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European Radiology

, Volume 28, Issue 1, pp 17–23 | Cite as

Hyoscine butylbromide significantly decreases motion artefacts and allows better delineation of anatomic structures in mp-MRI of the prostate

  • T. Ullrich
  • M. QuentinEmail author
  • A. K. Schmaltz
  • C. Arsov
  • C. Rubbert
  • D. Blondin
  • R. Rabenalt
  • P. Albers
  • G. Antoch
  • L. Schimmöller
Urogenital

Abstract

Objectives

To prospectively evaluate the effect of hyoscine butylbromide (HBB) on visualisation of anatomical details and motion-related artefacts in mp-MRI of the prostate at 3.0 Tesla.

Methods

One hundred and three consecutive patients (65 ± 10 years) were included in this trial, powered to demonstrate an improvement of image quality after HBB administration, assessed on a 5-point scale by two blinded readers. All patients received high-spatial resolution axial T2-weighted TSE sequences at 3.0 T without spasmolytic agent, repeated after application of 40 mg HBB and followed by routine mp-MRI. Secondary endpoints were (1) susceptibility to side effects, (2) dependence of spasmolytic effect on patients´ weight, and (3) prostate volume.

Results

In 68% of patients, HBB significantly improved the anatomic score (mean 3.4 ± 0.9 before and 4.4 ± 0.7 after HBB for both readers, p = <0.001). In 67%, HBB significantly enhanced the artefact score (mean 3.2 ± 1 before and 4.2 ± 0.8 after HBB for reader 1, p = <0.001; 3.2 ± 1 and 4.1 ± 0.8 for reader 2, p = <0.001). Subgroup analysis revealed no statistically significant difference between patients with different bodyweight or prostate volume. Inter-reader agreement was excellent (k = 0.95–0.98).

Conclusions

Hyoscine butylbromide significantly improves image quality and reduces motion-related artefacts in mp-MRI of the prostate independent of bodyweight or prostate volume. No side effects were reported.

Key Points

Hyoscine butylbromide (HBB) improved image quality in over 2/3 of patients.

Severe artefacts were reduced after HBB in more than 20%.

The number of non-diagnostic MRI was reduced to <1% after HBB.

HBB effect was independent of bodyweight and prostate volume.

No side effects of HBB were reported in this study population.

Keywords

Prospective trial Multiparametric MRI Prostate cancer Image quality Hyoscine butylbromide 

Abbreviations

mp-MRI

Multiparametric magnetic resonance imaging

HBB

Hyoscine butylbromide; scopolamine butylbromide; butylscopolamine

T2WI

T2-weighted imaging

DWI

Diffusion-weighted imaging

DCE

Dynamic contrast-enhanced imaging

PSA

Prostate-specific antigen

IQR

Interquartile range

ESUR

European Society of Urogenital Radiology

ACR

American College of Radiology

PI-RADS

Prostate imaging reporting and data system, version 2

PCA

Prostate cancer

MR-GB

MRI-guided biopsy

Notes

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Lars Schimmöller.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional review board approval was obtained.

Methodology

• prospective

• diagnostic or prognostic study

• performed at one institution

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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • T. Ullrich
    • 1
  • M. Quentin
    • 1
    Email author
  • A. K. Schmaltz
    • 1
  • C. Arsov
    • 2
  • C. Rubbert
    • 1
  • D. Blondin
    • 1
  • R. Rabenalt
    • 2
  • P. Albers
    • 2
  • G. Antoch
    • 1
  • L. Schimmöller
    • 1
  1. 1.Department of Diagnostic and Interventional RadiologyUniversity Dusseldorf, Medical FacultyDusseldorfGermany
  2. 2.Department of UrologyUniversity Dusseldorf, Medical FacultyDusseldorfGermany

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