Empowering Children Through Virtual Reality: A New Alternative to General Anesthesia for MRI

MRI often requires general anesthesia in children, which carries risks, increases costs, and prolongs scan wait times.  Our study aimed to evaluate whether virtual reality (VR) simulations could familiarize children with the MRI experience to enable awake scans without anesthesia. Secondary objectives included assessing child anxiety and determining whether movement during the simulation correlated with scan quality.  In this prospective study, 18 participants underwent a 10-minute VR simulation of an MRI procedure presented as an avatar-led game before their head MRI scan. Child and caregiver anxiety surveys were completed before the simulation and after the MRI. The VR software recorded head motion during the simulation, which was correlated with MRI scan quality.  All participants (n = 18) successfully completed an awake MRI after the simulation session, aiding clinical diagnoses. The average participant age was 5.0 years (±1.3 years). MRI quality assessments indicated 44.4% excellent, 27.8% high-acceptable, 22.2% acceptable, and 5.6% low-acceptable scan quality. No statistically significant changes in anxiety levels were observed. 94.1% of legal guardians reported the VR simulation was effective at preparing their child for the MRI scan.  VR sessions were associated with a significant improvement in caregiver perceptions and enabled successful completion of MRI scans without the need for sedation in all children initially considered to require anesthesia. While no statistically significant reduction in anxiety was observed, the intervention resulted in diagnostic-quality imaging with minimal motion artifacts, supporting its utility as a strategy to facilitate pediatric MRI without anesthesia.