{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:27:42Z","timestamp":1790803662515,"version":"4.1.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T00:00:00Z","timestamp":1616457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T00:00:00Z","timestamp":1616457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["32003B_176229\/1"],"award-info":[{"award-number":["32003B_176229\/1"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>To compare the impact of laxative enema preparation versus air\/gas suction through a small catheter on image quality of prostate DWI.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this single-center study, 200 consecutive patients (100 in each arm) with either enema or catheter preparation were retrospectively included. Two blinded readers independently assessed aspects of image quality on 5-point Likert scales. Scores were compared between groups and the influence of confounding factors evaluated using multivariable logistic regression. Prostate diameters were compared on DWI and T<jats:sub>2<\/jats:sub>-weighted imaging using intraclass correlation coefficients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Image quality was significantly higher in the enema group regarding the severity of susceptibility-related artifacts (reader 1: 0.34 \u00b1 0.77 vs. 1.73 \u00b1 1.34, reader 2: 0.38 \u00b1 0.86 vs. 1.76 \u00b1 1.39), the differentiability of the anatomy (reader 1: 3.36 \u00b1 1.05 vs. 2.08 \u00b1 1.31, reader 2: 3.37 \u00b1 1.05 vs. 2.09 \u00b1 1.35), and the overall image quality (reader 1: 3.66 \u00b1 0.77 vs. 2.26 \u00b1 1.33, Reader 2: 3.59 \u00b1 0.87 vs. 2.23 \u00b1 1.38) with almost perfect inter-observer agreement (<jats:italic>\u03ba<\/jats:italic> = 0.92\u20130.95). In the enema group, rectal distention was significantly lower and strongly correlated with the severity of artifacts (reader 1: <jats:italic>\u03c1<\/jats:italic> = 0.79, reader 2: <jats:italic>\u03c1<\/jats:italic> = 0.73). Furthermore, there were significantly fewer substantial image distortions, with odds ratios of 0.051 and 0.084 for the two readers which coincided with a higher agreement of the prostate diameters in the phase-encoding direction (0.96 vs. 0.89).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Enema preparation is superior to catheter preparation and yields substantial improvements in image quality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p><jats:italic>\u2022 Enema preparation is superior to decompression of the rectum using air\/gas suction through a small catheter.<\/jats:italic><\/jats:p>\n                <jats:p><jats:italic>\u2022 Enema preparation markedly improves the image quality of prostate DWI regarding the severity of susceptibility-related artifacts, the differentiability of the anatomy, and the overall image quality and considerably reduces substantial artifacts that may impair a reliable diagnosis.<\/jats:italic><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-021-07842-9","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T19:03:57Z","timestamp":1616526237000},"page":"6708-6716","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["How to improve image quality of DWI of the prostate\u2014enema or catheter preparation?"],"prefix":"10.1007","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6624-6615","authenticated-orcid":false,"given":"Carolin","family":"Reischauer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timmy","family":"Cancelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonaz","family":"Malekzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes M.","family":"Froehlich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harriet C.","family":"Thoeny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,23]]},"reference":[{"key":"7842_CR1","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1007\/s00330-011-2377-y","volume":"22","author":"JO Barentsz","year":"2012","unstructured":"Barentsz JO, Richenberg J, Clements R et al (2012) ESUR prostate MR guidelines 2012. 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Froehlich is consultant of Guerbet.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"No complex statistical methods were necessary for this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Due to the retrospective nature of the study, informed consent was waived.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The study was approved by the Cantonal Ethical Committee of Bern with BASEC number 2019-00826.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"\u2022 retrospective\u2022 observational\u2022 performed at one institution","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}