Radiation Exposure During Contrast-Enhanced Videofluoroscopic Swallow Studies in Dogs and Cats

Contrast-enhanced videofluoroscopic swallow studies are considered the gold standard diagnostic for determining underlying etiologies of dysphagia. Swallow studies are commonly performed procedures utilizing fluoroscopy in which personnel are exposed to ionizing radiation. The study objective was to document radiation exposure to individual personnel involved in performing gastrointestinal swallow studies in dogs and cats, compare radiation exposure based on the localization of disease, and evaluate radiation exposure based on the experience (i.e., year of training) of the diagnostic imaging resident. This prospective observational study population was comprised of 61 client-owned animals, 58 dogs and 3 cats, presenting to a university teaching hospital over 8 months. Dose was evaluated for positions/roles: position 1 (personnel feeding/at patient head), position 2/3 (restraining), and position 4 (image acquisition). Patient characteristics, diagnosis(es), fluoroscopy time, radiation dose, and personnel positions were recorded. A linear mixed effects model was utilized for statistical analysis. Radiation dose based on anatomic disease location (e.g., cricopharyngeal, esophageal, gastroesophageal, none) was not statistically significant (p = .438). Th effect of personnel position (p < .001) and fluoroscopy time (p = .005) was statistically significant. The lowest median radiation dose was for personnel acquiring images (position 4), estimated at 16.38 µSv. The highest median radiation dose was for personnel feeding patients (position 1), estimated at 48.13 µSv. Unsurprisingly, personnel positioned closer to the radiation source during contrast-enhanced videofluoroscopic swallow studies were exposed to higher radiation doses. Personnel should be aware of this occupational hazard. Rotation of personnel roles (e.g., feeding, restraining, image acquisition) should be considered to limit dose to specific personnel.