Novel Virtual Reality App for Training Patients on MRI-guided Radiation Therapy

Background Patients receiving respiratory gated Magnetic Resonance Imaging guided Radiation Therapy (MRIgRT) for abdominal targets must hold their breath for ≥25 seconds at a time. Virtual reality (VR) has shown promise for improving patient education and experience for diagnostic MRI scan acquisition. We aimed to develop and pilot-test the first VR app to educate, train, and reduce anxiety and discomfort in patients preparing to receive MRIgRT. Methods A multi-disciplinary team iteratively developed a new VR app with patient input. The app begins with mini-games to help orient patients to using the VR device and to train patients on breath-holding. Next, app users are introduced to the MRI linac vault and practice breath-holding during MRIgRT. In this quality improvement project, patients with pancreatic cancer who were eligible for MRIgRT and clinic personnel tested the VR app for feasibility, acceptability, and potential efficacy for training patients on using breath-holding during MRIgRT. Results The new VR app experience was tested by 19 patients and 67 clinic personnel. The experience was completed on average in 18.6 minutes (SD = 5.4) by patients and in 14.9 (SD = 3.5) minutes by clinic personnel. Patients reported the app was “extremely helpful” (58%) or “very helpful” (32%) for learning breath-holding used in MRIgRT and “extremely helpful” (28%) or “very helpful (50%) for reducing anxiety. Patients and clinic personnel also provided qualitative feedback on improving future versions of the VR app. Conclusion The VR app was feasible and acceptable for training patients on breath-holding for MRIgRT. Patients eligible for MRIgRT for pancreatic cancer and clinic personnel reported on future improvements to the app to enhance its usability and efficacy.