, Volume 28, Issue 3, pp 464–467 | Cite as

Challenges in Preparing Contrast Media for Videofluoroscopy

  • Catriona M. Steele
  • Sonja M. Molfenter
  • Melanie Péladeau-Pigeon
  • Shauna Stokely
Letter to the Editor

To the Editor,

We congratulate Popa Nita et al. [ 1] for their article exploring the challenges of matching the rheological (i.e., flow) properties of contrast agents used in videofluoroscopy to thickened liquids used in dysphagia management. This article clearly illustrates the complexities of this challenge; however, there are three additional points that we feel would be clinically relevant and important to bring to the attention of the readers of Dysphagia:
  1. (1)

    The rheological characteristics of barium preparations need to be understood with respect to how they map to clinical categories of liquid consistency.

  2. (2)

    The concentration of barium in commercially available suspensions affects both its visibility on the radiographic image and the degree to which the suspension leaves a coating on the pharyngeal mucosa.

  3. (3)

    Mixing barium powder into already thickened liquids may result in further thickening of the liquid.


We provide a brief elaboration on each of these points below.



Barium Apple Juice Thickened Liquid Barium Concentration Bracco Diagnostics 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Funding support for the work described in this Letter to the Editor was provided through an NSERC Create Care Award to SM. Additional funding support was received through a Canadian Institutes of Health Research New Investigator award and an NIDCD RO1 Grant to CMS and from the Toronto Rehabilitation Institute—University Health Network, which receives funding under the Provincial Rehabilitation Research Program from the Ministry of Health and Long-Term Care in Ontario. The views expressed do not necessarily reflect those of the Ministry. The authors gratefully acknowledge the assistance of Sarah Hori, Clemence Tsang, Rossini Yue, and Tasnim Shariff with data collection, and Dr. David James for use of rheological testing equipment.

Conflict of interest

The authors have no conflicts of interest to disclose.


  1. 1.
    Popa Nita S, Murith M, Chisholm H, Engmann J. Matching the rheological properties of videofluoroscopic contrast agents and thickened liquid prescriptions. Dysphagia. 2013;28(2):245–52.PubMedCrossRefGoogle Scholar
  2. 2.
    Fink TA, Ross JB. Are we testing a true thin liquid? Dysphagia. 2009;24:285–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Cichero J, Nicholson T, Dodrill P. Liquid barium is not representative of infant formula: characterisation of rheological and material properties. Dysphagia. 2011;26(3):264–71.PubMedCrossRefGoogle Scholar
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    National Dysphagia Diet Task Force ADA. National Dysphagia Diet: Standardization for Optimal Care. Chicago, IL: Faulhaber; 2002.Google Scholar
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    Dantas RO, Dodds WJ, Massey BT, Kern MK. The effect of high- vs low-density barium preparations on the quantitative features of swallowing. AJR Am J Roentgenol. 1989;153:1191–5.PubMedCrossRefGoogle Scholar
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    Hind J, Divyak E, Zielinski J, Taylor A, Hartman M, Gangnon R, Robbins J. Comparison of standardized bariums with varying rheological parameters on swallowing kinematics in males. J Rehabil Res Dev. 2012;49(9):1399–404.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Catriona M. Steele
    • 1
    • 2
    • 3
  • Sonja M. Molfenter
    • 1
    • 3
  • Melanie Péladeau-Pigeon
    • 1
  • Shauna Stokely
    • 1
  1. 1.Toronto Rehabilitation Institute, University Health NetworkTorontoCanada
  2. 2.Bloorview Research Institute, Holland Bloorview Kids RehabilitationTorontoCanada
  3. 3.University of TorontoTorontoCanada

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