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.
Of those who perform a scout projections, 7 perform lateral only, perform AP only, 7 perform both AP/lateral, 4 perform scout projection if there is history of surgery. Few others perform variety of other projections for scout (e.g. anterior and oblique, RAO only, and AP/lateral/RAO/LAO).
Double vs Single Contrast: Just over half of the participants routinely perform double contrast studies (n=36, 54%).
Effervescent: When performing double contrast study, 18 (27%) administer effervescent at the start of examination, 23 (35%) after performing erect cervical oesophagus projection and 6 (9%) after performing erect thoracic oesophagus projection. Some participants administered gas at other times.
Type of contrast used: 31 (47%) use liquid Polibar, 27 (41%) use E-Z HD, 2 (3%) use Baritop and 6 (9%) use another product.
On average, most bariums are performed with 2/3 to 1 cup volume.
Cervical Oesophagus Projections and Frame Rates: All participants perform lateral cervical oesophagus projection. The vast majority perform AP and lateral projections (n = 59, 88%) for cervical oesophagus.
30 (45%) evaluate the cervical oesophagus with 3 frames/second,13 use 2 frames/second (19%), 6 (9%) use 4 frames/second, 5 (7%) use 2-3 frames/second, 4 (6%) use 3-4 frames/second, and a few used none of the above.
Phonation views: 6 (9%) participants perform phonation views.
Terminology for thoracic erect projections: For purposes of simplicity and to reduce confusion, following discussion, we have combined right anterior oblique (RAO) and left posterior oblique (LPO) projections together and left anterior oblique (LAO) with right posterior oblique (RPO) projections together. This is because of the variability of how terminology is used amongst participants. Some label positioning based on patient’s position with respect to the fluoroscopic table whilst others, with respect to the position of the x-ray tube which is NOT ALWAYS placed beneath the table.
Erect Thoracic Oesophagus Projections and Frame Rates: The projections obtained for thoracic oesophagus varies greatly. The most commonly performed series of projections are AP and lateral (n = 11, 16%).
To evaluate thoracic oesophagus, the frame rate is generally lower than the rates for cervical oesophagus. 8% still utilises 3 or more frame rates per second.
Prone thoracic oesophagus assessment: Vast majority (n=57, 85%) also examine the patient in prone position. There were also radiologists who purely examine patients in prone position (n=1).
Of those who examine in prone position, 26 (43%) use both fluoroscopy and acquisition, 21 (34%) use fluoroscopy and 14 (23%) use both.
Whilst prone, 41 (72%) of participants get patients to continuously drink while the remainder ask the patient to drink one mouthful at a time.
Majority utilises frame rate of 1-2 frames/ second.
Reflux Assessment: 46 (70%) participants routinely evaluate for gastroesophageal reflux.
Solids Assessment: Most (n=52, 79%) do not give solids/bread. A few (n=3, 4%) give solids sometimes depending on individual clinical scenario.
Others: Participants also tailor barium swallow technique according to indication of study. For performing additional views or limiting length of study if the patient is frail and if patient has trouble with mobilization. A few participants explained that they have no routine method for barium swallow and every study depends on clinical indication of the case.