With a U.S. health-care system that is responsible for 9.8% of America’s greenhouse gas emissions, some radiology departments are pursuing ways to reduce waste and institute sustainable practices.
Benjamin E. Northrup, MD, assistant professor of radiology and a passionate climate change advocate, is especially focused on improving sustainability within his specialty, musculoskeletal imaging and intervention. A single interventional radiology case produces an average of 8 kilograms of waste, with coil placements and embolization the biggest offenders.
Through his work with Radiologists for a Sustainable Future, an independent advocacy group with ties to a variety of organizations including the ACR and RSNA, Northrup learned of a free GE Healthcare contrast recycling program. With the low overhead and ease of implementation, he considered it a clear win for waste reduction and got to work on presenting the initiative to leadership and procuring the necessary equipment.
MIR became one of the first 10 institutions in the U.S. to implement the program, which consists of recycling unused, uncontaminated iodinated contrast material. The contrast is saved in a dedicated container and sent to a processing facility, where the iodine is extracted and used to produce new contrast.
In about a year of program operation, MIR has avoided more than 220 liters of contrast waste filling 61 containers — at no cost to the department. The program is currently active across six School of Medicine/BJC HealthCare imaging locations.
“Not only does this promote sustainable practice, but it’s critical to ensuring the future of our specialty,” Northrup said. “Radiology is a large contributor to medical waste, so it’s our duty to do what we can, particularly in the case of iodinated contrast.” Since iodine is a nonrenewable resource, reducing contrast usage and recycling contrast can modify the iodine lifecycle, ultimately extending reserves and lowering extraction costs.
While current contrast recycling efforts are largely limited to one type of contrast, Northrup is hopeful for the development of another sustainable method that would expand recycling capabilities: multidose iodinated contrast packaging and delivery systems. These systems, which are the focus of a recent study at Vanderbilt University, would markedly reduce the waste associated with typical single-dose vials.
“Right now, if we perform a contrast-enhanced CT and a patient needs 125 milliliters, we are often restricted to using 100-milliliter vials, meaning we’d would waste 75 milliliters on the second vial,” Northrup explained. “With this technology, we could potentially use a larger vial with the ability to safely spread the dose among multiple patients with comparatively minimal waste.”
Published in Focal Spot Fall 2024 Issue