High success rates of sedation-free brain MRI scanning in young children using simple subject preparation protocols with and without a commercial mock scanner--the Diabetes Research in Children Network (DirecNet) experience

TitleHigh success rates of sedation-free brain MRI scanning in young children using simple subject preparation protocols with and without a commercial mock scanner--the Diabetes Research in Children Network (DirecNet) experience
Publication TypeJournal Article
Year of Publication2014
AuthorsBarnea-Goraly, N., Weinzimer S. A., Ruedy K. J., Mauras N., Beck R. W., Marzelli M. J., Mazaika P. K., Aye T., White N. H., Tsalikian E., Fox L., Kollman C., Cheng P., & Reiss A. L.
Corporate AuthorsDiabetes Research in Children Network(DirecNet)
JournalPediatric radiology
Volume44
Issue2
Pagination181-6
Date Published2014 Feb
ISSN1432-1998
KeywordsAdolescent; Artifacts; Brain; Child; Child, Preschool; Conscious Sedation; Desensitization, Psychologic; Diabetes Mellitus, Type 1; Diffusion Magnetic Resonance Imaging; Feasibility Studies; Female; Humans; Image Enhancement; Male; Motion; Reproducibility of Results; Sensitivity and Specificity; United States
Abstract

BACKGROUND: The ability to lie still in an MRI scanner is essential for obtaining usable image data. To reduce motion, young children are often sedated, adding significant cost and risk.
OBJECTIVE: We assessed the feasibility of using a simple and affordable behavioral desensitization program to yield high-quality brain MRI scans in sedation-free children.
MATERIALS AND METHODS: 222 children (4-9.9 years), 147 with type 1 diabetes and 75 age-matched non-diabetic controls, participated in a multi-site study focused on effects of type 1 diabetes on the developing brain. T1-weighted and diffusion-weighted imaging (DWI) MRI scans were performed. All children underwent behavioral training and practice MRI sessions using either a commercial MRI simulator or an inexpensive mock scanner consisting of a toy tunnel, vibrating mat, and video player to simulate the sounds and feel of the MRI scanner.
RESULTS: 205 children (92.3%), mean age 7 ± 1.7 years had high-quality T1-W scans and 174 (78.4%) had high-quality diffusion-weighted scans after the first scan session. With a second scan session, success rates were 100% and 92.5% for T1-and diffusion-weighted scans, respectively. Success rates did not differ between children with type 1 diabetes and children without diabetes, or between centers using a commercial MRI scan simulator and those using the inexpensive mock scanner.
CONCLUSION: Behavioral training can lead to a high success rate for obtaining high-quality T1-and diffusion-weighted brain images from a young population without sedation.





DOI10.1007/s00247-013-2798-7
Alternate JournalPediatr Radiol
Refereed DesignationRefereed