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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