title: Evaluation of dysphagia by novel real-time MRI.
abstract: OBJECTIVE
  To assess safety and feasibility of real-time (RT) MRI for evaluation of dysphagia and to compare this technique to standard assessment by flexible endoscopic evaluation of swallowing (FEES) and videofluoroscopy (VF) in a cohort of patients with inclusion body myositis (IBM).
  
  
  METHODS
  Using RT-MRI, FEES, and VF, an unselected cohort of 20 patients with IBM was studied as index disease with a uniform dysphagia. Symptoms of IBM and dysphagia were explored by standardized tools including Swallowing-Related Quality of Life Questionnaire (SWAL-QoL), IBM Functional Rating Scale, Patient-Reported Functional Assessment, and Medical Research Council Scale.
  
  
  RESULTS
  Dysphagia was noted in 80% of the patients and SWAL-QoL was impaired in patients with IBM compared to published reference values of healthy elderly. Swallowing in a supine position during RT-MRI was well-tolerated by all patients. RT-MRI equally revealed dysphagia compared to VF and FEES and correlated well with the SWAL-QoL. Only RT-MRI allowed precise time measurements and identification of the respective tissue morphology. The pharyngeal transit times were 2-fold longer compared to published reference values and significantly correlated with morphologic abnormalities.
  
  
  CONCLUSIONS
  RT-MRI is safe and equally capable as VF to identify the cause of dysphagia in IBM. Advantages of RT-MRI include visualization of soft tissue, more reliable timing analysis, and lack of X-ray exposure. RT-MRI may become a routine diagnostic tool for detailed assessment of the esophagus and other moving parts of the body, facilitating longitudinal evaluations in daily practice and clinical trials.
authors: From the Departments of Otorhinolaryngology, Phoniatrics and Pedaudiology (A.O.), Neurology (P.-O.C., J.S.), Diagnostic and Interventional Radiology (E.v.F., J.L.), and Medical Statistics (T.F.), University Medical Center Göttingen; and Biomedizinische NMR Forschungs GmbH at the Max-Planck-Institute for Biophysical Chemistry (S.Z., J.F.), Göttingen, Germany. j.schmidt@gmx.org olthoff@med.uni-goettingen.de.
authors: Arno
authors: A
authors: Olthoff
authors: From the Departments of Otorhinolaryngology, Phoniatrics and Pedaudiology (A.O.), Neurology (P.-O.C., J.S.), Diagnostic and Interventional Radiology (E.v.F., J.L.), and Medical Statistics (T.F.), University Medical Center Göttingen; and Biomedizinische NMR Forschungs GmbH at the Max-Planck-Institute for Biophysical Chemistry (S.Z., J.F.), Göttingen, Germany.
authors: Per-Ole
authors: PO
authors: Carstens
authors: From the Departments of Otorhinolaryngology, Phoniatrics and Pedaudiology (A.O.), Neurology (P.-O.C., J.S.), Diagnostic and Interventional Radiology (E.v.F., J.L.), and Medical Statistics (T.F.), University Medical Center Göttingen; and Biomedizinische NMR Forschungs GmbH at the Max-Planck-Institute for Biophysical Chemistry (S.Z., J.F.), Göttingen, Germany.
authors: Shuo
authors: S
authors: Zhang
authors: From the Departments of Otorhinolaryngology, Phoniatrics and Pedaudiology (A.O.), Neurology (P.-O.C., J.S.), Diagnostic and Interventional Radiology (E.v.F., J.L.), and Medical Statistics (T.F.), University Medical Center Göttingen; and Biomedizinische NMR Forschungs GmbH at the Max-Planck-Institute for Biophysical Chemistry (S.Z., J.F.), Göttingen, Germany.
authors: Eva
authors: E
authors: von Fintel
authors: From the Departments of Otorhinolaryngology, Phoniatrics and Pedaudiology (A.O.), Neurology (P.-O.C., J.S.), Diagnostic and Interventional Radiology (E.v.F., J.L.), and Medical Statistics (T.F.), University Medical Center Göttingen; and Biomedizinische NMR Forschungs GmbH at the Max-Planck-Institute for Biophysical Chemistry (S.Z., J.F.), Göttingen, Germany.
authors: Tim
authors: T
authors: Friede
authors: From the Departments of Otorhinolaryngology, Phoniatrics and Pedaudiology (A.O.), Neurology (P.-O.C., J.S.), Diagnostic and Interventional Radiology (E.v.F., J.L.), and Medical Statistics (T.F.), University Medical Center Göttingen; and Biomedizinische NMR Forschungs GmbH at the Max-Planck-Institute for Biophysical Chemistry (S.Z., J.F.), Göttingen, Germany.
authors: Joachim
authors: J
authors: Lotz
authors: From the Departments of Otorhinolaryngology, Phoniatrics and Pedaudiology (A.O.), Neurology (P.-O.C., J.S.), Diagnostic and Interventional Radiology (E.v.F., J.L.), and Medical Statistics (T.F.), University Medical Center Göttingen; and Biomedizinische NMR Forschungs GmbH at the Max-Planck-Institute for Biophysical Chemistry (S.Z., J.F.), Göttingen, Germany.
authors: Jens
authors: J
authors: Frahm
authors: From the Departments of Otorhinolaryngology, Phoniatrics and Pedaudiology (A.O.), Neurology (P.-O.C., J.S.), Diagnostic and Interventional Radiology (E.v.F., J.L.), and Medical Statistics (T.F.), University Medical Center Göttingen; and Biomedizinische NMR Forschungs GmbH at the Max-Planck-Institute for Biophysical Chemistry (S.Z., J.F.), Göttingen, Germany. j.schmidt@gmx.org olthoff@med.uni-goettingen.de.
authors: Jens
authors: J
authors: Schmidt
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects / Q000379:methods*; D008297:Male; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D014741:Video Recording