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

To investigate whether it is possible to reduce the radiation dose during video fluoroscopic feeding studies below the current 30 frames/s (continuous fluoroscopy).

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.

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.

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.