GI Fluoroscopy: Training vs. Reality

Dr. DiSantis speaks during the opening ceremony of ARRS 2026 in Pittsburgh, PA.

Heartiest of congratulations to Dr. David DiSantis of Mayo Clinic Jacksonville on garnering Best Overall Scientific Program Oral Presentation Abstract at ARRS 2026. “GI Fluoroscopy: What Are We Still Doing?” provides a data-driven roadmap for modernizing trainee education.

Venue Change: Despite the rise of cross-sectional imaging, GI fluoroscopy remains a pillar of clinical practice—with >2.2 million procedures performed nationwide annually. However, where these procedures happen is changing.

By the Numbers: Using 2023 Medicare data, DiSantis et al. revealed a massive disparity in procedure volumes as you move down the alimentary canal:

  • Swallowing studies: 1,085,826
  • Esophagrams: 551,897
  • Upper GI: 409,174
  • Small bowel: 152,967
  • Contrast enemas: 74,445 (Double contrast study considered “moribund” with only 15,302 performed).

Above the Diaphragm: >1.6 million fluoroscopic procedures are concentrated in swallowing studies and esophagrams. To ensure rads-in-training provide useful interpretations in real-world practice, residency programs must shift their emphasis to areas “above the diaphragm.”

RadFYI: Training must follow the volume. This award-winning research proves that mastering the upper GI tract is the most critical skill set for the modern rad performing fluoroscopy.

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