Prabhakar Suman, Schieda Nicola
Department of Medical Imaging, The Ottawa Hospital, Canada.
Department of Medical Imaging, The Ottawa Hospital, 1053 Carling Avenue, Room C159, Ottawa, ON K1Y 4E9, Canada.
Eur J Radiol. 2023 May;162:110758. doi: 10.1016/j.ejrad.2023.110758. Epub 2023 Feb 26.
To perform a scoping review of the literature evaluating patient preparation for prostate MRI.
We conducted a search of English language literature, between 1989 and 2022 using MEDLINE and EMBASE for key terms: diet, enema, gel, catheter and anti-spasmodic agents linked to prostate MRI. Studies were reviewed for: level of evidence (LOE), study design and key results. Knowledge gaps were identified.
Three studies evaluated dietary modification in 655 patients. LOE was 3. All studies showed improved DWI and T2W image quality (IQ) and reduced DWI artifact. Nine studies evaluated enema use in 1551 patients. Mean LOE was 2.8 (range 2-3). Six studies reported IQ; DWI and T2W IQ were significantly improved with enema in 5/6 and 4/6 studies respectively. Only one study evaluated DWI/T2W lesion visibility which was improved with enema. One study evaluated impact of enema on eventual prostate cancer diagnosis, showing no benefit in false negative reduction. One study (LOE = 2, 150 patients) evaluated rectal gel; however, in combination with enema showing improved DWI and T2W IQ, lesion visibility and PI-QUAL compared to no preparation. Two studies evaluated use of rectal catheter in 396 patients. LOE was 3. One study showed improved DWI and T2W IQ and artifact compared to no preparation; however, the other showed inferior results comparing rectal catheter to enema. Six studies evaluated anti-spasmodic agent use in 888 patients. Mean LOE was 2.8 (range 2-3). Benefit of anti-spasmodic agent use on image quality and artifact on DWI and T2W are conflicting with no clear benefit.
Data evaluating patient preparation for prostate MRI is limited by level of evidence, study design and conflicting results. The majority of published studies do not evaluate impact of patient preparation on eventual prostate cancer diagnosis.
对评估前列腺MRI患者准备情况的文献进行范围综述。
我们使用MEDLINE和EMBASE在1989年至2022年间检索了英文文献，关键词为：与前列腺MRI相关的饮食、灌肠、凝胶、导管和抗痉挛药物。对研究进行了如下评估：证据水平（LOE）、研究设计和关键结果。确定了知识空白。
三项研究评估了655例患者的饮食调整。证据水平为3级。所有研究均显示弥散加权成像（DWI）和T2加权成像（T2W）图像质量（IQ）有所改善，DWI伪影减少。九项研究评估了1551例患者使用灌肠的情况。平均证据水平为2.8（范围2 - 3）。六项研究报告了图像质量；在5/6和4/6的研究中，灌肠分别使DWI和T2W图像质量显著提高。只有一项研究评估了灌肠对DWI/T2W病变可见性的影响，结果显示灌肠可改善病变可见性。一项研究评估了灌肠对最终前列腺癌诊断的影响，结果显示在减少假阴性方面无益处。一项研究（证据水平 = 2，150例患者）评估了直肠凝胶；然而，与未做准备相比，直肠凝胶联合灌肠可改善DWI和T2W图像质量、病变可见性和前列腺影像报告和数据系统（PI-QUAL）。两项研究评估了396例患者使用直肠导管的情况。证据水平为3级。一项研究显示与未做准备相比，DWI和T2W图像质量及伪影有所改善；然而，另一项研究显示直肠导管与灌肠相比效果较差。六项研究评估了888例患者使用抗痉挛药物的情况。平均证据水平为2.8（范围2 - 3）。抗痉挛药物对DWI和T2W图像质量及伪影的益处存在矛盾，无明确益处。
评估前列腺MRI患者准备情况的数据受到证据水平、研究设计和相互矛盾结果的限制。大多数已发表的研究未评估患者准备对最终前列腺癌诊断的影响。
