VR-Based Anxiety Reduction Framework for Pediatric MRI Using Gamified Biofeedback

Magnetic resonance imaging (MRI) procedures often induce anxiety in pediatric patients, reducing compliance and image quality. We present a VR-based anxiety reduction framework that integrates gamified environments with real-time biofeedback to enhance MRI training for children. The system employs a Unity-based VR game simulating the MRI scanner environment, augmented with adaptive challenges controlled by physiological signals such as heart rate variability (HRV) and galvanic skin response (GSR). A reinforcement learning module dynamically adjusts task difficulty to maintain engagement while gradually exposing children to scanner-related sounds and postures. In a clinical study with 60 participants aged 8-15, the VR-biofeedback group showed a 41% reduction in pre-scan anxiety scores (measured by m-STAIC) compared with 17% in traditional video training. Scan motion artifacts were reduced by 35%, and task completion rates improved by 28%. These findings indicate that gamified VR combined with biofeedback offers a powerful, scalable solution to improve pediatric MRI compliance and outcomes.