The patient experience in MRI

Patient experience plays a huge role in generating good images with MRI. Patient movement is the main source of image artifacts and patient anxiety contributes to this.1 Techniques to help manage patient anxiety and shorten scan times may  improve image quality.1

Undergoing magnetic resonance imaging (MRI) can be extremely anxiety-inducing for patients.2 This is not helped by the rumbling scanner noise, not to mention having to remain still in awkward positions for some time.3 The enclosed structure of the scanner can also cause claustrophobia.2,4 While essential, administrative tasks and safety screenings also probably don’t help improve the patient experience.3

The time required for the examination is a major factor, during which the patient must be as still as possible, even holding their breath, which of course contributes to anxiety.1,2 The imaging process is  very sensitive to patient movement and anxious patients may be more inclined to move during the procedure. An anxious patient may abandon the examination or even refuse to undergo one.2 This is particularly an issue with pediatric patients, where managing anxiety and movement are the major concerns. In difficult-to-manage situations sedation may be required, which is associated with a risk of side effects.5

Another sometimes over-looked consequence of the anxious patient is the cost. A moving patient may require images to be reacquired in a subsequent scan, which entails additional personnel, machine and administrative costs. For example, a single center study that reviewed a total of 192 completed clinical examinations, identified significant motion artifacts on sequences in 7.5% of outpatient and 29.4% of inpatient and emergency department MR examinations. The prevalence of repeat sequences was 19.8% of total MRI examinations. Based on these 2015 estimations, the potential average cost owing to motion artifacts was calculated to be about $115,000 per scanner per year.6

A number of solutions may help improve the patient experience of MRI.1 These could include background music – indeed some centers already offer patients a choice of music to listen during examination – which helps mask the unnerving sound of scanners.2 Therapeutic scents, using faint, sweet, vanilla-like perfumes, have also been found to be useful to mitigate patient anxiety. This effect may be due to the physiological effects of the fragrance and the distraction caused by mental associations with the perfume.1

Better communication between the radiographer/technologist and the patient could also be expected to reduce patient fears.1 This could include more comprehensive information shared with the patient before the procedure, possibly in the form of a patient brochure or as educational posters.2 On the technical side, shortened scan times also contribute to minimizing patent discomfort.1 Scan parameters can also be modified, including reducing imaging resolution and signal-to-noise, or other measures such as parallel imaging or compressed sensing in order to shorten MRI acquisition times.1

Irrespective of the source of the patient’s anxiety, some simple measures to lessen it might improve not only the patient’s experience but also the quality of the images, thus improving patient management and potentially lowering the costs to the health system.1,6 It certainly seems worth trying.

 

References

  1. Oztek MA, Brunnquell CL, Hoff MN, Boulter DJ, Mossa-Basha M, Beauchamp LH, et al. Practical considerations for radiologists in implementing a patient-friendly MRI experience. Top Magn Reson Imaging. 2020;29(4):181-6.
  2. Munn Z, Pearson A, Jordan Z, Murphy F, Pilkington D, Anderson A. Addressing the patient experience in a magnetic resonance imaging department: Final results from an action research study. J Med Imaging Radiat Sci. 2016;47(4):329-36.
  3. Ajam AA, Xing B, Siddiqui A, Yu JS, Nguyen XV. Patient satisfaction in outpatient radiology: effects of modality and patient demographic characteristics. J Patient Exp. 2021;8:23743735211049681.
  4. Dewey M, Schink T, Dewey CF. Claustrophobia during magnetic resonance imaging: cohort study in over 55,000 patients. J Magn Reson Imaging. 2007;26(5):1322-7.
  5. Rosenberg DR, Sweeney JA, Gillen JS, Kim J, Varanelli MJ, O'Hearn KM, et al. Magnetic resonance imaging of children without sedation: preparation with simulation. J Am Acad Child Adolesc Psychiatry. 1997;36(6):853-9.
  6. Andre JB, Bresnahan BW, Mossa-Basha M, Hoff MN, Smith CP, Anzai Y, et al. Toward quantifying the prevalence, severity, and cost associated with patient motion during clinical MR examinations. J Am Coll Radiol. 2015;12(7):689-95.