ACR Appropriateness Criteria ® Dysphagia

Expert Panel on Gastrointestinal Imaging

Research output: Contribution to journalArticle

Abstract

This review summarizes the relevant literature for the initial imaging of patients with symptoms of dysphagia. For patients with oropharyngeal dysphagia who have an underlying attributable cause, a modified barium swallow is usually appropriate for initial imaging but for those who have unexplained dysphagia a fluoroscopic biphasic esophagram is usually appropriate. Fluoroscopic biphasic esophagram is usually appropriate for initial imaging in both immunocompetent and immunocompromised patients who have retrosternal dysphagia. For postoperative patients with dysphagia, fluoroscopic single-contrast esophagram and CT neck and chest with intravenous (IV) contrast are usually appropriate for oropharyngeal or retrosternal dysphagia occurring in the early postoperative period where water-soluble contrast is usually preferred rather than barium sulfate. In the later postoperative period (greater than 1 month), CT neck and chest with IV contrast and fluoroscopic single-contrast esophagram are usually appropriate. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Original languageEnglish (US)
Pages (from-to)S104-S115
JournalJournal of the American College of Radiology
Volume16
Issue number5
DOIs
StatePublished - May 1 2019

Fingerprint

Deglutition Disorders
Postoperative Period
Neck
Thorax
Guidelines
Barium Sulfate
Expert Testimony
Immunocompromised Host
Barium
Deglutition
Radiology
Water
Therapeutics

Keywords

  • Appropriate Use Criteria
  • Appropriateness Criteria
  • AUC
  • CT
  • Dysphagia
  • Esophagram
  • Esophagus
  • Modified barium swallow
  • Oropharynx

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

ACR Appropriateness Criteria ® Dysphagia . / Expert Panel on Gastrointestinal Imaging.

In: Journal of the American College of Radiology, Vol. 16, No. 5, 01.05.2019, p. S104-S115.

Research output: Contribution to journalArticle

Expert Panel on Gastrointestinal Imaging. / ACR Appropriateness Criteria ® Dysphagia In: Journal of the American College of Radiology. 2019 ; Vol. 16, No. 5. pp. S104-S115.
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