Rethinking contrast media deployment could save healthcare system billions
New approaches to contrast media deployment could potentially save the healthcare system billions while also helping preserve the planet.
Imaging utilization is predicted to double over the next decade with an associated uptick in the utilization of iodinated contrast, experts detailed Oct. 2 in JACR. This comes with a corresponding impact on the environment, given the resources needed to procure and distribute such finite resources.
Researchers recently aimed to assess the impact of various strategies to mitigate contrast use. They found these approaches could reduce emissions by up to 53% while also cutting costs nearly in half.
“[Iodinated contrast media] is a major modifiable contributor to healthcare’s environmental impact and also cost for a radiology practice,” radiologist Florence X. Doo, MD, director of innovation at the University of Maryland, and co-authors concluded. “By integrating ICM stewardship into clinical practice and strategic planning, radiology can take meaningful steps to leading healthcare sustainability efforts through informed, data-driven decisions.”
For the study, researchers used a 100 mL polymer vial of contrast media as the standard reference case for baseline comparison. They modeled the impact of four different strategies to reduce contrast utilization. These included vial optimization, hardware or software (artificial intelligence enabled) dose reduction, and multi-dose vial/injector systems.
Doo and colleagues estimated the supply chain life cycle of a 100 mL vial produces about 1,029 g CO2e, primarily driven by iodine extraction and clinical use. The four strategies were able to reduce such emissions nationwide by between 12% and 50%, the modeling study found. A 125% tariff could potentially inflate national iodinated contrast-related costs to approximately $11.9 billion, and the strategy of AI-enhanced dose reduction could cut this figure down to $2.7 billion, the study’s authors estimated.
“Institutional analysis reveals that the ICM savings from high-capital upfront investment strategies can offset their initial investment, highlighting important trade-offs for implementation decision-making,” Doo et al. noted.
The study further proposes a data-driven decision framework, helping to categorize contrast-saving strategies based on their environmental benefit, cost and operational feasibility. This can help radiology providers to prioritize changes that best fit their clinical and operational capacity.
“Our decision framework highlights that while high-reduction [iodinated contrast media] strategies offer maximal environmental benefit, lower-complexity interventions may provide more immediate, scalable impact across diverse clinical settings,” the authors wrote. “Tailoring interventions based on local practice capacity and priorities can lead to more meaningful, sustainable optimization.”
Read much more, including potential study limitations, in the Journal of the American College of Radiology.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.