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

Area of Science:

• Radiology
• Medical Imaging
• Urology

Background:

• Prostate multiparametric MRI (mpMRI) is widely used for diagnosis.
• Bowel preparation methods are commonly employed before mpMRI, but their efficacy is debated.
• Existing evidence for the effectiveness of bowel preparation techniques is contradictory or lacking.

Purpose of the Study:

• To evaluate the impact of hyoscine N-butyl-butylbromide (HBB), microenema (ME), and dietary restrictions (DR) on artifact reduction and image quality (IQ) in prostate mpMRI.
• To determine if these interventions improve diagnostic accuracy in prostate cancer assessment.
• To provide evidence-based recommendations for pre-procedural protocols in prostate mpMRI.

Main Methods:

• Retrospective analysis of 180 treatment-naïve men undergoing prostate mpMRI between October 2018 and February 2020.
• Patients received either HBB, ME, DR, or a combination of these interventions prior to scanning.
• Image quality parameters (T2w, DWI, ADC maps) were assessed by two radiologists using a 5-point Likert-like scale.

Main Results:

• Microenema (ME) was identified as a significant independent predictor of good overall MRI image quality for both readers.
• Diffusion-weighted imaging (DWI) geometric distortion was more pronounced in patients who did not receive ME.
• Hyoscine N-butylbromide (HBB) and dietary restrictions (DR) did not demonstrate a significant benefit in improving image quality or reducing artifacts.

Conclusions:

• Microenema (ME) administration appears to significantly enhance the image quality of diffusion-weighted imaging (DWI) and the overall mpMRI dataset for the prostate.
• Hyoscine N-butylbromide (HBB) and dietary restrictions (DR) do not offer a discernible advantage for improving prostate mpMRI quality.
• These findings suggest that ME may be a valuable component of the pre-procedural protocol for prostate mpMRI, while HBB and DR may not be necessary.