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Published on: March 1, 2015
Contribution of Swallow Studies to Cumulative Radiation Exposure in Infants in the Neonatal Intensive Care Unit
Pamela Dodrill1,2, Samuel Chutkow1, Katherine Gibson1
1Brigham and Women's Hospital, Boston, MA.
Insights
Infants in the neonatal intensive care unit (NICU) received minimal radiation exposure from videofluoroscopic swallow studies (VFSS), supporting their continued safe use when clinically indicated.
Area of Science:
- Neonatal imaging
- Pediatric radiology
- Radiation safety
Background:
- Neonatal intensive care units (NICUs) frequently utilize radiographic imaging for diagnosis.
- Quantifying radiation exposure from various procedures is crucial for infant safety.
Purpose of the Study:
- To quantify ionizing radiation exposure in infants undergoing videofluoroscopic swallow studies (VFSS).
- To compare VFSS radiation exposure with other common radiographic modalities in the NICU.
Main Methods:
- Retrospective review of demographic and clinical data for infants in a Level III NICU over 3 years.
- Calculation of total radiographic examinations, mean effective dose (mSv), and proportional exposure by modality.
- Stratification of infants by gestational age (GA) at birth.
Main Results:
- Chest X-rays comprised the majority of exams (63%) and radiation exposure (47%).
- VFSS accounted for only 3% of exams and 15% of cumulative radiation exposure.
- Infants born <28 weeks GA had the highest cumulative exposure, primarily from chest and abdominal imaging.
Conclusions:
- VFSS contributes minimally to overall infant radiation exposure in the NICU.
- The findings support the continued safe use of VFSS when clinically indicated for diagnostic swallow evaluations.
Purpose:
This study aimed to quantify exposure to ionizing radiation in infants undergoing VFSS in a Level III neonatal intensive care unit (NICU) and compare with other common radiographic modalities.
Method:
Demographic and clinical data were collected from the medical records for infants admitted to the NICU for ≥ 72 hr over a 3-year period (mid-2022 to 2025). Infants were stratified by gestational age (GA) at birth. Total radiographic examinations, mean effective dose (mSv), and proportional exposure by modality were calculated based on established reference values.
Results:
Among 2,230 infants, 10,958 procedures of interest were performed, with a mean cumulative radiation exposure of 0.095 mSv per infant. Chest X-rays accounted for both the largest number of exams and the highest contribution to cumulative radiation exposure (63% and 47%, respectively), followed by babygrams (19%; 24%), abdominal X-rays (15%; 14%), and VFSSs (3%; 15%). The subset of infants born below 28 weeks GA underwent the greatest number of exams and had the highest cumulative radiation exposure, primarily from chest and abdominal imaging. In contrast, relative VFSS use was higher in infants born ≥ 37 weeks GA compared to other GA groups within the NICU, though overall radiation exposure was low in this subset.
Conclusion:
Although VFSS contributed to infant cumulative radiation exposure in the NICU, its relative and actual contribution was minimal; this supports the ongoing use of diagnostic swallow studies safely when clinically indicated.
