October 19, 2021 by Peter B. Laird
Miami Cancer Institute First to Use New Virtual Reality Game that Keeps Kids Calm and Still During Brain MRIs
Lying perfectly still for 30 minutes or more while getting a magnetic resonance imaging study (MRI) can be a challenge for anyone. For younger patients – who tend to be fidgety anyway, and not always adept at following instructions – it can be especially difficult, doctors say, and often requires sedation. But a new virtual reality game making its U.S. debut at Miami Cancer Institute is helping lower anxiety and reduce the need for anesthesia for pediatric brain tumor patients, which results in higher quality imaging.
(Watch now: Dr. Matthew Hall at Miami Cancer Institute discusses benefits of the MRI Stillness Game, which helps young cancer patients stay perfectly still during what can be a loud and, for some, scary procedure. Video by Anthony Vivian.)
“Anyone who’s had an MRI knows what it’s like to be strapped on the table, rolled inside the tube and subjected to that loud thumping sound for half an hour,” says Matthew D. Hall, M.D., MBA, lead pediatric radiation oncologist at Miami Cancer Institute, which is part of Baptist Health South Florida. “Imagine what it’s like if you’re a young child, in there all by yourself.”
The MRI Stillness Game, a virtual reality game developed by healthcare technology manufacturer Reimagine Well and tested by Miami Cancer Institute, prepares kids for their brain MRI, easing anxiety and improving care, says Dr. Hall.
The virtual reality game helps train children to stay still and better cope with the often stress-provoking noises and claustrophobic feeling some get during an MRI, Dr. Hall says. The result is a reduction in the number of children who must be anesthetized for the study; a better, clearer image that leads to the highest-quality care; a shorter study time; and a happier patient.
“If a child moves during the MRI, it can create a fuzzy image and make it more difficult to interpret,” Dr. Hall notes. “To plan and deliver the sharp-shooting radiation treatment our patients receive, we need clear images. We’re excited that this technology will make this possible and make our patients more comfortable.”
Miami Cancer Institute is the first cancer center in the nation to offer the Reimagine Well MRI Stillness Game as an option for pediatric patients. According to Dr. Hall, brain tumor patients typically require a number of MRI studies throughout their treatment and for several years during follow-up. Dr. Hall says that up to 50 percent of pediatric patients at Miami Cancer Institute require anesthesia for MRIs due to anxiety or discomfort.
Children use the simulation program during a pre-study visit, Dr. Hall explains. A specially trained child life specialist helps them don a virtual reality headset and positions them on the table as if they were having the MRI. The patient is first led through a virtual tour of the MRI suite and then the game begins.
The headset can measure tiny movements of the head, according to Dr. Hall; the longer the child remains still, the more immersive of an experience they can enjoy, as a black and white image turns into full and vibrant color. During three successive levels – each more challenging than the last – the child experiences a rainforest, a hot air balloon festival and a coral reef environment. The entire game takes about 20 minutes, according to Dr. Hall.
“Kids receive immediate feedback, starting with the color changes,” Dr. Hall says. “Then, as they demonstrate they can lay still, the loud noises of the MRI machine decrease and are replaced by the more natural sounds for the image they’re viewing. With this biofeedback, they learn to drown out the noise.” Children also see their stillness score increase as they improve, he adds.
For five-year-old Ayan Radu, the game not only helped him feel better about his scheduled MRI at Miami Cancer Institute, it was also fun and surprising. “He saw an ocean in front of him,” says his mother, Anca Radu. “He was very interested to play the game. When he was inside, he was quite calm and very curious about what was happening there.”
While there are a few cancer treatment facilities in the country using similar technology for children undergoing radiation therapy, Miami Cancer Institute, with its specialized pediatric team that works closely with young patients, doesn’t see a need for virtual reality in that area. When it comes to MRIs, however, even many adults have difficulty remaining motionless, notes Dr. Hall, who says the Institute may eventually offer this program to adult patients as well.
Miami Cancer Institute is also collecting data to measure the effectiveness of the simulation. It will analyze the information to see if there is a correlation between lower game scores and the need for anesthesia or a longer amount of time in the MRI machine. “We’re hoping it will become a predictive measure to help guide us so that we can better forecast which children might need more support in getting through an MRI study,” Dr. Hall says.