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Radiation Exposure Time during MBSS: Influence of Swallowing Impairment Severity, Medical Diagnosis, Clinician Experience, and Standardized Protocol Use

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Abstract

Guidelines and preventive measures have been established to limit radiation exposure time during modified barium swallow studies (MBSS) but multiple variables may influence the duration of the exam. This study examined the influence of clinician experience, medical diagnosis category, swallowing impairment severity, and use of a standardized protocol on fluoroscopy time. A retrospective review of 739 MBSSs performed on 612 patients (342 males/270 females; age range = 18–96 years) completed in 1 year at the Medical University of South Carolina was performed with IRB approval. All studies were completed by speech-language pathologists trained in the data collection protocol, interpretation, and scoring of the MBSImP™©. Medical diagnosis category, swallowing impairment severity (MBSImP™© score), clinician experience, and fluoroscopy time were the variables recorded for analysis. Fluoroscopy time was not significantly associated with medical diagnosis category (p = 0.10). The severity of the MBSImP™© Oral Total and Pharyngeal Total resulted in statistically significant increases in fluoroscopy time (p < 0.05). Studies by novice clinicians had longer exposure times when compared to those of experienced clinicians (p = 0.037). Average radiation exposure time using the MBSImP™© approach was 2.9 min, with a 95 % confidence interval of 2.8–3.0 min, which was well within the range of exposure times reported in the literature. This study provides preliminary information regarding the impact of medical diagnosis category, swallowing impairment severity, and clinician experience on fluoroscopy time. These findings also suggest that a thorough, standardized protocol for MBSSs did not cause unnecessary radiation exposure time during the MBSS.

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Acknowledgments

This work was supported by Grants K23 DC005764-05 NIH/NIDCD, KL2 UL1 RR029880 NIH/NCRR, and Bracco Diagnostics. This work was also supported in part by the Biostatistics and Clinical Trials Shared Resource, Hollings Cancer Center, Medical University of South Carolina (P30 CA138313). Other financial or material support was provided by Evelyn Trammell Voice and Swallowing Institute and Northern Speech Services.

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Authors and Affiliations

  1. Department of Health Sciences and Research, Medical University of South Carolina, 77 President St, Charleston, SC, 29425, USA

    Heather Shaw Bonilha, Katlyn McGrattan & Bonnie Martin-Harris

  2. Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA

    Heather Shaw Bonilha & Bonnie Martin-Harris

  3. Evelyn Trammell Institute of Voice and Swallowing, Medical University of South Carolina, Charleston, SC, USA

    Kate Humphries, Julie Blair, Katlyn McGrattan, Brittni Carnes & Bonnie Martin-Harris

  4. Biostatistics and Epidemiology, Medical University of South Carolina, Charleston, SC, USA

    Elizabeth G. Hill

  5. Department of Radiology, Medical University of South Carolina, Charleston, SC, USA

    Walter Huda

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  1. Heather Shaw Bonilha
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  2. Kate Humphries
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  3. Julie Blair
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  4. Elizabeth G. Hill
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  7. Walter Huda
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  8. Bonnie Martin-Harris
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Correspondence to Heather Shaw Bonilha.

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Bonilha, H.S., Humphries, K., Blair, J. et al. Radiation Exposure Time during MBSS: Influence of Swallowing Impairment Severity, Medical Diagnosis, Clinician Experience, and Standardized Protocol Use. Dysphagia 28, 77–85 (2013). https://doi.org/10.1007/s00455-012-9415-z

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  • DOI: https://doi.org/10.1007/s00455-012-9415-z

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