Oro‐pharyngo‐esophageal radionuclide scintigraphy predicts aspiration pneumonia risk and associated survival in post‐irradiated nasopharyngeal carcinoma patients
Abstract Objective To demonstrate that oro‐pharyngo‐esophageal radionuclide scintigraphy (OPERS) not only detects tracheobronchial aspiration after swallowing, but also quantifies the amount of aspiration and subsequent clearance. Methods Data collected between 2014 and 2019 were reviewed for aspira...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-02-01
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| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.704 |
| _version_ | 1818284832434683904 |
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| author | Peter K. M. Ku Ki Wang Alexander C. Vlantis Evelyn W. K. Tang Thomas S. C. Hui Ronald Lai Zenon W. C. Yeung Ryan H. W. Cho Thomas Law Simon Y. P. Chan Becky Y. T. Chan Jeffrey K. T. Wong Andrew vanHasselt Michael C. F. Tong |
| author_facet | Peter K. M. Ku Ki Wang Alexander C. Vlantis Evelyn W. K. Tang Thomas S. C. Hui Ronald Lai Zenon W. C. Yeung Ryan H. W. Cho Thomas Law Simon Y. P. Chan Becky Y. T. Chan Jeffrey K. T. Wong Andrew vanHasselt Michael C. F. Tong |
| author_sort | Peter K. M. Ku |
| collection | DOAJ |
| description | Abstract Objective To demonstrate that oro‐pharyngo‐esophageal radionuclide scintigraphy (OPERS) not only detects tracheobronchial aspiration after swallowing, but also quantifies the amount of aspiration and subsequent clearance. Methods Data collected between 2014 and 2019 were reviewed for aspiration pneumonia at 12 and 24‐months after OPERS. The predictive value for aspiration pneumonia on flexible endoscopic evaluation of swallowing (FEES), videofluoroscopic swallowing study (VFSS), and OPERS, and the overall survival of patients with or without aspiration were determined. Results Thirty‐seven patients treated with radiotherapy for nasopharyngeal carcinoma (NPC) were reviewed. The incidence of aspiration detected on FEES, VFSS, and OPERS was 78.4%, 66.7%, and 44.4%, respectively. Using VFSS as a gold standard, the sensitivity and specificity of OPERS for aspiration was 73.7% and 100%. The positive and negative predictive values for aspiration were 100% and 66.7%, respectively, with an overall accuracy of 82.8%. A history of aspiration pneumonia was one factor associated with a higher chance of subsequent aspiration pneumonia within 12 months (odds ratio: 15.5, 95% CI 1.67–145.8, p < .05) and 24 months (odds ratio: 23.8, 95% CI 3.69–152.89, p < .01) of the swallowing assessment. Aspiration detected by OPERS was a significant risk factor for future aspiration pneumonia at 12 and 24 months respectively. Significantly, better survival was associated with an absence of aspiration on OPERS only, but not on FEES or VFSS. Conclusion OPERS predicts the safety of swallowing, the incidence of subsequent aspiration pneumonia, and the survival prognosis in post‐irradiated NPC dysphagia patients. Level of Evidence 3. |
| first_indexed | 2024-12-13T00:59:04Z |
| format | Article |
| id | doaj.art-2e573b12e23a4d8f9417a8402171a369 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-12-13T00:59:04Z |
| publishDate | 2022-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-2e573b12e23a4d8f9417a8402171a3692022-12-22T00:04:43ZengWileyLaryngoscope Investigative Otolaryngology2378-80382022-02-017117017910.1002/lio2.704Oro‐pharyngo‐esophageal radionuclide scintigraphy predicts aspiration pneumonia risk and associated survival in post‐irradiated nasopharyngeal carcinoma patientsPeter K. M. Ku0Ki Wang1Alexander C. Vlantis2Evelyn W. K. Tang3Thomas S. C. Hui4Ronald Lai5Zenon W. C. Yeung6Ryan H. W. Cho7Thomas Law8Simon Y. P. Chan9Becky Y. T. Chan10Jeffrey K. T. Wong11Andrew vanHasselt12Michael C. F. Tong13Department of Otorhinolaryngology—Head and Neck Surgery United Christian Hospital and Tseung Kwan O Hospital New Territories Hong KongDepartment of Imaging and Interventional Radiology Prince of Wales Hospital Shatin New Territories Hong KongDepartment of Otorhinolaryngology, Head and Neck Surgery The Chinese University of Hong Kong, Prince of Wales Hospital Shatin New Territories Hong KongDepartment of Imaging and Interventional Radiology Prince of Wales Hospital Shatin New Territories Hong KongDepartment of Otorhinolaryngology—Head and Neck Surgery United Christian Hospital and Tseung Kwan O Hospital New Territories Hong KongDepartment of Otorhinolaryngology—Head and Neck Surgery United Christian Hospital and Tseung Kwan O Hospital New Territories Hong KongDepartment of Otorhinolaryngology—Head