Radiation Exposure Time during MBSS: Influence of Swallowing Impairment Severity, Medical Diagnosis, Clinician Experience, and Standardized Protocol Use
Open accessAbstract
Guidelines and preventive measures have been established to limit radiation exposure time during modified barium swallow studies (MBSS) but multiple variables may influence the duration of the exam. This study examined the influence of clinician experience, medical diagnosis category, swallowing impairment severity, and use of a standardized protocol on fluoroscopy time. A retrospective review of 739 MBSSs performed on 612 patients (342 males/270 females; age range = 18-96 years) completed in 1 year at the Medical University of South Carolina was performed with IRB approval. All studies were completed by speech-language pathologists trained in the data collection protocol, interpretation, and scoring of the MBSImP™(©). Medical diagnosis category, swallowing impairment severity (MBSImP™(©) score), clinician experience, and fluoroscopy time were the variables recorded for analysis. Fluoroscopy time was not significantly associated with medical diagnosis category (p = 0.10). The severity of the MBSImP™(©) Oral Total and Pharyngeal Total resulted in statistically significant increases in fluoroscopy time (p < 0.05). Studies by novice clinicians had longer exposure times when compared to those of experienced clinicians (p = 0.037). Average radiation exposure time using the MBSImP™(©) approach was 2.9 min, with a 95 % confidence interval of 2.8-3.0 min, which was well within the range of exposure times reported in the literature. This study provides preliminary information regarding the impact of medical diagnosis category, swallowing impairment severity, and clinician experience on fluoroscopy time. These findings also suggest that a thorough, standardized protocol for MBSSs did not cause unnecessary radiation exposure time during the MBSS.
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The MBSImP protocol does not prolong radiation exposure.
“Subsequent studies determined that the MBSImP protocol does not prolong radiation exposure14 and that abnormal esophageal clearance is correlated with abnormal findings on esophageal manometry with impedance.15”
From Classification of high-resolution manometry data according to videofluoroscopic parameters using pattern recognition (2013) · cites this paper as [14]
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Modified Barium Swallow Study ACR-SPR Practice Parameter: 2023 Update
Zarzour, J. G., Martin‐Harris, B., & Hill, J. G. (2024) · Applied Radiology · doi:10.37549/ar2963 · Cited by 2 · see citing works
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Esophageal Screening During the Videofluoroscopic Swallow Study: Roadblocks and Roadmaps
Watts, S. A., Gregor, J. W., Miles, A., Lott, D. G., Kahn, A., Vela, M. F., Tritter, A. G., Jain, A. S., Yokum, M., Belafsky, P. C., et al. (2025) · Perspectives of the ASHA Special Interest Groups · doi:10.1044/2025_persp-25-00143 · Cited by 1 · see citing works
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Videofluoroscopic Evaluation of the Swallow in Infants and Children
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Instrumental assessment (VFS, FEES, and HRM)
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Diagnostic Validity of Clinical Observations for Detecting Physiologic Swallowing Impairment
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Self-citationChanges in hyo-laryngeal elevation post-pharyngeal electrical stimulation
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Doppler SD-OCT Blood Flow Analysis and Extraneous Operator Influences
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Evaluating Feeding and Swallowing in Infants and Children
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Tongue-Tie in Children: Clinical Controversies and a Comprehensive Review
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Transfer Learning for Dysphagia Detection
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CFSCNet: A Coarse-Fine Stream Conformer Neural Network for Swallow Segmentation
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Die Zungenfunktion als beständiges Rätsel der modernen Funktionsdiagnostik?
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- Authors
- Bonilha, H. S., Humphries, K., Blair, J., Hill, E. G., McGrattan, K., Carnes, B., Huda, W., & Martin-Harris, B.
- Affiliations
- Medical University of South Carolina (US)
- Corresponding author
- Bonilha, Heather Shaw
- Venue
- Dysphagia
- Published
- 2012-06-13
- Volume
- 28
- Issue
- 1
- Pages
- 77-85
- ISSN
- 0179-051X (ISSN-L)
- 1432-0460
- PMC
- PMC3477506
- OpenAlex
- W2014484741
- Cited by
- 90
- References
- 26
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 11 · 2023: 2 · 2022: 8 · 2021: 4 · 2020: 9 · 2019: 8 · 2018: 11 · 2017: 5 · 2016: 6 · 2015: 7 · 2014: 6 · 2013: 4
- FWCI
- 4.11
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Dysphagia (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Medical University of South Carolina
- National Institutes of Health (KL2TR000060, UL1TR000062)
- National Cancer Institute (P30CA138313)
- National Institute on Deafness and Other Communication Disorders (K23DC005764, K24DC012801)
- National Center for Research Resources (UL1RR029882, KL2RR029880, KL2 UL1 RR029880)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
- Keywords
- modified barium swallow, fluoroscopy time, radiation exposure, clinician experience, standardized protocols
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Barium Sulfate, Clinical Competence, Clinical Protocols, Contrast Media, Deglutition Disorders, Female, Fluoroscopy, Humans, Male, Middle Aged, Radiation Dosage, Retrospective Studies, Severity of Illness Index, Time Factors, Young Adult
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