Medical Professionals: Radiologists' Role in Decreasing Unused Iodinated Contrast Material
In the realm of healthcare, waste reduction is a crucial concern, and one area that has garnered significant attention is the reduction of Iodinated Contrast Media (ICM) waste. Two pilot studies, published in 2024 in the Netherlands and Germany, have shown promising results in this regard, reducing ICM waste by approximately 45%.
The studies, led by Mateusz Chodorowski, MD, focused on the use of urine recuperation bags. However, it's important to note that these studies did not repeat the earlier fact about ICM waste occurring through patients releasing contrast waste through urine.
The medical industry has been actively working towards the recuperation and recycling of ICM. Companies such as RadiServe, Guerbet, and GE Healthcare are among those involved in this endeavour.
Chodorowski, a prominent figure in this field, has been advocating for the use of multipatient injectors due to potential cost savings. A study he led this year found that multipatient injectors resulted in 4.5 gallons of ICM waste compared to 25 gallons from single-patient injectors.
However, it's not just about the equipment. Successful waste reduction requires teamwork, including collaborating with technicians, industry vendors, patients, and legislators.
ICM waste can contaminate public water systems, a concern that has been highlighted in previous studies, which have found these contaminants in freshwater samples in several European countries. When ICM interacts with chlorine and chloramine, it creates iodinated disinfection byproducts, which are cytotoxic and genotoxic.
Recycling bags for contrast media, while beneficial, can lead to waste affecting air quality when burned. Therefore, it's essential to consider the entire lifecycle of these waste management solutions.
In an effort to further reduce ICM waste, Chodorowski has highlighted urine recuperation strategies with special toilets for ICM extraction. However, the high costs of specialized filters and toilet systems present a challenge. Patients needing to use these toilets must have digital codes assigned to them.
The use of these urine recuperation bags led to little to no changes in workflows in the studies. Chodorowski had to change the workflow of his department within the hospital to accommodate a single urine recuperation filter, which can accommodate up to 500 patients.
The medical industry has made strides in recuperating and recycling ICM. Examples include GE Healthcare's recycling facility in Norway, Bayer's re:contrast program, and Bracco's reverse osmosis systems.
Radiologists can also play a significant role in reducing ICM waste. They can do this by reducing contrast use, assessing patient needs, adjusting injection volumes, and using low kVpeak, photon-counting CT (PCCT), and AI to reduce doses.
In conclusion, reducing ICM waste is a collaborative effort that requires the participation of radiologists, technicians, industry vendors, patients, and legislators. By working together, we can not only reduce waste but also improve public health and protect our environment.
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