Assessing motion artifacts in T2-Weighted prostate MRI: Impact of antispasmodic agents, bladder volume, and rectal...

Prostate cancer is the most frequently diagnosed male cancer in the Western world, with MRI leading role in detection. The quality of T2-weighted (T2W) sequence can be affected by motion artifacts caused by rectal peristalsis or bladder filling, potentially compromising diagnostic accuracy. Antispasmodics are commonly administered to reduce these artifacts, though their effectiveness remains unclear. This study investigates the impact of antispasmodics and bladder and rectal volumes on motion artifacts in T2W prostate MRI.

This retrospective study included patients undergoing biparametric MRI (bpMRI) without antispasmodics or multiparametric MRI (mpMRI) with antispasmodics of the prostate. Two observers assessed T2W images using a 3-point Likert scale based on PI-QUAL v2 criteria, focusing on motion artifacts. The Mann-Whitney U test was used to assess differences in Likert scores. Bladder and rectal volumes were analyzed using logistic regression to evaluate their association with Likert scores. Intra- and inter-observer reliability were calculated using Cohen's weighted kappa and Intraclass Correlation Coefficients (ICC).

No significant differences in Likert scores were found between bpMRI and mpMRI groups (p > 0.05). Inter-observer reliability was substantial (k = 0.66), while intra-observer reliability ranged from moderate to almost perfect (k = 0.58 and k = 0.83). Bladder volume was not significantly associated with motion artifacts (p > 0.05), but rectal volumes were (odds ratio 1.023 p = 0.02). Inter-observer reliability was excellent for bladder measurements (ICC = 0.937) and good for rectal measurements (ICC = 0.805).

Administration of glucagon and hyoscine-butylbromide, as well as bladder volume, showed no significant association with motion artifacts on T2W prostate MRI. Larger rectal volume was significantly associated with motion artifacts.

Routine use of antispasmodics and bladder emptying may be reconsidered in prostate MRI, potentially improving patient comfort and workflow without compromising diagnostic quality.