Radiation Risks to Adult Patients Undergoing Modified Barium Swallow Studies.
Heather Shaw Bonilha, Walter Huda, Janina Wilmskoetter and 2 others
PMID 30830303WHAT IT FOUND
A full protocol modified barium swallow study delivered a median total effective dose of 0.27 mSv.
Thyroid dose was 1.7 mGy, and estimated cancer risk was 11 per million for 20-year-old men and 32 per million for 20-year-old women.
Key findings
01The thyroid received the highest organ dose, 1.7 mGy, and the lateral projection accounted for 85% of that dose.
02The median total effective dose for a full protocol MBSS was 0.27 mSv.
03Estimated excess cancer incidence risk was 11 per million for 20-year-old men and 32 per million for 20-year-old women.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study estimated doses and risks with software and did not follow patients for actual cancer outcomes. Only full-protocol adult MBSSs at one institution were modeled, so the findings do not describe partial protocols or non-adult patients. The dosimetry used mean height 1.68 m and mean weight 77 kg rather than individual patient anatomy. The analysis excluded organs not listed in BEIR VII, and the authors say total risk may be underestimated by up to about 20%. The authors state that radiation risk estimates at these levels carry uncertainty of factors of two to three.
Declared interests
The paper lists NIH extramural research support. The supplied text does not include a separate conflict-of-interest declaration.
The easy way to misread this
Do not read the 0.27 mSv effective dose as proof that MBSS is risk-free. The paper estimates modeled cancer risk, not observed cancers, and says risk estimates at these levels carry uncertainty of factors of two to three.