Having a magnetic resonance imaging (MRI) procedure can be a stressful experience, even for adults. To a child it can be terrifying.
As Hawaii’s pediatric specialty hospital, Kapiolani Medical Center for Women & Children does about 10 to 15 MRIs a day, more than half them on youngsters. It is a priority to invest in technology that can make the experience more comfortable — even fun — for kids.
The new CinemaVision Virtual Reality MRI headset does just that. More than just distracting young patients and reducing the knocking sound made by the machine, it gives them the feeling of being in a much larger space, similar to watching TV in their own living room. It’s equivalent to watching a 62-inch screen from 5 1⁄2 feet away. The added sense of space helps children relax and remain still, resulting in better-quality images and reducing the need for re-scans. Kids can bring in their favorite DVD, select a movie from our library or watch TV.
Another benefit is the two-way communication that lets children see and speak to our technologists at any time during the scan by simply pressing the call button.
The new goggles are so effective, we’ve experienced a drop in the age of children requiring sedation to 5 from 8 years old.
Punahou sixth-grader Ryder Lum is an example. Diagnosed with a brain tumor in 2007, Ryder has had more than his share of MRIs. For his first few procedures, he required sedation to keep him still and calm as his small body lay inside the MRI tube — sedation that Ryder said "makes you feel junk" and adds yet another chemical substance to his system, already burdened by powerful cancer-fighting drugs.
Now he gets MRIs with no sedative at all. What’s more, Ryder says the injection of contrast dye doesn’t hurt as much because he’s enjoying his favorite shows, and the procedure that used to feel hours long now seems much shorter.
MRI goggles are just one of the recent upgrades in Kapiolani’s Radiology Department. We can now do advanced neuro, muscular-skeletal and cardiac imaging, and both anatomic and functional imaging. This is important because often a body part can look normal but the functioning is defective; a traditional anatomic MRI would miss that.
For instance, in the heart we can measure velocity and direction of flow, detecting abnormalities even in cases where the heart itself looks normal. In the brain our MR spectroscopy measures the metabolism in various areas, detecting subtle abnormalities that might indicate a problem.
In radiology, pediatric protocols differ from those used with adult patients. Kids are not just small adults; their physiology is different, especially the cardiovascular system. Protocols are tailored to pick up the abnormalities more commonly seen in kids, such as congenital heart disease or brain malformations. And when we do fetal MRI, which can pick up spina bifida and other brain malformations in utero, protocols are designed to reduce the amount of radio wave energy delivered to the fetus during the exam.
Technologists also are trained to respond to children, explaining, soothing or joking when needed. Everything in our department, from the mural of happy monkeys on the wall to the CinemaVision goggles, is tailored just for kids.
New technology doesn’t come cheap. In fact, investment in "comfort" technology such as the MRI goggles is not covered by insurance. The hospital gratefully acknowledges J. Michael Windsor, via the General Atlantic Philanthropies fund, for his donation of $50,000 to purchase the headset.
The Lum family is thankful as well. Ryder’s cancer is in remission. He wants to be a children’s oncologist when he grows up.
Dr. Ryan Albritton is a radiologist at Kapiolani Medical Center for Women & Children. The monthly "Health Scene" column features information and advice from Hawaii health care professionals.