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Greer MLC, Gee MS, Pace E, Sotardi S, Morin CE, Chavhan GB, Jaimes C. A survey of non-sedate practices when acquiring pediatric magnetic resonance imaging examinations. Pediatr Radiol 2024; 54:239-249. [PMID: 38112762 DOI: 10.1007/s00247-023-05828-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 11/27/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Improving access to magnetic resonance imaging (MRI) in childhood can be facilitated by making it faster and cheaper and reducing need for sedation or general anesthesia (GA) to mitigate motion. Some children achieve diagnostic quality MRI without GA through the use of non- practices fostering their cooperation and/or alleviating anxiety. Employed before and during MRI, these variably educate, distract, and/or desensitize patients to this environment. OBJECTIVE To assess current utilization of non-sedate practices in pediatric MRI, including variations in practice and outcomes. MATERIALS AND METHODS A survey-based study was conducted with 1372 surveys emailed to the Society for Pediatric Radiology members in February 2021, inviting one response per institution. RESULTS Responses from 50 unique institutions in nine countries revealed 49/50 (98%) sites used ≥ 1 non-sedate practice, 48/50 (96%) sites in infants < 6 months, and 11/50 (22%) for children aged 6 months to 3 years. Non-sedate practices per site averaged 4.5 (range 0-10), feed and swaddle used at 47/49 (96%) sites, and child life specialists at 35/49 (71%). Average success rates were moderate (> 50-75%) across all sites and high (> 75-100%) for 20% of sites, varying with specific techniques. Commonest barriers to use were scheduling conflicts and limited knowledge. CONCLUSION Non-sedate practice utilization in pediatric MRI was near-universal but widely variable across sites, ages, and locales, with room for broader adoption. Although on average non-sedate practice success rates were similar, the range in use and outcomes suggest a need for standardized implementation guidelines, including patient selection and outcome metrics, to optimize utilization and inform educational initiatives.
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Affiliation(s)
- Mary-Louise C Greer
- Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Erika Pace
- Department of Radiology, Royal Marsden NHS Foundation Trust, London, England, UK
| | - Susan Sotardi
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Cara E Morin
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Govind B Chavhan
- Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Camilo Jaimes
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Inhestern L, Herrmann J, Schürmann J, Meister RL, Nawka MT, Mynarek M, Linhart D, Bergelt C. Child-centredness in paediatric magnetic resonance imaging: Information needs and experiences of children requiring magnetic resonance imaging and their parents. Child Care Health Dev 2024; 50:e13157. [PMID: 37581953 DOI: 10.1111/cch.13157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Assessing patient experiences is essential to provide high quality health-care. The objectives of this study were to examine (1) child- and parent-reported information status before magnetic resonance imaging (MRI), (2) experiences during an MRI and (3) needs and suggestions for improvement. METHODS Children (≥8 years) and parents answered questionnaires (before and after planned MRI examination) covering mental condition, information status/needs, preparation for MRI, and potential stressors. Before MRI n = 132 accompanying parents and n = 91 children provided data (after MRI: n = 93 parents; n = 71 children). The mean age of the children undergoing MRI was 10.5 years (SD = 4.9). Children had on average seven previous MRIs before our survey (Range: 1-33). Twenty-three percent of the children were to be sedated during the examination. RESULTS Parents and children reported low to medium levels of burden, high knowledge and high information status. For the children, most stressful factors during the MRI were boredom and noise. Main information resources were the radiologists or self-searches. Parents of children with their first MRI reported higher anxiety levels in their children and stated a worse information status (main information source: self-searches/internet). Parents reported needs regarding organization of the MRI (e.g., reduction of waiting times), age-appropriate information and communication during the MRI. Children wished to visit the MRI room prior the examination (44%) and to get more information (44%). Children suggested improvements such as better sound quality of films/music, more transparency about the procedure, being in contact with a parent and shorter examinations. CONCLUSION Results suggest that preparation, information provision and care is perceived positively by families. Needs and suggestions for improvement were, for example, higher transparency of procedures, better communication and reduction of stress. Findings indicate that preparation in routine-care should follow an individualized child-focused approach, should focus on families without previous MRIs and should address children with high anxiety levels.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jochen Herrmann
- Section of Pediatric Radiology, Department of Diagnostic and Interventional Radiology and Nuclear medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jana Schürmann
- Faculty of Educational Science, University of Education Freiburg, Breisgau, Germany
| | - Rieke Lisa Meister
