Esophageal Scintigraphy in Systemic Sclerosis: A Simplified Imaging and Reporting Method

Patients suffering from systemic sclerosis can suffer from significant esophageal dysmotility. Standard tests such as esophageal manometry are invasive and can be distressing to the patient. Esophageal scintigraphy would be ideal, but most protocols are too time consuming for a busy clinical department. The aim of this study was to produce an optimal imaging and reporting protocol that would allow esophageal scintigraphy to become a standard clinical tool. Methods: We imaged 301 patients using a single swallow of a radiolabeled puree meal with the patient erect and in the supine position. A condensed image was produced, which was reported semiquantitatively using a five-point grading scale (0-4), where 0 was normal and 4 represented severe dysmotility. Results: All patients, even those with severe dysphagia, were able to tolerate the test. A sample of 25 studies was reported twice by two observers, who were blind to this study. There was no significant intraor interobserver variation. Conclusion: We recommend this method in routine assessment of patients with systemic sclerosis.