Heather Shaw Bonilha1,2, Bonnie Martin-Harris3, Ashli K O'Rourke2, Sameer V Tipnis4. 1. Department of Health Science and Research, Medical University of South Carolina, Charleston, South Carolina. 2. Department of Otolaryngology-Head and Neck Surgery. 3. Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois. 4. Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA.
Abstract
PURPOSE OF REVIEW: The modified barium swallow study (MBSS) is an X-ray examination of swallowing used to detect the presence and type impairment, aspiration risk, and to develop intervention plans. In this review, we will cover the use of ionizing radiation in MBSSs and review recent literature concerning radiation exposure and cancer risks to patients undergoing MBSSs. Lastly, we will discuss the clinical implications of these findings. RECENT FINDINGS: Recent literature confirms that the MBSS is a low-dose examination and that reducing pulse rate negatively impacts diagnostic accuracy. Importantly, cancer risks to adults undergoing MBSSs were also reported to be low. SUMMARY: An adult undergoing MBSS using a standardized, valid protocol, like the Modified Barium Swallow Impairment Profile (MBSImP), has low-radiation exposure and very low associated cancer risks. MBSSs should be used whenever relevant to adult patient care without undue concern regarding radiation exposure. Children also have low radiation exposure from MBSSs; however, cancer risks from that exposure remain unknown. Best practices in radiation safety must always be followed. Reducing pulse rates in the adult or pediatric population to reduce radiation exposure is not a valid strategy because of the resulting reduction in diagnostic accuracy.
PURPOSE OF REVIEW: The modified barium swallow study (MBSS) is an X-ray examination of swallowing used to detect the presence and type impairment, aspiration risk, and to develop intervention plans. In this review, we will cover the use of ionizing radiation in MBSSs and review recent literature concerning radiation exposure and cancer risks to patients undergoing MBSSs. Lastly, we will discuss the clinical implications of these findings. RECENT FINDINGS: Recent literature confirms that the MBSS is a low-dose examination and that reducing pulse rate negatively impacts diagnostic accuracy. Importantly, cancer risks to adults undergoing MBSSs were also reported to be low. SUMMARY: An adult undergoing MBSS using a standardized, valid protocol, like the Modified Barium Swallow Impairment Profile (MBSImP), has low-radiation exposure and very low associated cancer risks. MBSSs should be used whenever relevant to adult patient care without undue concern regarding radiation exposure. Children also have low radiation exposure from MBSSs; however, cancer risks from that exposure remain unknown. Best practices in radiation safety must always be followed. Reducing pulse rates in the adult or pediatric population to reduce radiation exposure is not a valid strategy because of the resulting reduction in diagnostic accuracy.
Authors: G Lo Re; F Vernuccio; M L Di Vittorio; L Scopelliti; A Di Piazza; M C Terranova; D Picone; C Tudisca; S Salerno Journal: Acta Otorhinolaryngol Ital Date: 2019-03-25 Impact factor: 2.124