- Section of Pediatric Radiology, Department of Diagnostic and Interventional Radiology and Nuclear medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marie Teresa Nawka
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Mynarek
- Department for Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dieter Linhart
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department for Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Medical Psychology, University Medicine Greifswald, Greifswald, Germany
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Thestrup J, Hybschmann J, Madsen TW, Bork NE, Sørensen JL, Afshari A, Borgwardt L, Berntsen M, Born AP, Aunsholt L, Larsen VA, Gjærde LK. Nonpharmacological Interventions to Reduce Sedation and General Anesthesia in Pediatric MRI: A Meta-analysis. Hosp Pediatr 2023; 13:e301-e313. [PMID: 37727937 DOI: 10.1542/hpeds.2023-007289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
CONTEXT Nonpharmacological strategies are increasingly used in pediatric procedures, but in pediatric MRI, sedation and general anesthesia are still commonly required. OBJECTIVES To evaluate the effectiveness of nonpharmacological interventions in reducing use of sedation and general anesthesia in pediatric patients undergoing MRI, and to investigate effects on scan time, image quality, and anxiety. DATA SOURCES We searched Ovid Medline, CINAHL, Embase, and CENTRAL from inception through October 10, 2022. STUDY SELECTION We included randomized controlled trials and quasi-experimental designs comparing the effect of a nonpharmacological intervention with standard care on use of sedation or general anesthesia, scan time, image quality, or child and parental anxiety among infants (<2 years), children, and adolescents (2-18 years) undergoing MRI. DATA EXTRACTION Standardized instruments were used to extract data and assess study quality. RESULTS Forty-six studies were eligible for the systematic review. Limited to studies on children and adolescents, the meta-analysis included 20 studies with 33 873 patients. Intervention versus comparator analysis showed that nonpharmacological interventions were associated with reduced need for sedation and general anesthesia in the randomized control trials (risk ratio, 0.68; 95% confidence interval, 0.48-0.95; l2 = 35%) and nonrandomized studies (risk ratio, 0.58; 95% confidence interval, 0.51-0.66; l2 = 91%). The effect was largest among children aged 3 to 10 years when compared with older children and adolescents aged 11 to 18 years. LIMITATIONS There was substantial heterogeneity among nonrandomized studies. CONCLUSIONS Nonpharmacological interventions must be considered as standard procedure in infants, children, and adolescents undergoing MRI.
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Affiliation(s)
| | | | | | | | - Jette L Sørensen
- Juliane Marie Centre and Mary Elizabeth's Hospital
- Department of Clinical Medicine, Faculty of Health and Medicine Sciences
| | | | | | | | | | - Lise Aunsholt
- Neonatology
- Comparative Pediatrics and Nutrition, Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke A Larsen
- Radiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Line K Gjærde
- Juliane Marie Centre and Mary Elizabeth's Hospital
- Pediatrics and Adolescent Medicine, Neuropaediatric Unit
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Chen JV, Zapala MA, Zhou A, Vu N, Meyer L, Smith MD, Kelleher C, Glenn OA, Courtier J, Li Y. Factors and Labor Cost Savings Associated with Successful Pediatric Imaging without Anesthesia: a Single-Institution Study. Acad Radiol 2023; 30:1979-1988. [PMID: 36641347 DOI: 10.1016/j.acra.2022.12.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/13/2022] [Accepted: 12/25/2022] [Indexed: 01/15/2023]
Abstract
RATIONALE AND OBJECTIVES In pediatric imaging, sedation is often necessary to obtain diagnostic quality imaging. We aim to quantify patient and imaging-specific factors associated with successful pediatric scans without anesthesia and to evaluate labor cost savings associated with our institutional Scan Without Anesthesia Program (SWAP). MATERIALS AND METHODS Patients who participated in SWAP between 2019-2022 were identified. Chart review was conducted to obtain sociodemographic and clinical information. Radiology database was used to obtain scan duration, modality/body part of examination, and administration of contrast. Mann-Whitney U and Chi-Square tests were used for univariate analysis of factors associated with success. Multivariate logistic regression was used to evaluate independent contributions to success. Associated hospital labor cost savings were estimated using salary information obtained through publicly available resources. RESULTS Of 731 patients, 698 had successful and 33 had unsuccessful scans (95% success rate). In univariate analysis, older age, female sex, absence of developmental delay, and administration of contrast were significantly associated with successful scans. Multivariate analyses revealed that older age, female sex, and absence of developmental delay were significant independent factors lending toward success. Imaging-related factors were not associated with outcome in multivariate analysis. Estimated labor cost savings were $139,367.80 per year for the medical center. CONCLUSION SWAP had an overall success rate of 95%. Older age, absence of developmental delay, and female sex were independently significantly associated with successful outcome. Cost analysis reveals substantial labor cost savings to the institution compared with imaging under anesthesia.
