The claustrophobia-inducing closeness of an MR or PET/CT coupled with the loudness of the machine can create a stressful experience for anyone. But imagine being a child and having to undergo these procedures, perhaps regularly; it’s a scary experience for any kid, as well as the parent who has to watch their child struggle to stay still so the machine can acquire an accurate image.

But the health care industry has picked up on this issue, and is introducing machines and other best practices to try to alleviate some of the stress.

The look and feel of comfort
GE’s Adventure Series line debuted in pilot facilities during 2008 and has taken off since. The company now has the child-friendly machines in about 50 rooms in more than a dozen health care facilities throughout the U.S. Some rooms are completely decked out with wall décor that ties into the themes, and mood lighting and aromatherapy to accompany the specific adventure. Others offer distraction techniques like video games, televisions or soothing lighting. The trend of catering to patient comfort, however facilities are doing it, is becoming more common.

In some cases, the experience begins in the waiting room. For example, children may be given coloring books that introduce characters that are part of the story before their procedure.

Dr. Donald Frush, a pediatric radiologist with Duke Medicine, said more hospitals are catering to the unique needs of pediatric patients with warmer settings and more accommodating personnel.

“Themed rooms can reduce anxiety for the patient and parent, but also provide a better work experience or work culture for the staff who work in such areas,” Frush said. Training technologists and nurses can also improve the child’s experience and caregivers’ and should not be dismissed as unimportant.”

A human-centered imaging experience
The adventure rooms at the Children’s Hospital of Pittsburgh of UPMC are a good example of these kid-friendly imaging havens.

GE offers pre-planned themes, such as its Cozy Camp PET/CT outdoor adventure, the Pirate Island CT and an MR machine set in a safari theme. These aren’t just machines with decals on them — there is matching wall décor and related sounds and scents to make imaging more of an adventure.

At the University of California San Francisco hospital, GE is working on three rooms for pediatric patients. Clients can choose one of the established Adventure Series themes, or work with the OEM to originate a custom environment—in this case, the child is going through a cable car adventure as they move through the imaging process that pays homage to the region. In another one, the child walks on a dock to board a boat (really, the MR machine), then they are off on a journey on the San Francisco Bay. In the third, they’re taken to a Muir Woods-inspired natural sanctuary.



“The piece of equipment almost totally disappears in the room,” says Doug Dietz, a GE Adventure Series founder and innovation architect with GE Healthcare’s Global Design organization.

As part of the experience, the tech guides the child through a story that relates to the room’s decor. Even the surface coil, which goes on the patient’s head, is transformed into something that ties in the theme — in some cases, it may be a helmet for boys or a tiara for girls.

“It’s very human-centered design process,” Dietz says about creating the machines. “It’s a human-centered solution to a problem.”

Siemens Healthcare has also developed a few innovations to make the pediatric patient experience a little easier. Siemens’ ImageScapes mixes together imaging equipment and wall wraps, décor for exam rooms and waiting areas, tranquil sounds, and inviting aromatherapy. People can choose their preference of scents and sounds to tie into the experience. For instance, a sand castle room boasts waves crashing and seagulls chirping while a subtle aroma of coconut wafts through the room.

Dietz says that the facilities with GE’s Adventure Series equipment installed report improved patient satisfaction. It’s common to sedate some children during imaging procedures, but with the kid-tailored experience, they are often so relaxed and engaged in the adventure that they don’t need additional medication — a relief especially for parents.

“This is about the families coming through here,” Kemper says of the hospitals that use the machines. “It’s a lot less threatening than a clinical environment.”

Lower sedation and radiation, improved patient satisfaction
More awareness about trying to lower the dose of radiation has emerged with the Alliance for Radiation Safety in Pediatric Imaging’s Image Gently campaign. While not all imaging rooms are kid-friendly, having a low dose for pediatric imaging is a must. The initiative urges technicians to use the lowest radiation dose possible.

However, it’s not just the technicians helping to reduce dose. Due to advances in technology, new scanners that use less radiation are being introduced.

Siemens has introduced two CT scanners — the SOMATOM Definition Flash CT system, which is already on the market, and the SOMATOM Force, which received 510(k) clearance from the U.S. Food and Drug Administration last month. Both can scan a child and can automatically choose the lowest dose of radiation possible based on the patient’s size. In fact, these scanners can deliver high-quality imaging while utilizing a 70 kV tube so the patient receives a very low dose.



