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 AbMole Pyriproxyfen 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 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 AbMole Povidone iodine 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 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. Recalculating the power of our study we note that with a 33% average event rate, true differences of 20% achieve sufficient power for 174 patients. Observed differences of 14% would have been significant. Second, the study design with the option of undergoing a second MR examination after cross-referral can be discussed as one reason for the high number of claustrophobic events in both study groups. However, this also meant a second appointment for imaging with additional efforts for the patients. Third, our negative results may serendipitously point to more salient factors to explain why so many scans were prevented or aborted. Undoubtedly, there are several factors which can contribute to anxiety during MR imaging such as pain, noise, previous unpleasant MR experiences, concern about possible diagnostic findings, the examination duration, and symptoms of depression, while feet-first positioning can alleviate claustrophobia by a factor of more than 10. These and other influencing factors were assessed or tempted to be kept constant in our study. In subgroup analyses, there were no relevant differences comparing the two groups and in patients with and without events, except for assessing subjective pain levels and the examination duration.