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Affiliation(s)
- Joshua Vic Chen
- School of Medicine, University of California, San Francisco, CA
| | - Matthew A Zapala
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Alice Zhou
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Nola Vu
- School of Public Health, University of California, Berkeley, CA
| | - Lauren Meyer
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Mikaela Demartini Smith
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Chloe Kelleher
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Orit A Glenn
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Jesse Courtier
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628
| | - Yi Li
- Department of Radiology and Biomedical Imaging, University of California, Neuroradiology Section, 505 Parnassus Avenue, M-391, San Francisco, California, 94143-0628.
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5
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Michaud V, Morel B, Adamsbaum C, Bruneau B, Lenoir M, Petit P, Leiber LM, Blondiaux E, Brunereau L, Remérand F, Brisse HJ, Laffon M. French survey of sedation practices for pediatric magnetic resonance and computed tomography imaging. Pediatr Radiol 2023; 53:1669-1674. [PMID: 36932258 DOI: 10.1007/s00247-023-05635-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Pediatric magnetic resonance imaging (MRI) and computed tompgraphy (CT) require patient immobility and therefore often require sedation or general anesthesia of patients. Consensus on these procedures is lacking in France. OBJECTIVE Thus, the aim of this study was to describe the current sedation practices for pediatric MRI and CT in France. MATERIAL AND METHODS From January 2019 to December 2019, an online questionnaire was delivered by electronic mail to a representative radiologist in 60 pediatric radiology centers registered by the French-speaking pediatric and prenatal imaging society. Questions included protocols, drugs used, monitoring and side effects. RESULTS Representatives of 40 of the 60 (67%) radiology centers responded to the survey. Among them, 31 performed sedation including 17 (55%) centers where radiologists performed sedation without anesthesiologists present during the procedure. The premedication drugs were hydroxyzine (n = 8, 80%) and melatonin (n = 2, 20%), Sedation drugs used for children ages 0 to 6 years old were pentobarbital (n = 9, 60%), midazolam (n = 2, 13%), chloral hydrate (n = 2, 13%), diazepam (n = 1, 6.5%) and chlorpromazine (n = 1, 6.5%). A written sedation protocol was available in 10/17 (59%) centers. In 6/17 (35%) centers, no monitoring was used during the procedures. Blood pressure monitoring and capnography were rarely used (< 10%) and post-sedation monitoring was heterogeneous. No life-threatening adverse effect was reported, but 6 centers reported at least one incident per year. CONCLUSION For half of the responding radiology centers, radiologists performed sedation alone in agreement with the local anesthesiology team. Sedation procedures and monitoring were heterogenous among centers. Adjustment and harmonization of the practices according to the capacity of each center may be useful.
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Affiliation(s)
- Valentin Michaud
- Anesthesia and Intensive Care Department, University Hospital of Tours, 2 Boulevard Tonnelé, 37044, Tours, France.
| | - Baptiste Morel
- UMR 1253, iBrain, Inserm, University of Tours, 37000, Tours, France
| | - Catherine Adamsbaum
- Pediatric Radiology Department, University of Paris Saclay, AP-HP, Bicêtre Hospital, 94270, Le Kremlin Bicêtre, France
| | - Bertrand Bruneau
- Radiology Department, University Hospital of Rennes, 35200, Rennes, France
| | - Marion Lenoir
- Radiology Department, University Medical Center, 25000, Besançon, France
| | - Philippe Petit
- Pediatric and prenatal imaging unit, Aix Marseille University, La Timone-Enfants Hospital, 13005, Marseille, France
| | - Louis-Marie Leiber
- Department of Radiology, University Hospital of Angers, 49000, Angers, France
| | - Eléonore Blondiaux
- Department of Radiology, Trousseau Hospital, APHP, Sorbonne University, 75012, Paris, France
| | - Laurent Brunereau
- Radiology Department, University Hospital of Tours, 37000, Tours, France
| | - Francis Remérand
- Anesthesia and Intensive Care Department, University Hospital of Tours, 2 Boulevard Tonnelé, 37044, Tours, France
| | - Hervé J Brisse
- Imaging Department, Institut Curie, 75005, Paris, France
| | - Marc Laffon
- Anesthesia and Intensive Care Department, University Hospital of Tours, 2 Boulevard Tonnelé, 37044, Tours, France
