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The Value of Pharyngeal Scintigraphy in Predicting Videofluoroscopic Findings

Huang, Yu-Hui MD, PhD; Chang, Shih-Chung MD; Kao, Pan-Fu MD, MSc; Chiang, Tung-Hua MD; Chen, Sung-Lang MD, PhD; Lee, Ming-Shan MD; Wu, Ming-Che MD

American Journal of Physical Medicine & Rehabilitation: December 2013 - Volume 92 - Issue 12 - p 1075–1083
doi: 10.1097/PHM.0b013e31829e77e3
Original Research Articles

Objective: The aim of this study was to evaluate the correlation between scintigraphy and videofluoroscopy (VFS) in swallowing evaluation and the ability of scintigraphy to predict penetration/aspiration in VFS.

Design: This is a case-control study enrolling 50 patients with dysphagia who received scintigraphy and VFS and 18 age-matched control subjects who received scintigraphy alone. Three parameters were compared between scintigraphy and VFS: premature pharyngeal entry, pharyngeal transit time, and postswallow pharyngeal stasis, with cutoff values defining dysfunction of 3% or greater, 1.2 secs or longer, and 9% or greater, respectively.

Results: The correlation coefficients were fair to good between scintigraphy and VFS (r = 0.678, 0.837, and 0.721 for premature pharyngeal entry, pharyngeal transit time, and postswallow pharyngeal stasis, respectively, P < 0.05). The scintigraphy parameters also had good predictive value for the VFS findings, with sensitivity, specificity, positive predictive values, and negative predictive values between 70% and 95%. Scintigraphy had good sensitivity in detecting 91% of aspirations and 81% of penetrations and/or aspirations in VFS if one of the three parameters was abnormal; however, the specificities were low (46% and 52% for scintigraphy and VFS, respectively).

Conclusions: The measurements of premature pharyngeal entry, pharyngeal transit time, and postswallow pharyngeal stasis by scintigraphy were correlated with those of VFS. Scintigraphy also had good sensitivity in detecting penetration and/or aspiration in VFS.

From the Departments of Physical Medicine & Rehabilitation (Y-HH, S-CC, M-SL, M-CW), Nuclear Medicine (P-FK), and Urology (S-LC), Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan (Y-HH, P-FK, S-LC); and Department of Neurology, Cheng Ching Hospital, Taichung, Taiwan (T-HC).

All correspondence and requests for reprints should be addressed to: Sung-Lang Chen, MD, PhD, School of Medicine, Chung Shan Medical University, 110, Chien-Kuo North Rd, Section 1, Taichung, Taiwan 402.

Supported by a research grant from the Chung Shan Medical University Hospital (CSH 2009-B-005).

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2013 by Lippincott Williams & Wilkins