Thus, the CLQ might be a useful tool to identify patients at increased risk for claustrophobia during MR imaging which allows for early interventions such as by relaxation techniques , social support or conscious sedation. At seven-months follow-up, 86% of all scanned patients reported that their clinical symptoms were explained by findings at MR imaging. Furthermore, 47% reported an improved medical condition at follow-up, which may at least in part be due to adequate MR referrals according to the American College of Radiology guidelines in all patients. Thus, our results support previous findings which show that adherence to referral guidelines is pivotal considering MRI��s limited diagnostic yield for instance in patients referred for lumbar spine radiographs or without any back pain. Furthermore, all completed MR examinations had diagnostic image quality. Assessing claustrophobia after seven months, patients had reduced mean scores on the claustrophobia visual analogue scale and the CLQ, which is consistent with reports of decreased anxiety after completed MR examinations and highlights the potential of exposure therapy to reduce claustrophobia. However, anxiety during MR imaging can also increase or even induce claustrophobia after the examination , which was reported by 32% of our patients with events. Interestingly, patients rated their pre-imaging anxiety at the first MR appointment significantly higher in retrospect at seven-month follow-up compared with the assessment directly before MR imaging. This is the first trial directly comparing short-bore and open MR imaging with regard to reduction of claustrophobia as well as diagnostic utility. Strengths of our study include the random assignment of patients to one of the two scanners and the inclusion of NVP-BEZ235 customer reviews psychological instruments. We decided to include only patients with an increased risk to suffer from claustrophobia in MR imaging, because these patients should be addressed when more patient-centered MR scanners are developed. Furthermore, for the power analysis we used published non-randomized studies which suggested an advantage of open MR imaging. Our study has also limitations. It is a single-center study with two MR scanners in a specific environment, which may affect its generalizability. However, we believe that our results are likely to be generalizable to other MR scanners with a similar design approach. Furthermore, neither patients nor assessors could be blinded to the study group because of the MR imaging setting. Further potential Nutlin-3 limitations require discussion. First, our results did not show the superiority of open MR imaging that this study was powered to detect based on data from recent non-randomized trials.