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

Abstract

AIM:To evaluate the value of administration of hyoscine-N-butyl-bromide (HBB) for image quality magnetic resonance imaging (MRI) of the prostate. METHODS:Seventy patients were retrospectively included in the study. Thirty-five patients were examined with administration of 40 milligrams of HBB (Buscopan ® ; Boehringer, Ingelheim, Germany); 35 patients were examined without HBB. A multiparametric MRI protocol was performed on a 3.0 Tesla scanner without using an endorectal coil. The following criteria were evaluated independently by two experienced radiologists on a five-point Likert scale: anatomical details (delineation between peripheral and transitional zone of the prostate, visualisation of the capsule, depiction of the neurovascular bundles); visualisation of lymph nodes; motion related artefacts; and overall image quality. RESULTS:Comparison of anatomical details between the two cohorts showed no statistically significant difference (3.9 ± 0.7 vs 4.0 ± 0.9, P = 0.54, and 3.8 ± 0.7 vs 4.2 ± 0.6, P = 0.07) for both readers. There was no significant advantage regarding depiction of local and iliac lymph nodes (3.9 ± 0.6 vs 4.2 ± 0.6, P = 0.07, and 3.8 ± 0.9 vs 4.1 ± 0.8, P = 0.19). Motion artefacts were rated as "none" to "few" in both groups and showed no statistical difference (2.3 ± 1.0 vs 1.9 ± 0.9, P = 0.19, and 2.3 ± 1.1 vs 1.9 ± 0.7, P = 0.22). Overall image quality was rated "good" in average for both cohorts without significant difference (4.0 ± 0.6 vs 4.0 ± 0.9, P = 0.78, and 3.8 ± 0.8 vs 4.2 ± 0.6, P = 0.09). CONCLUSION:The results demonstrated no significant effect of HBB administration on image quality. The study suggests that use of HBB is not mandatory for MRI of the prostate at 3.0 Tesla.

Value of bowel preparation techniques for prostate MRI: a preliminary study

“…Our study results showed no benefit with HBB, neither when used exclusively, nor in combination with ME and or DR. We observed a positive trend toward better delineation of anatomic detail and less motion artifacts on T2w sequences for R1 only; however, the difference was not statistically significant. These results are in line with Wagner [9] and Roethke et al [12]. Still, the data must be interpreted with caution due to comparably lower field strength (1.5T) used by Wagner et al [9] in their study setting.…”

“…In this context, antispasmodic agents such as hyoscine N-butylbromide (HBB) are widely used for suppression of bowel peristalsis. However, study results regarding the use of HBB are equivocal, as some authors did find positive effects on artifact reduction and/or IQ [7,11], while others did not [9,12].…”

Efficacy of butylscopolamine in obtaining clear MR image for intensity-modulated radiotherapy for prostate cancer

“…Butylscopolamine for prostate imaging has been reported, but some reports indicate that butylscopolamine is unnecessary [7][8][9][10]. The reason for these results is that organs including the prostate, bladder, rectum, and lymph nodes are not different whether or not butylscopolamine is used.…”

mpMRI of the Prostate (MR-Prostatography): Updated Recommendations of the DRG and BDR on Patient Preparation and Scanning Protocol

“…The use of an intestinal spasmolytic leads to a relevant reduction of artifacts caused by the natural movement of the bowel and thus to an increase in image quality and should therefore be applied routinely [20][21][22][23]. Individual studies, but without a prospective comparison within a patient and in some cases with the use of an endorectal coil, assessed the effect to be lower [24,25].…”