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6
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Fletcher S, Lardner D, Bagshawe M, Carsolio L, Sherriff M, Smith C, Lebel C. Effectiveness of training before unsedated MRI scans in young children: a randomized control trial. Pediatr Radiol 2023; 53:1476-1484. [PMID: 37010547 DOI: 10.1007/s00247-023-05647-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/17/2023] [Accepted: 03/10/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Young children requiring clinical magnetic resonance imaging (MRI) may be given general anesthesia. General anesthesia has potential side effects, is costly, and introduces logistical challenges. Thus, methods that allow children to undergo awake MRI scans are desirable. OBJECTIVES To compare the effectiveness of mock scanner training with a child life specialist, play-based training with a child life specialist, and home book and video preparation by parents to allow non-sedated clinical MRI scanning in children aged 3-7 years. MATERIALS AND METHODS Children (3-7 years, n=122) undergoing clinical MRI scans at the Alberta Children's Hospital were invited to participate and randomized to one of three groups: home-based preparation materials, training with a child life specialist (no mock MRI), or training in a mock MRI with a child life specialist. Training occurred a few days prior to their MRI. Self- and parent-reported functioning (PedsQL VAS) were assessed pre/post-training (for the two training groups) and pre/post-MRI. Scan success was determined by a pediatric radiologist. RESULTS Overall, 91% (111/122) of children successfully completed an awake MRI. There were no significant differences between the mock scanner (89%, 32/36), child life (88%, 34/39), and at-home (96%, 45/47) groups (P=0.34). Total functioning scores were similar across groups; however, the mock scanner group had significantly lower self-reported fear (F=3.2, P=0.04), parent-reported sadness (F=3.3, P=0.04), and worry (F=3.5, P=0.03) prior to MRI. Children with unsuccessful scans were younger (4.5 vs. 5.7 years, P<0.001). CONCLUSIONS Most young children can tolerate awake MRI scans and do not need to be routinely anesthetized. All preparation methods tested, including at-home materials, were effective.
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Affiliation(s)
- Sarah Fletcher
- Faculty of Medicine, University of British Columbia, T3B6A8, Vancouver, Canada
| | - David Lardner
- Alberta Children's Hospital, T3B6A8, Calgary, Canada
| | | | - Lisa Carsolio
- Alberta Children's Hospital, T3B6A8, Calgary, Canada
| | | | - Cathy Smith
- Alberta Children's Hospital, T3B6A8, Calgary, Canada
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7
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Weiler-Wichtl LJ, Fries J, Fohn-Erhold V, Schwarzinger A, Holzer AE, Pletschko T, Furtner-Srajer J, Prayer D, Bär P, Slavc I, Peyrl A, Azizi A, Hansl R, Leiss U. Initial Evidence for Positive Effects of a Psychological Preparation Program for MRI "iMReady" in Children with Neurofibromatosis Type I and Brain Tumors-How to Meet the Patients' Needs Best. J Clin Med 2023; 12:jcm12051902. [PMID: 36902689 PMCID: PMC10003409 DOI: 10.3390/jcm12051902] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/22/2023] [Accepted: 02/25/2023] [Indexed: 03/08/2023] Open
Abstract
To provide an effective alternative to sedation during MRI examinations in pediatric cancer and NF1 patients, the aims of the present study were to (1) exploratively evaluate a behavioral MRI training program, to (2) investigate potential moderators, as well as to (3) assess the patients' well-being over the course of the intervention. A total of n = 87 patients of the neuro-oncology unit (mean age: 6.83 years) underwent a two-step MRI preparation program, including training inside the scanner, and were recorded using a process-oriented screening. In addition to the retrospective analysis of all data, a subset of 17 patients were also analyzed prospectively. Overall, 80% of the children receiving MRI preparation underwent the MRI scan without sedation, making the success rate almost five times higher than that of a group of 18 children that opted out of the training program. Memory, attentional difficulties, and hyperactivity were significant neuropsychological moderators for successful scanning. The training was associated with favorable psychological well-being. These findings suggest that our MRI preparation could present an alternative to sedation of young patients undergoing MRI examinations as well as a promising tool for improving patients' treatment-related well-being.
