A survey of non-sedate practices when acquiring pediatric magnetic resonance imaging examinations

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 methodsA 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.

Automated summary

Improving access to pediatric magnetic resonance imaging (MRI) can be achieved by utilizing non-sedate practices, which reduce the need for sedation or general anesthesia and improve diagnostic quality. A survey-based study assessed the current utilization of non-sedate practices in pediatric MRI, revealing widespread but variable implementation rates across different ages and locations.