Parametric oesophageal multiple swallow scintigraphy for validation of dysphageal symptoms during external beam irradiation of mediastinal tumours

The aim of the study was to evaluate dysphageal symptoms and to measure the effect of local analgesic treatment using parametric oesophageal multiple swallow scintigraphy (PES) during external beam irradiation of the mediastinal region. Fifteen patients (most with lung cancer) with dysphagia grade II underwent PES during external beam radiotherapy of the mediastinum before and after application of local analgesics. Dynamic parametric condensed images were recorded. The intensity of clinical symptoms was correlated with the emptying rate at 10 s (ER-10 s) and the mean transit time (MTT). Visual analysis of the images was performed and the results were correlated with the fields of irradiation portals. Of the 15 patients, 12 showed a correlation between irradiation portals and the region of oesophageal motility disorder. Concordant results of clinical symptoms and PES data were found. In nine patients with a decrease in dysphagia following local analgesia, an increase in mean ER-10 s and a decrease in MTT were observed. In three patients with deterioration in clinical symptoms after analgesic treatment, a similar decrease in mean ER-10 s was found, though MTT remained constant. In three patients with normal values, motility disorders were detected in the dynamic study. In conclusion, PES was found to be a sensitive tool for the validation of dysphageal symptoms in patients during external beam irradiation of mediastinal tumours and for the evaluation and quantification of the efficacy of local analgesic treatment. Additional visual analysis of the dynamic study is helpful in diagnosing minimal disorders. (orig.)