UROGENITAL Hyoscine butylbromide significantly decreases motion artefacts and allows better delineation of anatomic structures in mp-MRI of the prostate T. Ullrich 1 & M. Quentin 1 & A. K. Schmaltz 1 & C. Arsov 2 & C. Rubbert 1 & D. Blondin 1 & R. Rabenalt 2 & P. Albers 2 & G. Antoch 1 & L. Schimmöller 1 Received: 7 April 2017 /Revised: 2 June 2017 /Accepted: 8 June 2017 # European Society of Radiology 2017 Abstract Objectives To prospectively evaluate the effect of hyoscine butylbromide (HBB) on visualisation of anatomical details and motion-related artefacts in mp-MRI of the prostate at 3.0 Tesla. Methods One hundred and three consecutive patients (65 ± 10 years) were included in this trial, powered to demonstrate an improvement of image quality after HBB administration, assessed on a 5-point scale by two blinded readers. All pa- tients received high-spatial resolution axial T2-weighted TSE sequences at 3.0 T without spasmolytic agent, repeated after application of 40 mg HBB and followed by routine mp-MRI. Secondary endpoints were (1) susceptibility to side effects, (2) dependence of spasmolytic effect on patients´ weight, and (3) prostate volume. Results In 68% of patients, HBB significantly improved the anatomic score (mean 3.4 ± 0.9 before and 4.4 ± 0.7 after HBB for both readers, p = <0.001). In 67%, HBB significantly enhanced the artefact score (mean 3.2 ± 1 before and 4.2 ± 0.8 after HBB for reader 1, p = <0.001; 3.2 ± 1 and 4.1 ± 0.8 for reader 2, p = <0.001). Subgroup analysis revealed no statisti- cally significant difference between patients with different bodyweight or prostate volume. Inter-reader agreement was excellent (k = 0.95–0.98). Conclusions Hyoscine butylbromide significantly improves image quality and reduces motion-related artefacts in mp- MRI of the prostate independent of bodyweight or prostate volume. No side effects were reported. Key Points • Hyoscine butylbromide (HBB) improved image quality in over 2/3 of patients. • Severe artefacts were reduced after HBB in more than 20%. • The number of non-diagnostic MRI was reduced to <1% after HBB. • HBB effect was independent of bodyweight and prostate volume. • No side effects of HBB were reported in this study population. Keywords Prospective trial . Multiparametric MRI . Prostate cancer . Image quality . Hyoscine butylbromide Abbreviations mp-MRI Multiparametric magnetic resonance imaging HBB Hyoscine butylbromide; scopolamine butylbromide; butylscopolamine T2WI T2-weighted imaging DWI Diffusion-weighted imaging DCE Dynamic contrast-enhanced imaging PSA Prostate-specific antigen IQR Interquartile range ESUR European Society of Urogenital Radiology ACR American College of Radiology PI-RADS Prostate imaging reporting and data system, version 2 PCA Prostate cancer MR-GB MRI-guided biopsy * M. Quentin michael.quentin@gmx.de 1 Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, D-40225 Dusseldorf, Germany 2 Department of Urology, University Dusseldorf, Medical Faculty, D-40225 Dusseldorf, Germany Eur Radiol DOI 10.1007/s00330-017-4940-7