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Updated: Oct 7, 2025

Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection
05:32

Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection

Published on: September 21, 2015

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Rectal preparation significantly improves prostate imaging quality: Assessment of the PI-QUAL score with visual

Michael A Arnoldner1, Stephan H Polanec2, Mathias Lazar3

  • 1Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Austria.

European Journal of Radiology
|January 10, 2022
PubMed
Abstract

Insights

Rectal preparation significantly enhances prostate imaging quality (PI-QUAL) and lesion visibility during MRI scans. This regimen, involving a cleansing enema and endorectal gel, offers improved diagnostic accuracy for prostate conditions.

Area of Science:

  • Radiology
  • Medical Imaging
  • Gastroenterology

Background:

  • Prostate cancer diagnosis relies heavily on accurate multiparametric MRI (mpMRI).
  • Image quality and lesion conspicuity are critical for reliable mpMRI interpretation.
  • Standard mpMRI protocols may be limited by factors affecting image quality.

Purpose of the Study:

  • To evaluate the impact of a specific rectal preparation regimen on prostate imaging quality (PI-QUAL).
  • To assess the effect of a rectal cleansing enema and endorectal gel on MRI image quality and lesion visibility.

Main Methods:

  • A prospective study involving 150 patients undergoing mpMRI for prostate evaluation.
  • Patients were randomized into two groups: one receiving rectal preparation (enema + gel) and a control group.
  • Image quality and lesion visibility were independently assessed by two uroradiologists using standardized scales and PI-QUAL scoring.

Main Results:

  • Rectal preparation significantly improved general image quality and lesion visibility on diffusion-weighted imaging (DWI).
  • Enhanced lesion conspicuity was observed on T2-weighted (T2w) and dynamic contrast-enhanced (DCE) images with rectal preparation.
  • Overall PI-QUAL scores were significantly higher in the group that underwent rectal preparation.

Conclusions:

  • A rectal preparation regimen comprising a cleansing enema and endorectal gel significantly improves mpMRI quality for prostate imaging.
  • This preparation method enhances lesion visibility and overall image quality, potentially aiding in more accurate prostate cancer detection.
  • The study suggests considering this rectal preparation protocol to optimize diagnostic performance in prostate MRI.
Keywords:
MRIPI-QUALProstateProstate cancerQuality standardsmpMRI

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