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Affiliation(s)
- Liesa Josephine Weiler-Wichtl
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence: ; Tel.: +43-1-40400-34262
| | - Jonathan Fries
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, 1010 Vienna, Austria
| | - Verena Fohn-Erhold
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Agathe Schwarzinger
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Angelika Elisabeth Holzer
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
- Interdisciplinary Follow-Up Clinic for Childhood Cancer Survivors (IONA), Österreichische Gesundheitskasse (ÖGK), 1060 Vienna, Austria
| | - Thomas Pletschko
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Julia Furtner-Srajer
- Department of Radiology and Nuclear Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Daniela Prayer
- Department of Radiology and Nuclear Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Paul Bär
- Department of Radiology and Nuclear Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Irene Slavc
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Andreas Peyrl
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Amedeo Azizi
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Rita Hansl
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Ulrike Leiss
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, 1090 Vienna, Austria
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Tribot AS, Blanc N, Brassac T, Guilhaumon F, Casajus N, Mouquet N. What makes a teddy bear comforting? A participatory study reveals the prevalence of sensory characteristics and emotional bonds in the perception of comforting teddy bears. THE JOURNAL OF POSITIVE PSYCHOLOGY 2023. [DOI: 10.1080/17439760.2023.2170273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
| | - Nathalie Blanc
- EPSYLON EA, Univ Paul Valéry Montpellier 3, Montpellier, France
| | - Thierry Brassac
- Service Culture Scientifique Univ Montpellier, Montpellier, France
| | - François Guilhaumon
- MARBEC, Univ Montpellier, CNRS, Ifremer, IRD, Montpellier, France
- ENTROPIE, IRD, Saint-Denis, France
| | | | - Nicolas Mouquet
- MARBEC, Univ Montpellier, CNRS, Ifremer, IRD, Montpellier, France
- FRB – CESAB, Montpellier, France
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9
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Suzuki A, Yamaguchi R, Kim L, Kawahara T, Ishii-Takahashi A. Effectiveness of mock scanners and preparation programs for successful magnetic resonance imaging: a systematic review and meta-analysis. Pediatr Radiol 2023; 53:142-158. [PMID: 35699762 DOI: 10.1007/s00247-022-05394-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 03/31/2022] [Accepted: 05/03/2022] [Indexed: 01/24/2023]
Abstract
This review aimed to summarise the effectiveness of preparation programs for magnetic resonance imaging (MRI) in children using mock scanners and the success rates by systematically reviewing the current literature. We initially identified 67 articles using the search terms "MRI," "mock" and "child" on online databases. All studies involving a preparation programme for MRI on children ages 18 years or younger, healthy children and those with medical diagnoses were included. The authors extracted data on study design, participant data, details of the MRI protocol and the total numbers of patients who underwent preparation programs and were scanned while awake, without sedation or general anesthesia. Twenty-three studies were included in this review. Preparation programs included in-home and hospital/research facility components; these consisted of a mock scanner, explanatory booklets, recorded MRI scan sounds and other educational materials. The success rate of MRI after the preparation programme reported in each study ranged from 40% to 100%. When all participants from studies that specifically assessed the efficacy of preparation programs were combined, participants who underwent a preparation programme (n = 196) were more likely to complete a successful MRI than those who did not undergo a preparation programme (n = 263) (odds ratio [OR] = 1.98). Our results suggest that preparation programs may help reduce the risk of children failing MRI scans.
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Affiliation(s)
- Akane Suzuki
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Department of Child Psychiatry, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Rio Yamaguchi
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Leesa Kim
- Department of Child Psychiatry, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan.,Division of Clinical Psychology, Graduate School of Education, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Takuya Kawahara
- Clinical Research Promotion Center, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ayaka Ishii-Takahashi
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. .,Department of Child Psychiatry, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan. .,Department of Developmental Disorders, National Center of Neurology and Psychiatry, National Institute of Mental Health, Kodaira, Tokyo, Japan.
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10
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Bray L, Booth L, Gray V, Maden M, Thompson J, Saron H. Interventions and methods to prepare, educate or familiarise children and young people for radiological procedures: a scoping review. Insights Imaging 2022; 13:146. [PMID: 36064983 PMCID: PMC9445139 DOI: 10.1186/s13244-022-01278-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/24/2022] [Indexed: 11/11/2022] Open
Abstract
Children attending hospital for radiological procedures can experience uncertainty, anxiety and distress; this can result in sub-optimal experiences for children, poor scan quality and the need for radiological procedures to be rescheduled or sedation to be used. The preparation and education of children before clinical procedures has been shown to have a positive influence on procedural outcomes. This scoping review aimed to locate and examine the evidence relating to non-invasive interventions and methods to prepare, educate and familiarise children for radiological procedures within a healthcare setting. A comprehensive search strategy identified 36 articles. A narrative synthesis approach was adopted to make sense of the key findings. Studies investigated a range of radiological procedures (MRI, plain radiographs, CT, fluoroscopy and Micturating cystourethrogram) using a wide range of interventions (smartphone applications, storybooks, videos, mock scanners) which varied by method, mode of delivery and target audience. The outcomes used to evaluate the value and impact of the interventions are wide, varied and inconsistently applied making it difficult to judge which interventions offer the optimal impact on scan quality, scan completion and children’s experiences. This review highlights that there is a need to further understand which specific elements of the non-invasive interventions ‘work best’ for children. There is a need for consistency on the outcomes measured and for these measures to include child-centred outcomes alongside scan quality and length of radiological procedure.
