This is an observational study which aims to examine the different barium swallow techniques amongst radiology consultants and registrars and compare them against current available guidelines.
Methods and materials
Barium swallow is a fluoroscopic examination which offers evaluation of the pharynx, oesophagus, gastroesophageal junction and proximal stomach for motility, function and morphology. (1, 2) Common indications for barium swallow include dysphagia, reflux as well as post-surgical assessment. (2, 3, 4) It has advantages of easy accessibility, non-invasive nature, and low cost. (5, 6)
Single-contrast or double-contrast study can be performed. Single-contrast swallow is used for evaluation of motility disorders and strictures. Double-contrast swallow provides better visualization of mucosal details and is indicated for evaluation...
Of the 200 surveys sent, 67 responded.
Participants: Consultants make up 55.3% of the responses. Level of training of registrars (junior, intermediate and senior) are equally distributed.
Frequency of conducting barium swallows: Most participants (n=28, 42%) perform 1-4 swallows per week, a few perform 5-10 per week (n=5, 8%) and a few perform none in the past year (n=5, 8%).
These do not include modified barium swallows for speech pathology.
Scout projections: 33 (49%) participants routinely obtain scout projection.
There is marked heterogeneity of routine barium swallow techniques amongst radiology consultants and registrars in South Australia, some that deviate beyond the available consensus guidelines or teaching resources. This can be explored further. Research can also be expanded to assess the practice elsewhere in Australia. Ongoing education or local / college-level guidelines should be considered to improve consistency of technique.
Disantis DJ, Lewis JI, Menias CO, Balfe DM, Morgan DE, Cernigliaro JG. Imaging tips for performing a perfect barium swallow. Radiographics. 2019 Sep-Oct;39(5):1325-6.
American College of Radiology. ACR practice parameter for the performance of esophagrams and upper gastrointestinal examinations in adults [Internet]. Resolution 8. American College of Radiology; 2019 [cited 2019 Oct 7]. 11 p. Available from: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/UpperGIAdults.pdf
Levine MS, Rubesin SE, Ott DJ. Update on esophageal radiology. AJR. 1990 Nov;155:933-41.
Levine MS, Rubesin SE. Radiologic investigation of dysphagia. AJR. 1990 Jun;154:1157-63.
Debi U, Sharma...