Cheap MRI markers can ease children’s anxieties during scanning

Using imaging markers such as gummy candies or a plastic, fish-shaped container can alleviate children’s anxieties during MRI exams and cut costs for radiology departments, according to a recent Australian study published in BMJ Open.

In radiology, fiducial markers are placed in or on the surface of a patient to help pinpoint specific areas on images; they also offer a frame of reference when multiple modalities are used in an exam.

Paige Little, with Queensland University of Technology in Australia, and colleagues got the idea to test out various MRI markers during a sleep postures research project at their institution.

"Single-use commercial markers cost between $6 and $10 each, and for our sleep posture study we had 50 participants, and we needed 50 markers for each participant, which made the cost prohibitive," Little said in a prepared statement. "We needed to find a marker that was small, inexpensive and easily sourced, which showed up clearly on MRI and was easily distinguishable from bone and soft tissue.”

The group tested 17 different items, including various gummy candies, a coffee bean, vitamin tablet and capsules and a fish-shaped soy sauce container that comes with an order of sushi. They also tested a traditional commercial marker.

The items were placed on the thigh of a team member, who was then scanned at the University’s imaging center using the five most commonly ordered MRI sequences.

Overall, the vitamin D capsule offered the best substitute for a commercial marker for all MRI protocols, especially for small parts of the body such as fingers and toes, according to Little. A fish oil capsule, paint ball pellet and soy sauce sushi tube were all great substitutes for commercial markers. The jelly candy and “plasticine play doh” were “surprise candidates” that showed high-quality visibility and intensity contrast for the 3D T1-weighted sequence.

"Our conclusion was that depending on the reason for imaging and the sequence selected, these four items were cheap and reliable alternatives to a commercial marker,” Little added, in the statement.

While the study only tested a single brand of commercial fiducial marker used at their institution, the researchers believe these atypical markers could produce great results.

"Single-use markers are a significant component of an imaging department's costs, and also for researchers, so we thought this study was a practical examination of viable alternatives,” the authors wrote. “And if using something familiar would help make the imaging process less frightening for children, particularly those children who have experienced many medical procedures, then that is a terrific bonus."