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Affiliation(s)
- Lucy Bray
- Faculty of Health, Social Care and Medicine, Child Health Literacy, Edge Hill University, Ormskirk, UK.
| | - Lisa Booth
- Institute of Health and Wellbeing, University of Cumbria, Cumbria, UK
| | - Victoria Gray
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | | | - Jill Thompson
- Division of Nursing and Midwifery, Health Sciences School, The University of Sheffield, Sheffield, UK
| | - Holly Saron
- Faculty of Health, Social Care and Medicine, Child Health Literacy, Edge Hill University, Ormskirk, UK
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11
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Schneider DT, Balg J, Bernbeck B, Ellerkmann R, Klein M, Leutner A, Lindel P, Manns G, Mause U, Preziosi M, Schilling A, Schnittfeld S, Seyfert A, Winkelmann A, Rohde S. Magnetresonanztomographie-Untersuchung von Kindern in einem audiovisuell gestalteten Kinder-Magnetresonanztomographen. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01541-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Anwar I, McCabe B, Simcock C, Harvey-Lloyd J, Malamateniou C. Paediatric magnetic resonance imaging adaptations without the use of sedation or anaesthesia: A narrative review. J Med Imaging Radiat Sci 2022; 53:505-514. [DOI: 10.1016/j.jmir.2022.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
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13
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Kraus D, Horowitz‐Kraus T. Functional MRI research involving healthy children: Ethics, safety and recommended procedures. Acta Paediatr 2022; 111:741-749. [PMID: 34986521 DOI: 10.1111/apa.16247] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/26/2021] [Accepted: 01/04/2022] [Indexed: 12/11/2022]
Abstract
AIM This specific review aims to expose clinicians, researchers and administrators in hospitals to the importance, procedures and safety of fMRI studies to promote the increased utilisation of such studies in different geographical places worldwide. The child's brain is developing rapidly, both structurally and functionally. These functional changes can only be detected using functional scans generated from an MRI machine and referred to as a functional MRI (fMRI). This method may be used clinically in complex medical and surgical conditions (e.g., epilepsy surgery), but these days are often used for research purposes. However, due to ethical and logistical considerations, fMRI in the paediatric population is not widely and equally used in different geographical places. CONCLUSIONS The benefits of using this method to define the functional changes occurring in the developing brain are discussed in this review, along with desensitisation methods recommended when working with this vulnerable population in research and even in a clinical setting.
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Affiliation(s)
- Dror Kraus
- Pediatric Neurology Institute Schneider Children's Medical Center of Israel Tel Aviv University Petach‐Tiqua Israel
| | - Tzipi Horowitz‐Kraus
- Educational Neuroimaging Group Faculty of Education in Science and Technology Faculty of Biomedical Engineering Haifa Israel
- Kennedy Krieger Institute Baltimore Maryland USA
- Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Baltimore Maryland USA
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14
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Le May S, Genest C, Hung N, Francoeur M, Guingo E, Paquette J, Fortin O, Guay S. The Effect of Virtual Reality Game Preparation for Children scheduled for MRI (IMAGINE): a Randomized Controlled Trial Protocol (Preprint). JMIR Res Protoc 2021; 11:e30616. [PMID: 35700000 PMCID: PMC9237773 DOI: 10.2196/30616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 03/06/2022] [Accepted: 05/11/2022] [Indexed: 11/25/2022] Open
Abstract
Background It is known that magnetic resonance imaging (MRI) procedures generate fear and anxiety. Children may become restless during scanning, which results in movement artifacts requiring the MRI procedure to be repeated with sedation. Few studies seem to have looked at the effect of immersive virtual reality (IVR) on anxiety in children scheduled for MRI scans and how to identify which children are more responsive. Objective The aims of this study are 3-fold: develop an algorithm of predictability based on biofeedback, address feasibility and acceptability of preprocedural IVR game preparation for anxiety management during MRI procedures, and examine the efficacy of IVR game preparation compared with usual care for the management of procedural anxiety during MRI scans. Methods This study will have 2 phases. We will first conduct a field test with 10 participants aged 7 to 17 years to develop a predictive algorithm for biofeedback solution and to address the feasibility and acceptability of the research. After the field test, a randomized controlled trial will be completed using a parallel design with 2 groups: an experimental group (preprocedural IVR game preparation) and a usual care group (standard care as per the radiology department’s protocol) in an equal ratio of 49 participants per group for 98 participants. Recruitment will be carried out at a hospital in Quebec, Canada. The experimental group will receive a preprocedural IVR game preparation (IMAGINE) that offers an immersive simulation of the MRI scan. Participants will complete a questionnaire to assess the acceptability, feasibility, and incidence of side effects related to the intervention and the biofeedback device. Data collected will include sociodemographic and clinical characteristics as well as measures of procedure-related anxiety with the French-Canadian version of the State-Trait Anxiety Inventory for Children (score 1-3) and the Children’s Fear Scale (score 0-4). Physiological signs will be noted and include heart rate, skin conductance, hand temperature, and muscle tension. Measures of the level of satisfaction of health care professionals, parents, and participants will also be collected. Analyses will be carried out according to the intention-to-treat principle, with a Cronbach α significance level of .05. Results As of May 10, 2022, no participant was enrolled in the clinical trial. The data collection time frame is projected to be between April 1, 2022, and March 31, 2023. Findings will be disseminated through peer-reviewed publications. Conclusions Our study provides an alternative method for anxiety management to better prepare patients for an awake MRI procedure. The biofeedback will help predict which children are more responsive to this type of intervention. This study will guide future medical practice by providing evidence-based knowledge on a nonpharmacological therapeutic modality for anxiety management in children scheduled for an MRI scan. Trial Registration ClinicalTrials.gov NCT04988516; https://clinicaltrials.gov/ct2/show/NCT04988516 International Registered Report Identifier (IRRID) PRR1-10.2196/30616
