Toia Giuseppe V, Ananthakrishnan Lakshmi
Departments of Radiology and Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison WI; and.
Department of Radiology, UT Southwestern Medical Center, Dallas TX.
J Comput Assist Tomogr. 2025;49(2):203-214. doi: 10.1097/RCT.0000000000001674. Epub 2024 Dec 2.
Iodinated contrast media (ICM) is an integral and ubiquitous component of modern diagnostic imaging. Although most radiology practices are familiar with ICM administration and physiological excretion, they may be less aware of how much ICM is wasted on a per exam basis. Furthermore, radiologists may not recognize the environmental fate of discarded ICM waste. In an evolving world where medical practices are increasingly cognizant of their environmental footprint and radiology practices are considered high consumers of resources, it behooves the radiology community to understand the ICM lifecycle and ways to mitigate unnecessary waste. This review article explains the origin and environmental fate of discarded ICM, with special focus on wastewater contamination. Secondly, the article focuses on feasible options to both optimize use and decrease consumable waste. Specifically, the article addresses ICM vial size inventory diversification, multi-use ICM vials, syringeless contrast injectors, and the potential for using multi-energy imaging (dual-energy or photon counting CT) to accomplish these goals. Finally, the authors share their institutional experience participating in an ICM recycling program and its current departmental impact.
碘化造影剂（ICM）是现代诊断成像中不可或缺且广泛使用的组成部分。尽管大多数放射科操作都熟悉ICM的给药和生理排泄过程，但他们可能不太清楚每次检查会浪费多少ICM。此外，放射科医生可能没有认识到废弃ICM的环境归宿。在一个医疗行业越来越关注其环境足迹且放射科操作被视为高资源消耗行业的不断发展的世界中，放射学界有必要了解ICM的生命周期以及减少不必要浪费的方法。这篇综述文章解释了废弃ICM的来源和环境归宿，特别关注废水污染。其次，文章重点介绍了优化使用和减少耗材浪费的可行方案。具体而言，文章讨论了ICM瓶规格库存多样化、多用途ICM瓶、无针筒造影剂注射器，以及利用多能量成像（双能或光子计数CT）实现这些目标的可能性。最后，作者分享了他们所在机构参与ICM回收计划的经验及其当前对科室的影响。
