Skip to main content

Advertisement

SpringerLink
Log in

Radiation Effective Doses to Adults Undergoing Modified Barium Swallow Studies

  • Original Article
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

Modified Barium Swallow Studies (MBSSs) are important tests to aid the diagnosis of swallowing impairment and guide treatment planning. Since MBSSs use ionizing radiation, it is important to understand the radiation exposure associated with the exam. This study reports the average radiation dose in routine clinical MBSSs, to aid the evidence-based decision-making of clinical providers and patients. We examined the MBSSs of 200 consecutive adult patients undergoing clinically indicated exams and used kilovoltage (kV) and Kerma Area Product to calculate the effective dose. While 100% of patients underwent the exam in the lateral projection, 72% were imaged in the upper posterior-anterior (PA) projection and approximately 25% were imaged in the middle and lower PA projection. Average kVs were 63 kV, 77 kV, 78.3 kV, and 94.3 kV, for the lateral, upper, middle, and lower PA projections, respectively. The average effective dose per exam was 0.32 ± 0.23 mSv. These results categorize a typical adult MBSS as a low dose examination. This value serves as a general estimate for adults undergoing MBSSs and can be used to compare other sources of radiation (environmental and medical) to help clinicians and patients assess the risks of conducting an MBSS. The distinction of MBSS as a low dose exam will assuage most clinician’s fears, allowing them to utilize this tool to gather clinically significant information about swallow function. However, as an X-ray exam that uses ionizing radiation, the principles of ALARA and radiation safety must still be applied.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Martin-Harris B, Logemann JA, McMahon S, Schleicher M, Sandidge J. Clinical utility of the modified barium swallow. Dysphagia. 2000;15:136–41. https://doi.org/10.1007/s004550010015.

    Article  CAS  PubMed  Google Scholar 

  2. Martin-Harris B, Jones B. The videofluorographic swallowing study. Phys Med Rehabil Clin N Am. 2008;19:769–85. https://doi.org/10.1016/j.pmr.2008.06.004.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Martin-Harris B, Brodsky MB, Michel Y, Castell DO, Schleicher M, Sandidge J, Maxwell R, Blair J. MBS measurement tool for swallow impairment—MBSImp: establishing a standard. Dysphagia. 2008;23:392–405. https://doi.org/10.1007/s00455-008-9185-9.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards. IAEA Safety standards for protecting people and the environment. Series No. GSR Part 3. Vienna: IAEA; 2014.

    Google Scholar 

  5. Tomà P, Bartoloni A, Salerno S, Granata C, Cannatà V, Magistrelli A, Arthurs OJ. Protecting sensitive patient groups from imaging using ionizing radiation: effects during pregnancy, in fetal life and childhood. Radiol Med. 2019;124:736–44. https://doi.org/10.1007/s11547-019-01034-8.

    Article  PubMed  Google Scholar 

  6. Bonilha HS, Huda W, Wilmskoetter J, Martin-Harris B, Tipnis SV. Radiation risks to adult patients undergoing modified barium swallow studies. Dysphagia. 2019;34:922–9. https://doi.org/10.1007/s00455-019-09993-w.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Mettler FA Jr., Huda W, Yoshizumi TT, Mahesh M. Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology. 2008;248:254–63. https://doi.org/10.1148/radiol.2481071451.

    Article  PubMed  Google Scholar 

  8. Aldrich JE, Williams J. Change in patient doses from radiological examinations at the Vancouver General Hospital, 1991–2002. Can Assoc Radiol J. 2005;56:94–9.

    PubMed  Google Scholar 

  9. Hersh C, Wentland C, Sally S, de Stadler M, Hardy S, Fracchia MS, Liu B, Hartnick C. Radiation exposure from videofluoroscopic swallow studies in children with a type 1 laryngeal cleft and pharyngeal dysphagia: a retrospective review. Int J Pediatr Otorhinolaryngol. 2016;89:92–6. https://doi.org/10.1016/j.ijporl.2016.07.032.

    Article  PubMed  Google Scholar 

  10. Chau KH, Kung CM. Patient dose during videofluoroscopy swallowing studies in a Hong Kong public hospital. Dysphagia. 2009;24:387–90. https://doi.org/10.1007/s00455-009-9214-3.