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Affiliation(s)
- Sylvie Le May
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
| | - Christine Genest
- Faculty of Nursing, Université de Montréal, Montreal, QC, Canada
- Trauma Studies Centre, Institut Universitaire en Santé Mentale de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est-de-l'Île de Montréal, Montreal, QC, Canada
| | - Nicole Hung
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
- Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Maxime Francoeur
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Estelle Guingo
- Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada
| | - Julie Paquette
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Olivier Fortin
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada
| | - Stéphane Guay
- Trauma Studies Centre, Institut Universitaire en Santé Mentale de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est-de-l'Île de Montréal, Montreal, QC, Canada
- School of Criminology, Université de Montréal, Montreal, QC, Canada
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15
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Sobey J, Tsai MH, Evans RE. An update on pediatric sedation techniques in nonoperating room locations. Curr Opin Anaesthesiol 2021; 34:449-454. [PMID: 34039846 DOI: 10.1097/aco.0000000000001018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To review advancements in care for pediatric patients in nonoperating room settings. RECENT FINDINGS Advances in patient monitoring technology, utilization of Child Life specialists, and alternative staffing models are helping anesthesia providers meet the rising demand for coverage of pediatric nonoperating room anesthesia (NORA) cases. The Wake Up Safe and Pediatric Sedation Research Consortium registries are exploring outcome measures regarding the safety of pediatric anesthesia in off-site locations and have reported an increased risk for severe respiratory and cardiac adverse events when compared to OR anesthesia sites. Additionally, malpractice claims for NORA have a higher proportion of claims for death than claims in operating rooms. SUMMARY Pediatric NORA requires thorough preparation, flexibility, and vigilance to provide safe anesthesia care to children in remote locations. Emerging techniques to reduce anesthetic exposure, improve monitoring, and alternative staffing models are expanding the boundaries of pediatric NORA to provide a safer, more satisfying experience for diagnostic and interventional procedures.
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Affiliation(s)
- Jenna Sobey
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - Mitchell H Tsai
- Department of Anesthesiology, Orthopaedics and Rehabilitation (by courtesy), and Surgery (by courtesy), Larner College of Medicine, University of Vermont
| | - Rebecca E Evans
- Division of Pediatric Anesthesiology, Larner College of Medicine, University of Vermont Medical Center, Burlington, Vermont, USA
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16
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Dillman JR, Gee MS, Ward CG, Drum ET, States LJ. Imaging sedation and anesthesia practice patterns in pediatric radiology departments - a survey of the Society of Chiefs of Radiology at Children's Hospitals (SCORCH). Pediatr Radiol 2021; 51:1497-1502. [PMID: 33606058 DOI: 10.1007/s00247-021-04996-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/04/2021] [Accepted: 01/31/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND There are few data describing practice patterns related to the use of sedation/anesthesia for diagnostic imaging in pediatric radiology departments. OBJECTIVE To understand current practice patterns related to imaging with sedation/anesthesia in pediatric radiology departments based on a survey of the Society of Chiefs of Radiology at Children's Hospitals (SCORCH) in conjunction with the American College of Radiology's Pediatric Imaging Sedation and Anesthesia Committee. MATERIALS AND METHODS A multi-question survey related to imaging with sedation/anesthesia in pediatric radiology departments was distributed to SCORCH member institutions in January 2019. A single reminder email was sent. Descriptive statistical analyses were performed. RESULTS Of the 84 pediatric radiology departments, 23 (27%) completed the survey. Fifty-seven percent of the respondents self-identified as academic/university-affiliated and 13% as a division/section in an adult radiology department. Imaging sedation (excluding general anesthesia) is commonly performed by pediatric anesthesiologists (76%) and intensive care unit physicians (intensivists, 48%); only 14% of departments expect their pediatric radiologists to supervise imaging sedation. Ninety-six percent of departments use child life specialists for patient preparation. Seventy percent of departments have preparatory resources available on a website, including simulation videos (26%) and audio clips (17%). Nearly half (48%) of the departments have a mock scanner to aid in patient preparation. Imaging sedation/anesthesia is most often scheduled at the request of ordering clinicians (65%), while 57% of departments allow schedulers to place patients into imaging sedation/anesthesia slots based on specified criteria. CONCLUSION Imaging sedation/anesthesia practice patterns vary among pediatric radiology departments, and understanding current approaches can help with standardization and practice improvement.
