxiety by approaching the human senses. IMPLICATIONS FOR PRACTICE: Reducing distress caused by DWIBS among women with breast cancer could provide a comfortable examination environment, potentially assisting them during longer treatment periods.

Patient-centric comparative analysis of experiences in open upright and conventional closed MRI scanners.

INTRODUCTION: MRI often induces anxiety, leading to incomplete scans and claustrophobia-related distress. Open MRI systems aim to enhance patient comfort. This study examines how prior MRI experiences impact subsequent encounters in an open upright MRI scanner. METHODS: In this cross-sectional study, 118 adult patients completed a self-administered questionnaire from August 2022 to October 2023. It covered previous MRI experiences, including questions about claustrophobia, premature scan terminations, sedative medication usage, general MRI experiences, and interactions with radiology technologists. RESULTS: Patients in open upright MRI reported less claustrophobia compared to closed MRI systems (18.4% vs. 58.3%), fewer premature scan terminations (5.3% vs. 31.0%), and less sedative use (5.3% vs. 46.9%). Moderate positive correlations were found between past and current claustrophobic events and premature scan terminations. Effective communication with radiology technologists was essential for patient comfort and reduced claustrophobia. Scan duration and noise triggered discomfort in 26.1% and 21.6% of study participants respectively. Persons without prior MRI experience were more satisfied with the examination and expressed no clear preference for future MRI settings, contrasting those with previous exposure favoring the open MRI setup. CONCLUSION: The study emphasizes the benefits of open upright MRI for high-risk claustrophobic patients. It identifies the lasting impact of negative MRI experience on future examinations and highlights the crucial role of radiology technologists. IMPLICATIONS FOR PRACTICE: Integrating open MRI scanners in medical facilities and prioritizing effective communication with radiology technologists enhances patient comfort. Positive experiences with open MRI may improve patient compliance and offer greater flexibility for future examinations.

Scan-associated anxiety (scanxiety): the enigma of emotional breathing oscillations at 0.32 Hz (19 bpm).

MRI-related anxiety in healthy participants is often characterized by a dominant breathing frequency at around 0.32 Hz (19 breaths per minute, bpm) at the beginning but in a few cases also at the end of scanning. Breathing waves at 19 bpm are also observed in patients with anxiety independently of the scanned body part. In patients with medically intractable epilepsy and intracranial electroencephalography (iEEG), spontaneous breathing through the nose varied between 0.24 and 0.37 Hz (~19 bpm). Remarkable is the similarity of the observed breathing rates at around 0.32 Hz during different types of anxiety states (e.g., epilepsy, cancer, claustrophobia) with the preferred breathing frequency of 0.32 Hz (19 bpm), which is predicted by the binary hierarchy model of Klimesch. This elevated breathing frequency most likely reflects an emotional processing state, in which energy demands are minimized due to a harmonic coupling ratio with other brain-body oscillations.

Enhanced Mental Reinstatement of Exposure to Improve Extinction Generalization: A Study on Claustrophobia and MRI Fear.

Fear of enclosed spaces prevents many people from receiving magnetic resonance imaging (MRI) scans. Although exposure therapy can effectively treat such fears, reductions in fear during exposure often do not generalize beyond the context in which they took place. This study tested a strategy designed to increase generalization, which involved revisiting the memory of a prior exposure to enhance retrieval of extinction learning. Forty-five participants with claustrophobia that included fear of MRI scans underwent a series of exposures lying inside a narrow cabinet. One week later, participants were randomly assigned to enhanced mental reinstatement (EMR) or control procedures. Prior to entering a mock MRI scanner, EMR participants recalled the memory of exposure training and listened to an audio recording of themselves describing what they learned, whereas control participants recalled a neutral memory. Compared to the control condition, EMR led to significantly reduced heart rate reactivity in the mock MRI scanner, but not self-reported fear or avoidance. There were no differences between conditions in claustrophobia symptoms or MRI fear at 1-month follow-up. Results suggest some benefits of mental reinstatement for improving generalization of gains following exposure training for claustrophobia, with measures of subjective fear and physiological arousal showing discordant outcomes.

Treating Radiation Anxiety With Systematic Desensitization: Head and Neck Cancer Case Reports.

Introduction: Head and neck cancer patients have high rates of psychological distress, which may be exacerbated by the treatments they receive. Many patients who undergo radiation therapy report significant anxiety associated with the thermoplastic mask required for immobilization during treatment. Case Description: This report presents two examples of head and neck cancer patients reporting high mask anxiety, along with a history of claustrophobia, who expressed concern about their abilities to initiate and adhere to treatment. Both were referred to supportive care psychology before radiation treatment initiation. With counseling and the use of systematic desensitization, they were successfully able to complete their treatments. Discussion: Results of these case reports highlight the value of integrating early supportive care in the treatment of head and neck cancer and support the need for further study in future randomized controlled trials.

Use of virtual reality for MRI preparation and technologist education: A scoping review.

BACKGROUND: Virtual Reality (VR) is becoming a popular educational tool in healthcare. This scoping review aimed to (1) determine if VR can be used to reduce the anxiety a patient experiences during an MRI and (2) explore how VR is being used to train MRI technologists. METHODS: PubMed, Web of Science, Cochrane Library, CINAHEL, and PsycINFO internet websites of VR in MRI were evaluated. Two authors independently reviewed the titles and abstracts using the inclusion and exclusion criteria. Articles chosen by both reviewers were automatically included for full text review. Articles chosen by one reviewer were audited by a third independent reviewer to determine inclusion for full text review. Descriptive analyses were conducted. RESULTS: The initial search resulted in 357 articles. A large portion of the articles were excluded because they were either based on fMRI or training-based tools for healthcare professionals, which were not our area of focus. Eight articles were included in the final review for assessing if VR can be a useful tool to aid with patient anxiety in MRI. No articles were found that used VR in MRI technologist training. CONCLUSIONS: This scoping review suggests there are potentially significant uses for VR in reducing anxiety in adults and children as patients. With further research and development of VR application for use with MRI testing may allow for better patient preparation and reduce scan interruptions, increase MRI operational efficiency, and improve patient outcomes.

Early MRI termination with major impact on the radiological interpretation: The experience of a large university hospital.

PURPOSE: To report the incidence of early magnetic resonance imaging (MRI) terminations and analyse their risk factors in a large university hospital. METHOD: All consecutive patients aged > 16 years who underwent an MRI over a 14-month period were included. The following parameters were collected: demographics, in- or outpatient, history of claustrophobia, anatomical region investigated, and early MRI termination along with its cause. The potential link between these parameters and early MRI termination was statistically analysed. RESULTS: Overall, 22,566MRIs were performed (10,792 [48%] men and 11,774[52%] women, mean age: 57 [range: 16-103] years). Early MRI termination was reported in 183 (0.8%) patients (99 men and 84 women, mean age: 63 years). Of these early terminations, 103 (56%) were due to claustrophobia and 80 (44%) to other causes. Early terminations were more common in inpatients than outpatients (1.2% vs. 0.6%, p < 0.001), for both claustrophobia- and non-claustrophobia-related reasons. A prior history of claustrophobia was strongly associated with claustrophobia-related early termination (6.6% vs. 0.2%, p = 0.0001). Non-claustrophobia-related early terminations were significantly more common (0.6% vs. 0.2%) in elderly patients (>65 years old) than in younger ones. No other parameter was significantly associated with early termination. CONCLUSIONS: Early MRI termination is currently rare. The main risk factors for claustrophobia-related terminations comprised a prior history of claustrophobia, and examinations in inpatients. Non-claustrophobia-related early terminations were more common in both elderly patients and inpatients.