Pediatric Esophageal Foreign Body: Possible Role for Digital Tomosynthesis

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Andrew Johansen1, Gregory P Conners, Jacob Lee1

  • 1From the School of Medicine, University of Missouri at Kansas City.

Pediatric Emergency Care
|May 17, 2018
PubMed

Insights

Digital tomosynthesis (DTS) shows high accuracy in detecting radiolucent foreign bodies (FBs) in children

Area of Science:

  • Pediatric Radiology
  • Medical Imaging Technology
  • Gastroenterology

Background:

  • Foreign body (FB) ingestion is a frequent cause of pediatric emergency department visits.
  • Radiolucent FBs, such as food, pose a diagnostic challenge compared to radiopaque objects.
  • Digital tomosynthesis (DTS) offers cross-sectional imaging capabilities similar to traditional radiography.

Purpose of the Study:

  • To evaluate the diagnostic performance of DTS for detecting esophageal foreign bodies in children.
  • To compare the sensitivity and specificity of DTS against esophagram and clinical impression.

Main Methods:

  • Retrospective review of pediatric patients (0-18 years) with suspected esophageal FB.
  • Inclusion of patients who underwent both esophagram and DTS.
  • Analysis of DTS images by three readers, comparing findings with esophagram and discharge diagnosis.

Main Results:

  • DTS demonstrated 100% specificity and 100% positive predictive value in detecting radiolucent esophageal FBs.
  • Compared to esophagram, DTS showed a sensitivity of 44% and a negative predictive value of 62%.
  • Compared to clinical impression, DTS had a sensitivity of 33% and a negative predictive value of 38%.

Conclusions:

  • Chest DTS is a highly specific and promising imaging modality for ruling in radiolucent esophageal foreign bodies in children.
  • DTS exhibits a very high positive predictive value for identifying these challenging FBs.
  • Further investigation may refine DTS's role in pediatric FB detection.
Abstract

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