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Affiliation(s)
- Jonathan R Dillman
- Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave., Cincinnati, OH, 45229-3039, USA.
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Christopher G Ward
- Department of Anesthesiology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth T Drum
- Department of Anesthesiology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Lisa J States
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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17
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Environnement lumineux et anxiété des patients en service d’IRM. PSYCHOLOGIE FRANCAISE 2021. [DOI: 10.1016/j.psfr.2020.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Gentle Touch: Noninvasive Approaches to Improve Patient Comfort and Cooperation for Pediatric Imaging. Top Magn Reson Imaging 2021; 29:187-195. [PMID: 32541256 DOI: 10.1097/rmr.0000000000000245] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Pediatric imaging presents unique challenges related to patient anxiety, cooperation, and safety. Techniques to reduce anxiety and patient motion in adults must often be augmented in pediatrics, because it is always mentioned in the field of pediatrics, children are not miniature adults. This article will review methods that can be considered to improve patient experience and cooperation in imaging studies. Such techniques can range from modifications to the scanner suite, different ways of preparing and interacting with children, collaborating with parents for improved patient care, and technical advances such as accelerated acquisition and motion correction to reduce artifact. Special considerations for specific populations including transgender patients, neonates, and pregnant women undergoing fetal imaging will be described. The unique risks of sedation in children will also be briefly reviewed.
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19
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Morel B, Piredda GF, Cottier JP, Tauber C, Destrieux C, Hilbert T, Sirinelli D, Thiran JP, Maréchal B, Kober T. Normal volumetric and T1 relaxation time values at 1.5 T in segmented pediatric brain MRI using a MP2RAGE acquisition. Eur Radiol 2020; 31:1505-1516. [PMID: 32885296 DOI: 10.1007/s00330-020-07194-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/02/2020] [Accepted: 08/13/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study introduced a tailored MP2RAGE-based brain acquisition for a comprehensive assessment of the normal maturing brain. METHODS Seventy normal patients (35 girls and 35 boys) from 1 to 16 years of age were recruited within a prospective monocentric study conducted from a single University Hospital. Brain MRI examinations were performed at 1.5 T using a 20-channel head coil and an optimized 3D MP2RAGE sequence with a total acquisition time of 6:36 min. Automated 38 region segmentation was performed using the MorphoBox (template registration, bias field correction, brain extraction, and tissue classification) which underwent a major adaptation of three age-group T1-weighted templates. Volumetry and T1 relaxometry reference ranges were established using a logarithmic model and a modified Gompertz growth respectively. RESULTS Detailed automated brain segmentation and T1 mapping were successful in all patients. Using these data, an age-dependent model of normal brain maturation with respect to changes in volume and T1 relaxometry was established. After an initial rapid increase until 24 months of life, the total intracranial volume was found to converge towards 1400 mL during adolescence. The expected volumes of white matter (WM) and cortical gray matter (GM) showed a similar trend with age. After an initial major decrease, T1 relaxation times were observed to decrease progressively in all brain structures. The T1 drop in the first year of life was more pronounced in WM (from 1000-1100 to 650-700 ms) than in GM structures. CONCLUSION The 3D MP2RAGE sequence allowed to establish brain volume and T1 relaxation time normative ranges in pediatrics. KEY POINTS • The 3D MP2RAGE sequence provided a reliable quantitative assessment of brain volumes and T1 relaxation times during childhood. • An age-dependent model of normal brain maturation was established. • The normative ranges enable an objective comparison to a normal cohort, which can be useful to further understand, describe, and identify neurodevelopmental disorders in children.
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Affiliation(s)
- Baptiste Morel
- Inserm UMR 1253, iBrain, Université de Tours, Tours, France. .,Pediatric Radiology Department, Clocheville Hospital, CHRU de Tours, 49 Boulevard Beranger, 37000, Tours, France.
| | - Gian Franco Piredda
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
| | | | - Clovis Tauber
- Inserm UMR 1253, iBrain, Université de Tours, Tours, France
| | | | - Tom Hilbert
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
| | | | - Jean-Philippe Thiran
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
| | - Bénédicte Maréchal
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
| | - Tobias Kober
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
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