Can we use pulsed fluoroscopy to decrease the radiation dose during video fluoroscopic feeding studies in children?

AIM: To investigate whether it is possible to reduce the radiation dose during video fluoroscopic feeding studies below the current 30 frames/s (continuous fluoroscopy). METHODS: Ten consecutive children who had supraglottic penetration while swallowing barium were evaluated as part of a video fluoroscopic feeding study. All fluoroscopic studies were performed with a pulse rate of 30 frames/s. Frame by frame analysis was performed of the first episode of penetration in each patient to determine on how many image frames the penetration could be detected. RESULTS: Supraglottic penetration occurred very rapidly. In seven of the 10 patients, full-depth penetration was only seen on one image frame. In no patient was the full-depth penetration seen in greater than two imaging frames. CONCLUSION: Decreasing the fluoroscopic pulse rate cannot be used as a method of decreasing radiation dose during performance of video fluoroscopic studies because it will potentially result in non-detection of episodes of supraglottic penetration of liquid barium. (C) 2008 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.