Thoughts on sustainability in the use of iodinated contrast media in CT: a practice-oriented review based on the example of a hospital and a private practice.

Abstract

Iodinated contrast media (CM) have become indispensable in computed tomography (CT), angiography, and cardiac cathlab as well as in other X-ray-based procedures, for example in urology. In this context, iodinated CM are released into the environment in particular via patient excretions along with other trace substances. At the same time, the use of iodinated CM also involves CM leftovers as well as packaging and consumables.In order to reduce the discharge of iodinated CM into the environment and to promote efficient use of resources, awareness of the sustainable and responsible use of iodinated CM and associated consumables is essential. A number of effective measures can contribute to this in the short, medium, and long term. Based on the literature and quantitative data from our own routine, aspects of sustainability when dealing with CM in computed tomography are discussed in this review using the example of a hospital and a private practice.When planning and performing contrast-enhanced CT examinations, personalized CM protocols can make CM use more efficient. Some CM manufacturers offer recycling programs for CM leftovers. The collection of CM excretions after CM injections using urine bags might have a major impact on reducing the discharge of iodinated CM into the environment. In addition, responsible use of consumables and packaging material, in particular the use of multi-patient systems, can make a valuable contribution to waste avoidance and resource conservation. All of these measures can ultimately be fully effective in terms of protecting the environment and resources if they can be implemented on a broad basis. For this purpose, an even greater focus on the topic of sustainability among all parties involved is desirable. · Sustainable and responsible use of iodinated contrast media is desirable.. · Various measures can be taken today to reduce the environmental impact and conserve resources.. · CM use can be made more efficient by optimizing contrast-enhanced CT examinations.. · Recycling programs for CM leftovers enable their further use.. · Urine bags might have a major impact on reducing the environmental impact..