Radiation Dose in Videofluoroscopic Swallow Studies

Videofluoroscopy has become an increasingly important armament in the investigation and assessment of swallowing disorders. However, very little work has been published on the radiation dose used in such examinations and currently there is no national diagnostic reference level in the United Kingdom. Videofluoroscopy in our hospital is performed predominantly by one radiologist (IZM) in a single fluoroscopy room. We recorded the screening times of 230 patients over a 45-month period. Screening time ranged from 18 to 564 s (median = 171 s) associated with a median dose-area product of 1.4 Gy cm². This is below the third quartile level of 2.7 Gy cm² for all such examinations performed across the northern England. The effective dose associated with a typical videofluoroscopy dose-area product is 0.2 mSv. Videofluoroscopy is the most appropriate instrumental examination for assessing oropharyngeal swallow biomechanics and intervention strategies. This data set is based on the largest number of videofluoroscopy swallow studies published to date. Our results show that videofluoroscopy can be performed using minimal radiation doses.