“It’s a very safe way to deliver the accurate dose to pediatric patients,” says Christine Ziemba-Landon, a product manager at Siemens.

The machines have reduced sedation rates among children because they offer quicker, quieter scanning.

“No parent wants to see their child sedated if they don’t need to be sedated,” Ziemba-Landon says. “If the technicians can get the patients on the table, and if they’re able to scan the patient in less than one second without sedation, while getting a highly diagnostic study, this scenario is contributing to a safer patient experience and more timely clinical decision making capabilities.”

Using the lowest dose of radiation possible is a top priority at the Children’s Hospital of Philadelphia, which participates in Image Gently and constantly focuses on optimizing dose.

“It’s not enough to buy a scanner with iterative reconstruction or a radiation dose tracking tool and call it a program,” says Chris Tomlinson, the executive director of radiology associates at the hospital. He says the hospital uses a committee of experts within the hospital as well as dose-tracking to follow best practices in low-dose pediatric radiation. They teamed up with the American College of Radiology to track dosing compared to other hospitals, and weigh evaluations extremely heavily on issues of dose and software to select equipment.

The cost of comfort
Dietz says that the fees vary for the GE Adventure Series, and there are additional costs for machinery decals and wall art. But he says the price is well worth the positive reactions that hospitals, patients and their families have. Nothing beats the response of a child who reports actually having fun during the procedure — and wants to do it again.

“This is really about people getting through the health care experience with a little bit of grace, a little bit of respect, if we have a little bit of fun along the way, that’s cool,” Kemper says.

Whatever it takes
Dr. Henrietta Kotlus Rosenberg, who heads the pediatric radiology department at the Kravis Children’s Hospital at Mount Sinai in New York City, said the hospital’s ultrasound room has an underwater theme inspired by Disney’s film, “The Little Mermaid.” The waiting and reception areas, patient examining rooms, nursing/baby changing room, and the hallway display similar artwork that ties into the motif.

Pediatric patients can enjoy a television show, listen to music or play a video game during their procedure, and the technicians go the extra mile to make their procedure as easy and enjoyable as possible.



“We do a lot of singing, dancing and trying to get them involved,” Rosenberg says of the technicians, who are trained to assist children. “They have quite a gamut of skills.”

They reward children with lollipops and stickers when they behave well — and that goes a long way to get a child to stay still for the time it takes to complete a procedure.

“We do whatever we have to do to try to get cooperation,” Rosenberg adds. “From the beginning to the end of the experience, we really try to provide a warm, cozy environment.”

The hospital also uses child life specialists that can sit with the children and respond to their parents’ needs before an imaging appointment.

Like other hospitals, Rosenberg has found that many adults want to enjoy distraction techniques during their imaging procedures. They need it too, and she believes that trend is spreading throughout the radiology field.

Preparing for success
In addition to distractions, the latest advancements in pediatric imaging also include programs that prepare children and their families for procedures long before they set foot in a medical facility.

Erin Stanford, a certified child life specialist at Children’s National Health System, which has imaging locations in Washington D.C. and Rockville, Maryland, helps run the hospital’s MR-I Can Do It program. The initiative enables parents and children to meet with a child life specialist who teaches them what to expect during the test. The hospital is currently studying the efficacy of the intervention program to see how well it works in reducing sedation rates among children.

For program participants, Stanford uses a customized approach to see which aspects of the experience might be stressful and how she can help make the experience easier.

“We try to prepare them at their level for about what they’re about to experience,” Stanford says. “We work with the family to help them cope with those stressors.”

Some children want to know what the scanner sounds like, and others want to practice lying still in a pop-up tunnel — all requests that Stanford accommodates. They also have a wooden MRI machine that the child can “operate” using a doll.

While some of their rooms feature GE Adventure Series, they also use video screens and headphones in their rooms so children can watch movies or listen to music during a scan.

In addition to the patient and family members, part of Stanford’s job is to coordinate with the technologist to convey the child’s specific needs. Simple things like letting a parent hold the child’s hand during a procedure can make a big difference in creating a positive experience. “We try to create a child-friendly environment,” Stanford adds.