Abstract
Background
Timed barium esophagogram (TBE) and esophageal transit scintigraphy (ETS) have been adopted as useful ways to evaluate achalasia patients. TBE has merit as a simple, non-invasive, and convenient method.
Aims
The study sought to compare the results of these two tests and verify their usefulness in evaluating treatment response. In addition, we assessed whether TBE could effectively replace ETS through correlation analysis.
Methods
The medical records of 50 achalasia patients treated between September 2011 and June 2014 were reviewed retrospectively. The height and width of the barium column at 1, 2, and 5 min were measured by TBE. Half-life (T 1/2, min) and R 30 (percentage of remaining radioactivity 30 s after radioisotope ingestion) were measured by ETS. Both tests were performed before and after treatment, and the tests were carried out 1 and 2 days after procedures. And we analyzed the correlation between the parameters from the two tests.
Results
The parameters of TBE and ETS were improved after treatment (p < 0.05). Before treatment, the height and width results at 5 min from TBE positively correlated with the T 1/2 parameter from ETS (correlation coefficients of 0.59 and 0.75, respectively). After treatment, the correlation coefficients between the 5-min height and width of the barium column by TBE and T 1/2 by ETS were 0.55 and 0.46, respectively.
Conclusions
Both TBE and ETS are useful modalities in assessing esophageal emptying and response to achalasia treatment. TBE and ETS results have a statistically significant correlation both pre- and post-treatment. We suggest that TBE could effectively replace ETS for the assessment of achalasia.
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References
Cohen AN. Motor disorders of the esophagus. N Engl J Med. 1979;301:1124.
Park W, Vaezi MF. Etiology and pathogenesis of achalasia: the current understanding. Am J Gastroenterol. 2005;100:1404–1414.
Kostic SV, Rice TW, Baker ME, et al. Timed barium esophagogram: a simple physiologic assessment for achalasia. J Thorac Cardiovasc Surg. 2000;120:935–943.
Eckardt AJ, Eckardt VF. Treatment and surveillance strategies in achalasia: an update. Nat Rev Gastroenterol Hepatol. 2011;8:311–319.
Kahrilas PJ, Bredenoord AJ, Fox M, et al. The Chicago Classification of esophageal motility disorders, v3.0. Neurogastroenterol Motil. 2015;27:160–174.
Hulselmans M, Vanuytsel T, Degreef T, et al. Long-term outcome of pneumatic dilation in the treatment of achalasia. Clin Gastroenterol Hepatol. 2010;8:30–35.
Yamashita H, Ashida K, Fukuchi T, et al. Predictive factors associated with the success of pneumatic dilatation in Japanese patients with primary achalasia: a study using high-resolution manometry. Digestion. 2013;87:23–28.
Vaezi MF, Baker ME, Achkar E, et al. Timed barium oesophagram: better predictor of long term success after pneumatic dilation in achalasia than symptom assessment. Gut. 2002;50:765–770.
Andersson M, Lundell L, Kostic S, et al. Evaluation of the response to treatment in patients with idiopathic achalasia by the timed barium esophagogram: results from a randomized clinical trial. Dis Esophagus. 2009;22:264–273.
Prasek J, Hep A, Dolina J, et al. Dynamic esophageal scintigraphy in patients with achalasia. Nucl Med Rev Cent East Eur. 2000;3:57–60.
Shen YY, Shiau YC, Sun SS, et al. Using radionuclide esophageal emptying test to evaluate pneumatic dilatation effects for achalasia. Hepato-Gastroenterology. 2001;48:1061–1063.
Jeon HH, Youn YH, Rhee K, et al. For patients with primary achalasia the clinical success of pneumatic balloon dilatation can be predicted from the residual fraction of radionuclide during esophageal transit scintigraphy. Dig Dis Sci. 2014;59:375–382.
Inoue H, Minami H, Kobayashi Y, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy. 2010;42:265–271.
Ghosh SK, Pandolfino JE, Rice J, et al. Impaired deglutitive EGJ relaxation in clinical esophageal manometry: a quantitative analysis of 400 patients and 75 controls. Am J Physiol Gastrointest Liver Physiol. 2007;293:G878–G885.
Eckardt VF, Aignherr C, Bernhard G. Predictors of outcome in patients with achalasia treated by pneumatic dilation. Gastroenterology. 1992;103:1732–1738.
Birgisson S, Richter JE. Achalasia: What’s new in diagnosis and treatment? Dig Dis. 1997;15:1–27.
Vaezi MF, Richter JE. Current therapies for achalasia: comparison and efficacy. J Clin Gastroenterol. 1998;27:21–35.
Eckardt VF, Gockel I, Bernhard G. Pneumatic dilation for achalasia: late results of a prospective follow up investigation. Gut. 2004;53:629–633.
Kahrilas PJ, Clouse RE, Hogan WJ. American Gastroenterological Association technical review on the clinical use of esophageal manometry. Gastroenterology. 1994;107:1865–1884.
Pandolfino JE, Kwiatek MA, Nealis T, et al. Achalasia: a new clinically relevant classification by high-resolution manometry. Gastroenterology. 2008;135:1526–1533.
Cho YK, Lipowska AM, Nicodeme F, et al. Assessing bolus retention in achalasia using high-resolution manometry with impedance: a comparator study with timed barium esophagram. Am J Gastroenterol. 2014;109:829–835.
Chung JJ, Park HJ, Yu JS, et al. A comparison of esophagography and esophageal transit scintigraphy in the evaluation of usefulness of endoscopic pneumatic dilatation in achalasia. Acta Radiol. 2008;49:498–505.
Moon JT, Jung IS, Kim YS, et al. Correlation between clinical symptoms and radiologic findings before and after pneumatic balloon dilatation for achalasia. Korean J Gastroenterol. 2008;52:16–20.
Rhee K, Jeon H, Kim JH, et al. An evidence of esophageal decompensation in patients with achalasia in the view of its subtype: a retrospective study. J Neurogastroenterol Motil. 2013;19:319–323.
Lee JY, Kim N, Kim SE, et al. Clinical characteristics and treatment outcomes of 3 subtypes of achalasia according to the chicago classification in a tertiary institute in Korea. J Neurogastroenterol Motil. 2013;19:485–494.
Rohof WO, Salvador R, Annese V, et al. Outcomes of treatment for achalasia depend on manometric subtype. Gastroenterology. 2013;144:718–725. quiz e713-714.
Baker ME. Is barium column surface area a better predictor of primary achalasia disease severity than barium column height? Nat Clin Pract Gastroenterol Hepatol. 2007;4:308–309.
Zanoni A, Rice TW, Lopez R, et al. Timed barium esophagram in achalasia types. Dis Esophagus. 2015;28:336–344.
Johnston BT, Collins BJ, Collins JS, et al. Perendoscopic pneumatic dilatation in achalasia: assessment of outcome using esophageal scintigraphy. Dysphagia. 1992;7:201–204.
Chawda SJ, Watura R, Adams H, et al. A comparison of barium swallow and erect esophageal transit scintigraphy following balloon dilatation for achalasia. Dis Esophagus. 1998;11:181–187. discussion 187–188.
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Park, Y.M., Jeon, H.H., Park, J.J. et al. Correlation Between Timed Barium Esophagogram and Esophageal Transit Scintigraphy Results in Achalasia. Dig Dis Sci 60, 2390–2397 (2015). https://doi.org/10.1007/s10620-015-3659-z
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DOI: https://doi.org/10.1007/s10620-015-3659-z