Radiology Sustainability—Let’s Start Here!

Living more sustainably has been on my mind recently, and I believe other radiologists may be interested, given our dedication to health care and wellbeing. As a radiologist, we play a crucial role in diagnosing and treating patients, and I strongly believe we can do even more.

Radiology, being an essential component of modern health care, has its environmental impact, particularly in terms of energy consumption and waste generation. However, I believe there are opportunities for positive change. By adopting sustainable practices in our radiology departments, we can reduce our ecological footprint and contribute to a healthier planet.

I’d love to discuss potential initiatives we could undertake together, such as our use of iodinated contrast media (ICM). ICMs accumulate as waste (residual in vials and tubing) and are released into the sewage system by patients who received ICMs. While ICMs are of low toxicity, they may be transformed into other chemicals when undergoing wastewater treatment, and/or drinking water purification. Those byproducts may pose a risk for the aquatic environment and our drinking water.

Following the shortage of iodinated contrast agents during the pandemic, many radiology practices had to adopt practices to decrease the use and waste of iodinated IV contrast. Why not adjust contrast volume for each patient based on body weight, lean body mass, or body surface? Certain imaging techniques can allow reduced IV contrast volumes, currently mostly used for patients with renal disease: low-kV techniques, dual-energy scanning with reconstruction of low-keV images, and contrast boost technique for CT angiography.

Using multi-patient injection systems for bottle sizes up to 500 ml can make IV contrast administration even more efficient by individualizing the amount of contrast material injected without increasing contrast waste. Yes, true, it may require some planning ahead of the imaging day to do this efficiently.

Changing habits can be difficult. Do you switch the lights off when you leave a room in your home? At work? It’s tough to remember to do it. It often feels like a big effort to change habits, and it is unclear whether a small contribution can make a difference.

Hang in here—the 1% rule (“rule of marginal gains”) is the idea that big goals can be achieved through small steps. No need for making big changes overnight. Instead, let’s aim for small daily improvements.

The three “r”s of sustainability—reduce, reuse, recycle—translate to radiology, and there are a few low-hanging fruits worth considering. What about adopting environmentally friendly practices that also save money? Rethinking how we administer iodinated contrast can be a feasible first step.

More reading:

Tackling the increasing contamination of the water supply by iodinated contrast media

Nadja Kadom, MD

Director for Quality, Department of Radiology, Children’s Healthcare of Atlanta
Interim Director for Quality, Department of Radiology and Imaging Sciences, Emory Healthcare
Professor, Emory University School of Medicine

The opinions expressed on RadTeams are those of the author(s); they do not necessarily reflect the viewpoint or position of the editors, reviewers, or publisher.