and Neck Surgery United Christian Hospital and Tseung Kwan O Hospital New Territories Hong KongDepartment of Otorhinolaryngology—Head and Neck Surgery United Christian Hospital and Tseung Kwan O Hospital New Territories Hong KongDepartment of Otorhinolaryngology, Head and Neck Surgery The Chinese University of Hong Kong, Prince of Wales Hospital Shatin New Territories Hong KongDepartment of Speech Therapy Prince of Wales Hospital Shatin New Territories Hong KongDepartment of Speech Therapy Prince of Wales Hospital Shatin New Territories Hong KongDepartment of Imaging and Interventional Radiology Prince of Wales Hospital Shatin New Territories Hong KongDepartment of Otorhinolaryngology, Head and Neck Surgery The Chinese University of Hong Kong, Prince of Wales Hospital Shatin New Territories Hong KongDepartment of Otorhinolaryngology, Head and Neck Surgery The Chinese University of Hong Kong, Prince of Wales Hospital Shatin New Territories Hong KongAbstract Objective To demonstrate that oro‐pharyngo‐esophageal radionuclide scintigraphy (OPERS) not only detects tracheobronchial aspiration after swallowing, but also quantifies the amount of aspiration and subsequent clearance. Methods Data collected between 2014 and 2019 were reviewed for aspiration pneumonia at 12 and 24‐months after OPERS. The predictive value for aspiration pneumonia on flexible endoscopic evaluation of swallowing (FEES), videofluoroscopic swallowing study (VFSS), and OPERS, and the overall survival of patients with or without aspiration were determined. Results Thirty‐seven patients treated with radiotherapy for nasopharyngeal carcinoma (NPC) were reviewed. The incidence of aspiration detected on FEES, VFSS, and OPERS was 78.4%, 66.7%, and 44.4%, respectively. Using VFSS as a gold standard, the sensitivity and specificity of OPERS for aspiration was 73.7% and 100%. The positive and negative predictive values for aspiration were 100% and 66.7%, respectively, with an overall accuracy of 82.8%. A history of aspiration pneumonia was one factor associated with a higher chance of subsequent aspiration pneumonia within 12 months (odds ratio: 15.5, 95% CI 1.67–145.8, p < .05) and 24 months (odds ratio: 23.8, 95% CI 3.69–152.89, p < .01) of the swallowing assessment. Aspiration detected by OPERS was a significant risk factor for future aspiration pneumonia at 12 and 24 months respectively. Significantly, better survival was associated with an absence of aspiration on OPERS only, but not on FEES or VFSS. Conclusion OPERS predicts the safety of swallowing, the incidence of subsequent aspiration pneumonia, and the survival prognosis in post‐irradiated NPC dysphagia patients. Level of Evidence 3.https://doi.org/10.1002/lio2.704aspirationdysphagianasopharyngeal carcinomapneumoniaradionuclide scintigraphy |
| spellingShingle | Peter K. M. Ku Ki Wang Alexander C. Vlantis Evelyn W. K. Tang Thomas S. C. Hui Ronald Lai Zenon W. C. Yeung Ryan H. W. Cho Thomas Law Simon Y. P. Chan Becky Y. T. Chan Jeffrey K. T. Wong Andrew vanHasselt Michael C. F. Tong Oro‐pharyngo‐esophageal radionuclide scintigraphy predicts aspiration pneumonia risk and associated survival in post‐irradiated nasopharyngeal carcinoma patients Laryngoscope Investigative Otolaryngology aspiration dysphagia nasopharyngeal carcinoma pneumonia radionuclide scintigraphy |
| title | Oro‐pharyngo‐esophageal radionuclide scintigraphy predicts aspiration pneumonia risk and associated survival in post‐irradiated nasopharyngeal carcinoma patients |
| title_full | Oro‐pharyngo‐esophageal radionuclide scintigraphy predicts aspiration pneumonia risk and associated survival in post‐irradiated nasopharyngeal carcinoma patients |
| title_fullStr | Oro‐pharyngo‐esophageal radionuclide scintigraphy predicts aspiration pneumonia risk and associated survival in post‐irradiated nasopharyngeal carcinoma patients |
| title_full_unstemmed | Oro‐pharyngo‐esophageal radionuclide scintigraphy predicts aspiration pneumonia risk and associated survival in post‐irradiated nasopharyngeal carcinoma patients |
| title_short | Oro‐pharyngo‐esophageal radionuclide scintigraphy predicts aspiration pneumonia risk and associated survival in post‐irradiated nasopharyngeal carcinoma patients |
| title_sort | oro pharyngo esophageal radionuclide scintigraphy predicts aspiration pneumonia risk and associated survival in post irradiated nasopharyngeal carcinoma patients |
| topic | aspiration dysphagia nasopharyngeal carcinoma pneumonia radionuclide scintigraphy |
| url | https://doi.org/10.1002/lio2.704 |
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