Entering the comfort zone

By Greg Freiherr, Editor, gfreiherr@cmp.com

Nine years ago, Hitachi planted the seed for a patient revolution. It exhibited the Airis 0.3T open scanner at the 1994 RSNA meeting. At first the company didn't realize what it had. Executives described Airis' openness as the key to doing MR-guided interventions. What Airis actually did was provide a patient-friendly scanning environment. The rest is history, as every maker of MR scanners eventually leapt on to the open bandwagon.

Recognizing that there was more than one way to make patients more comfortable, Toshiba five years later introduced its Pianissimo technology, essentially a muffler for the bizarre noises that MR gradients make when they vibrate. Competitors have since latched onto this idea as well.

Last month, Siemens put a chair in place of a table in its new cardiac SPECT system. I have just one thing to say. It's about time. Almost a decade has passed since the industry first realized that patient comfort is important. Why did it take that long for someone to look at the one thing with which patients most directly interact?

The answer might be that building a more comfortable table or engineering a chair in its place doesn't have the allure that goes with technology that produces snazzier images or faster exams. Ironically, it can have just as important an effect. A more comfortable patient holds still longer. A more relaxed patient has a slower heart beat and takes fewer breaths. These are the things that affect motion artifact and, necessarily, the quality of the exam.

If patient comfort is an issue-and it should be-what can be done now to improve it? Plenty, I think. Small companies have been exhibiting ear phones and LCD televisions as patient comfort aids for years. And while some medical facilities have adopted them, until the makers of heavy iron get involved, I don't see them being mainstreamed. Yet the benefits are self-evident. Research on the television viewing habits of Americans demonstrates that this technological opiate can immobilize people for hours. It's especially effective with children. And children are the most easily frightened and, not surprisingly, present the greatest challenge as far as keeping them still.

Television may be one obvious way to affect patient comfort, but it's certainly not the only way. Each piece of radiological equipment-MR and CT scanners, SPECT cameras, fluoroscopy suites, and especially mammography equipment-needs to be looked at from the patient's point of view. Imaging exams shouldn't have to be frightening or uncomfortable to be effective.