The value of pharyngeal scintigraphy in predicting videofluoroscopic findings

Objective: The aim of this study was to evaluate the correlation between scintigraphy and videofluoroscopy (VFS) in swallowing evaluation and the ability of scintigraphy to predict penetration/aspiration in VFS. Design: This is a case-control study enrolling 50 patients with dysphagia who received scintigraphy and VFS and 18 age-matched control subjects who received scintigraphy alone. Three parameters were compared between scintigraphy and VFS: premature pharyngeal entry, pharyngeal transit time, and postswallow pharyngeal stasis, with cutoff values defining dysfunction of 3% or greater, 1.2 secs or longer, and 9% or greater, respectively. Results: The correlation coefficients were fair to good between scintigraphy and VFS (r = 0.678, 0.837, and 0.721 for premature pharyngeal entry, pharyngeal transit time, and postswallow pharyngeal stasis, respectively, P < 0.05). The scintigraphy parameters also had good predictive value for the VFS findings, with sensitivity, specificity, positive predictive values, and negative predictive values between 70% and 95%. Scintigraphy had good sensitivity in detecting 91% of aspirations and 81% of penetrations and/or aspirations in VFS if one of the three parameters was abnormal; however, the specificities were low (46% and 52% for scintigraphy and VFS, respectively). Conclusions: The measurements of premature pharyngeal entry, pharyngeal transit time, and postswallow pharyngeal stasis by scintigraphy were correlated with those of VFS. Scintigraphy also had good sensitivity in detecting penetration and/or aspiration in VFS.