Simultaneous electrical impedance tomography and videofluoroscopy in the assessment of swallowing

Simultaneous videofluoroscopy and electrical impedance tomography (EIT) were performed in 13 patients. Subjects swallowed a low-conductivity and a higher-conductivity bolus of between 5 and 20 ml. EIT images from the two swallows were then subtracted to cancel out movement related changes. The peak in the conductivity change was most closely associated in time with a point at which the pharynx is filled with bolus: this suggests that the subtraction process does produce data and images which are related to the bolus rather than to movement of involved structures. The full width at 50% and 75% of the maximum of the time conductivity plot was correlated with the time taken for the bolus to be cleared from the mouth (r = 0.63 and 0.68 respectively, p < 0.05 for both). Despite the sampling frequency of only 9 frames s-1, compared to 50 frames s-1 for videofluoroscopy, EIT recordings from the neck are able to detect the presence of a conductive bolus in the pharynx and for the first time the relationship between parameters of an EIT time-conductivity plot and a measure of bolus transit using an accepted technique has been established.