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.

Keywords: 3 Tesla; Buscopan; Butylscopolamine; Magnetic resonance imaging; Motion artefacts; Prostate cancer.

Figure 1

Flowchart of patient inclusion. Total of 70 patients were selected randomly out of the hyoscine-N-butyl-bromide (HBB) and the corresponding control group. MRI: Magnetic resonance imaging.

Figure 2

Average scores of the obtained imaging categories in both groups. No statistical significant difference could be obtained. HBB: Hyoscine-N-butyl-bromide.

Figure 3

The results demonstrated no significant effect of administration of hyoscine-N-butyl-bromide on visualisation of the prostate, iliac lymph nodes, periprostatic artefacts, and overall image quality. A: 54-year-old patient. Coronal T2w-TSE sequence after administration of hyoscine-N-butyl-bromide (HBB): Prostate capsule (arrows) and neurovascular bundles are well visualized. Central gland and peripheral zone can be differentiated. Bowel wall structures are sharply depicted without artefacts (arrowheads); B: 72-year-old patient after coronal T2w-TSE sequence without administration of hyoscine-N-butyl-bromide (HBB): Qualitative rating showed no significant difference in visualisation of prostate capsule (white arrow), differentiation between central and peripheral gland, and neurovascular bundle structures (black arrow). However, ill-defined and blurred small bowel loops with surrounding artefacts occurred (arrowheads) without affecting the prostate or periprostatic space.