The Iodine Opportunity for Sustainable Radiology: Quantifying Supply Chain Strategies to Cut Contrast's Carbon and Costs.
Authors
Affiliations (7)
Affiliations (7)
- Oakland University William Beaumont School of Medicine, Rochester, Michigan 48309.
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, MD 21201.
- Department of Radiology, Stanford University School of Medicine, Stanford, CA 94305.
- University of Maryland Institute for Health Computing (UM-IHC), North Bethesda, MD; University of Maryland School of Pharmacy, Baltimore, Maryland 21201.
- Department of Radiology, NYU School of Medicine, New York, NY 10016, United States.
- Department of Radiology, Center for Innovation in Imaging Biomarkers and Integrated Diagnostics (CIMBID), Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, United States.
- University of Maryland Institute for Health Computing (UM-IHC), North Bethesda, MD; University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201. Electronic address: [email protected].
Abstract
To estimate economic and environmental reduction potential of iodinated contrast media (ICM) saving strategies, by examining supply chain data (from iodine extraction through administration) to inform a decision-making framework which can be tailored to local institutional priorities. A 100 mL polymer vial of ICM was set as the standard reference case (SRC) for baseline comparison. To evaluate cost and emissions impacts, four ICM reduction strategies were modeled relative to this SRC baseline: vial optimization, hardware or software (AI-enabled) dose reduction, and multi-dose vial/injector systems. This analysis was then translated into a decision-making framework for radiologists to compare ICM strategies by cost, emissions, and operational feasibility. The supply chain life cycle of a 100 mL iodinated contrast vial produces 1,029 g CO2e, primarily from iodine extraction and clinical use. ICM-saving strategies varied widely in emissions reduction, ranging from 12%-50% nationally. Economically a 125% tariff could inflate national ICM-related costs to $11.9B, the ICM reduction strategy of AI-enhanced ICM systems could lower this expenditure to $2.7B. 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. ICM is a major and modifiable contributor to healthcare carbon emissions. Depending on the utilized ICM-reduction strategy, emissions can be reduced by up to 53% and ICM-related costs by up to 50%. To guide implementation, we developed a decision-making framework that categorizes strategies based on environmental benefit, cost, and operational feasibility, enabling radiology leaders to align sustainability goals with institutional priorities.