Effect of butylscopolamine on image quality in MRI of the prostate

Prostate magnetic resonance imaging at 3 Tesla: Is administration of hyoscine-N-butyl-bromide mandatory?

“…The findings correspond to the results of a study by Wagner et al [3] at 1.5 Tesla with ERC that found no significant effect of intravenous or intramuscular administration of HBB for visualisation of the prostate, neurovascular bundles, pelvic lymph nodes, and overall image quality. Studies promoting the use of HBB for pelvic MRI emphasize the advantage of suppressing bowel peristalsis to reduce motion artefacts [4,7,8] , which is particularly the case in MR-sequences with long acquisition times such as T2w TSE sequences [9] .…”

“…However, the number of patients was considerably small with 23 men and there was no dedicated MR-protocol for prostate imaging at a 1.0 Tesla system. In opposite to this study, Wagner et al [3] used an ERC for prostate imaging at 1.5 Tesla. To date, after introduction of 3.0 Tesla scanners, the increased SNR is frequently used to exclude the ERC from prostate examinations, mainly in order to prevent discomfort from patients and to avoid the additional costs for the ERC [12][13][14][15][16][17] .…”

“…The rationale behind it consists of motion reduction of prostate surrounding structures (bladder, rectum, and small bowels) that may cause motion related artefacts which potentially degrade signal-to-noise ratio (SNR) and image quality. However, a recent study by Wagner et al [3] found no benefit for HBB in prostate MRI at 1.5 Tesla. The authors contended that the prostate is located in the lower pelvis, between pelvic floor muscles, bladder and rectum, distant to small bowel structures, and thus it is not affected by peristaltic artefacts.…”

“…The readers scored the cases independently and in random order on Likert five-point scales. First, anatomical details (delineation between peripheral and transitional zone of the prostate, visualisation of the capsule, depiction of neurovascular bundles) and visualisation of local and iliac lymph nodes were assigned on a five-point scale referring to imaging criteria described by Wagner et al [3] : (1) non-diagnostic: structures cannot be evaluated; (2) poor visualization: heavily blurred appearance of structures; (3) moderate visualization: moderate blurring; (4) good delineation: slight blurring; and (5) excellent visualization: sharp delineation. Motion related artefacts in the prostatic area were scored on the following five-point scale: (1) no artefacts; (2) few artefacts; (3) moderate artefacts; (4) considerable artefacts; and (5) severely affected.…”

Practical aspects of prostate MRI: hardware and software considerations, protocols, and patient preparation

“…In some centers, antispasmodic agents like butylscopolamine are administered immediately prior to scanning to decrease bowel peristalsis and potential artifacts related to motion. However, peristaltic suppression is controversial, as some groups have failed to identify a significant improvement of image quality in studies performed on 3T scanner without an ERC [159][160][161]. Patients undergoing scans with an ERC should be advised to perform a saline laxative enema within a 3-h window of the exam to facilitate proper endorectal coil placement and minimize susceptibility artifacts associated with air or fecal contamination.…”