    Article  PubMed  Google Scholar 

  11. Yao H, Huda W, Mah E, He W. Review of kerma-area product and total energy incident on patients in radiography, mammography and CT. Radiat Prot Dosimetry. 2015;163:251–60. https://doi.org/10.1093/rpd/ncu157.

    Article  PubMed  Google Scholar 

  12. Bonilha HS, Wilmskoetter J, Tipnis S, Horn J, Martin-Harris B, Huda W. Relationships between radiation exposure dose, time, and projection in videofluoroscopic swallowing studies. Am J Speech Lang Pathol. 2019;28:1053–9. https://doi.org/10.1044/2019_ajslp-18-0271.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Bonilha HS, Wilmskoetter J, Tipnis SV, Martin-Harris B, Huda W. Effective dose per unit kerma-area product conversion factors in adults undergoing modified barium swallow studies. Radiat Prot Dosimetry. 2017;176:269–77. https://doi.org/10.1093/rpd/ncx006.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Tapiovaara M, Siiskonen T. PCXMC: a Monte Carlo program for calculating patient doses in medical X-ray examination. 2nd ed. Helsinki: Finnish Centre for radiation and nuclear safety; 2008.

    Google Scholar 

  15. Bhattacharyya N. The prevalence of dysphagia among adults in the United States. Otolaryngol Head Neck Surg. 2014;151:765–9. https://doi.org/10.1177/0194599814549156.

    Article  PubMed  Google Scholar 

  16. Martin CJ. Effective dose: how should it be applied to medical exposures? Br J Radiol. 2007;80:639–47. https://doi.org/10.1259/bjr/25922439.

    Article  CAS  PubMed  Google Scholar 

  17. US Nuclear Regulatory Commission. Doses in our daily lives. 2020. https://www.nrc.gov/about-nrc/radiation/around-us/doses-daily-lives.html. Accessed 18 June 2020

  18. US Nuclear Regulatory Commission. Title 10 part 20 of the code of federal regulations (10 CFR Part 20): standards for protection against radiation. Rockville: US Nuclear Regulatory Commission; 2020.

    Google Scholar 

  19. Miller DL, Vañó E, Bartal G, Balter S, Dixon R, Padovani R, Schueler B, Cardella JF, de Baère T. Occupational radiation protection in interventional radiology: a joint guideline of the cardiovascular and interventional radiology society of Europe and the Society of Interventional Radiology. Cardiovasc Intervent Radiol. 2010;33:230–9. https://doi.org/10.1007/s00270-009-9756-7.

    Article  PubMed  Google Scholar 

  20. Centers for Disease Control and Prevention. Radiation from air travel. 2015. https://www.cdc.gov/nceh/radiation/air_travel.html. Accessed 18 June 2020

Download references

Funding

This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases Grant R01DK098222 (H. S. B., B. M. H., S. T.) and by the National Institute of Deafness and Communication Disorders Grant 2K24DC012801-0 (B. M. H.)

Author information

Authors and Affiliations

  1. Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA

    Sameer V. Tipnis

  2. Department of Radiology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03766, USA

    Walter Huda

  3. Department of Health Science and Research, College of Health Professions, Medical University of South Carolina, 77 President St. MSC 700 office 311, Charleston, SC, 29425, USA

    Janina Wilmskoetter & Heather Shaw Bonilha

  4. Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA

    Bonnie Martin-Harris

  5. Otolaryngology-Head and Neck Surgery and Radiation Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Bonnie Martin-Harris

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

    Heather Shaw Bonilha

Authors
  1. Sameer V. Tipnis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Walter Huda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Janina Wilmskoetter
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bonnie Martin-Harris
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Heather Shaw Bonilha
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Heather Shaw Bonilha.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tipnis, S.V., Huda, W., Wilmskoetter, J. et al. Radiation Effective Doses to Adults Undergoing Modified Barium Swallow Studies. Dysphagia 37, 399–406 (2022). https://doi.org/10.1007/s00455-021-10291-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-021-10291-7

Keywords

Search

Navigation