Easing patients’ minds: bringing comfort and kindness to the diagnostic process

“I’d like to send you for a scan to get a clearer picture of what’s going on.”

If you’ve ever heard something like this from your doctor, then you’ll know what the immediate reaction feels like – a combination of, “okay, the sooner I get this checked out, the sooner I’ll feel better” and, well… just fear. It’s okay to be anxious – and perfectly natural – when you need to have tests of any kind. But the idea of having a scan can make the bravest among us feel apprehensive.

Immediately, for example, thoughts turn to what kind of scan you’re going to have, and how it might feel. “For MRI, people hear a lot of stories,” says Wolter de Graaf, PhD, who is a European Clinical Scientist in Magnetic Resonance at Canon Medical Systems Europe. “And they are not usually accurate. So, right at the beginning, radiographers spend more time than might seem necessary talking with the patient and making sure they are as comfortable as possible. They don’t want you to be anxious. And nervous people don’t stay still well, so they may have to stop scanning and start again. Sometimes comfort also means making sure we're done fast.”

Designing from both perspectives is key in the success of Canon Medical’s solutions. In Wolter’s area of expertise there have been huge innovations in how patients experience their scan, and the image quality clinicians gain from them. In a perfect world every scan would be a lightning-fast process but, as Wolter explains, “it is done line by line. In general, every knocking sound you hear inside the MRI is one line”. It can be slow but speeding it up comprises the quality of the image – and impacts the diagnostic process.

This is where the advent of Artificial Intelligence has been a huge breakthrough for medical imaging. AiCE (Advanced intelligent Clear‑IQ Engine), a Deep Learning technology from our Medical Research arm, works with Canon Medical's Vantage MRI systems to ‘clean up’ scan images that have been created at accelerated speed. So, patients are in the MRI for less time, but doctors still have sharp and detailed images to help with diagnosis.

Of course, this still doesn’t take away the fact that you have to lie inside the scanner – and that alone can make an already difficult time feel even harder, especially if you regularly experience anxiety. Sometimes, for example, a special contrast fluid is used to help certain areas show up more clearly. This can be especially helpful in brain scans, but needs to be injected, a well-known fear for many. “We’re famous for a very special technique called Time-SLIP,” explains Wolter. “Where we can follow the blood flowing through your body without using contrast dye. Of course, the use of a contrast agent is a decision that needs to be made by the radiologist based on the need and on a case-by-case basis, but we offer it as an option.”

Claustrophobia is also a very real concern for both patients and doctors alike, with a few extremely phobic patients requiring sedation before their scan. Scanners with a wider opening of 70cm are more widely available, but just that ten centimetre increase from the narrow 60cm bore has an effect on the image quality and this is a real challenge. This means that the focus must shift to finding other inventive ways to make the experience less stressful, such as adjusting the immediate environment, reducing the noise and even employing distraction tactics!

We recently introduced images from our Canon Ambassadors to Mobile Imaging Solutions, alongside gentle lighting and colours to create a soothing sensory experience. These portable clinics are fully equipped with the very latest scanning technology and tend to be deployed to hospitals to meet increased need. However, while they are an amazing boost to hospitals, they are sometimes unexpected for patients. “We wanted to create a space that is as calming as possible because we understand that the majority of patients don’t know what to expect when they arrive,” explains Johan Vochteloo, Director of Refurbished & Mobile Imaging Solutions.

MRI scans have a reputation for being incredibly noisy and while Wolter stresses that some noise is inevitable, it can be mitigated. “Since around 1999, we have had a technique called Pianissimo. It’s an Italian word from the music world and means ‘very soft’,” he explains. “It is a technology where the gradient coils (the parts of the machine that vibrate and make loud noises) are enclosed in a vacuum chamber. And as sound cannot propagate in a vacuum, all our sequences are damped by up to 33 dB. Hearing protection is still needed, but it helps a lot.” And although we even have almost completely quiet sequences, Wolter says, it turned out that some noise is actually necessary, “If patients can’t tell if we’re scanning or not scanning, they may scratch their nose and we have to start again!”

It's pretty hard to forget that you’re in an MRI scanner but some hospitals offer a version of ‘in-flight’ entertainment, called MR Theatre, playing music and images or videos during your scan. In theory, you could have a movie or TV show broadcast while you are scanned, but that can come with its own issues. “This was tested in a children’s hospital in the US with Bob the Builder cartoons for fidgety little ones. The thing was, it worked so brilliantly that the kids didn’t want to come out before the episode ended! So, you have to tailor what’s shown to the length of the exam.”

None of these are ‘nice to haves’ and Canon Medical completely understands how creating a calm, supportive environment helps us to feel safe, seen and in control when we are at our most vulnerable. “It’s what radiographers do, it’s in everybody’s interest to get good images,” says Wolter. “Taking time with the patients, so that they feel at ease. We understand that their comfort gives the best outcome.”