Comparison of esophageal screen findings on videofluoroscopy with full esophagram results

Abstract

Background: Videofluoroscopic swallowing studies do not routinely obtain images of the esophagus. We incorporated a single esophageal screening swallow into our videofluoroscopic swallowing study protocol. The purpose of this study was to compare findings from "esophageal screening" with the results of full esophagram.

Methods: Patients undergoing videofluoroscopic swallowing studies with an esophageal screen followed by full esophagram between January 1, 2009, and October 1, 2009, were retrospectively reviewed. Comparison of esophageal screening and esophagram results were undertaken, with esophagram used as the gold standard.

Results: Seventy-four patients underwent esophageal screening and esophagram. Sensitivity of esophageal screening is 63% (CI 50%-73%); specificity is 100% (CI 39%-100%). Positive and negative predictive values of esophageal screening were 100% and 13%, respectively.

Conclusions: Esophageal screening identified 44/70 (63%) patients with esophageal disease. Esophageal screening is a simple tool that may guide further esophageal investigation. The sensitivity of esophageal screening is limited (63%). If clinical suspicion is high, formal esophagram should be considered.