Recall of Psychotherapy Information and Immersiveness in a Virtual Reality Application for Cancer-Related Chronic Pain.

Magnetic resonance imaging (MRI) is a safe, noninvasive technique that uses magnetic fields and computation to generate images of tissues and organs, unlike positron emission tomography (PET) or Computed tomography (CT) scans, which use ionizing radiation. MRI is one of the most commonly used complementary diagnostic tests in Western countries, and its use has grown significantly in recent years, providing images with excellent soft-tissue contrast in both adults and children. However, to obtain high-quality images of various anatomical structures, patients must remain still throughout the examination to prevent motion artifacts, which reduces the diagnostic accuracy in MRI. If patients (adults or children) are unable to remain still, repeat scanning or sedation may be required, which may contribute to increasing anxiety or risks, such as respiratory depression and airway obstruction. This exam can also increase patients’ stress due to claustrophobia, noise, the requirement to remain still, fear of an unknown diagnosis, and the clinical environment. Studies have shown that around 10% of adults experience severe MRI anxiety, with claustrophobia being the most significant stressor. In addition, this type of scanner generates loud, repetitive, and sometimes scary noises, reaching up to 100 decibels throughout the exam. A study found that the size, design, and noise of MRI machines contribute to children’s anxiety. Anxious children may often become restless during the exam, leading to uncontrolled movements that can lead to unclear images and sometimes to an early termination of the procedure. Premature termination may require the exam to be repeated, thus increasing anxiety over time and increasing the use of hospital resources. Some pediatric hospitals use conscious sedation to help patients undergo an MRI. However, like any other medication, conscious sedation carries risks. Recent findings showed that sedation in children can not only lead to short-term procedure-related risks but also to neurocognitive long-term side effects. As a result, researchers emphasized nonpharmacological methods to reduce stress and anxiety in preparation for, or during, an MRI. For instance, educational material such as mock MRI scanners, which recreate the experience of an MRI, has been shown to lower anxiety in children. However, the necessary equipment, space, cost, and staff make its use impractical in many clinical settings. Many studies have demonstrated the efficacy of virtual reality (VR) in reducing procedural anxiety and fear, such as during dental, burn wound care, and needle-related procedures. However, to the best of our knowledge, few studies have investigated its effect as a preparatory technique on children’s anxiety specifically before an MRI. Recent research demonstrates that VR can significantly reduce preprocedural anxiety by immersing children in a simulated MRI environment. Dafer et al. (2025) showed that children initially considered for sedation successfully completed awake MRI scans, with caregivers reporting high perceived effectiveness, although no statistically significant reduction in anxiety was observed. Similarly, Saliba et al. (2025) reported a significant reduction in anxiety following VR exposure, highlighting its potential to alleviate psychological stress before MRI. Stunden et al. (2021) compared VR-based simulation with standard preparatory manuals and child life programs, finding comparable success rates in simulated MRI scans and demonstrating that VR preparation can be as effective as standard programs in reducing child and caregiver anxiety. More recently, Briody and Patlas (2026) emphasized the paradigm shift VR represents, reframing it as a behavioral training tool that empowers children to actively participate in their health care, potentially reducing reliance on sedation and improving workflow efficiency. These studies indicate that VR is a viable, engaging, and effective tool for improving pediatric MRI experiences. Although more research is needed to optimize session timing, duration, and age-specific adaptations, VR has become more accessible and popular over the past decade. This technology could reduce anxiety, improve cooperation, decrease the need for sedation, and increase satisfaction among patients, families, and health care providers during MRI procedures.