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Ghotra SS, Champendal M, Flaction L, Ribeiro RT, Sá Dos Reis C. Approaches to reduce medical imaging departments' environmental impact: A scoping review. Radiography (Lond) 2024; 30 Suppl 1:108-116. [PMID: 39146889 DOI: 10.1016/j.radi.2024.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 08/17/2024]
Abstract
INTRODUCTION Global warming stands as a paramount public health issue of our time, and it is fundamental to explore approaches to green medical imaging departments/(MID). This study aims to map the existing actions in the literature that promote sustainable development in MID towards the promotion of environmental impact reduction. METHODS Following the JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), this literature search was conducted on MEDLINE, Embase and CINAHL to encompass studies published after 2013. Combinations of keywords and relevant terms related to environmental sustainability, recycling, medical waste, and greening radiology were applied for this review. Three independent reviewers screened abstracts, titles, and eligible full-text. Disagreement was solved through consensus. RESULTS 38 out of 4630 articles met all inclusion criteria, and four additional articles were identified and added through reference search. A third of the studies included were published after 2022, and most were conducted in developed countries (36/41). Articles focused on computed tomography (9/41), magnetic resonance imaging (6/41), interventional radiology (4/41), conventional radiography (4/41), ultrasound (2/41), mixed modalities (10/41), or not applicable to an imaging modality (6/41). Four principal categories were identified to decrease ecological footprint: energy consumption, waste management, justification and environmental pollution. CONCLUSION To minimise the environmental impact of MIDs raising awareness and promoting education is fundamental. Examinations must be justified adequately, energy consumption must be reduced, and waste management practices need to be implemented. Further studies are required to prioritise the most effective strategies, supporting decision-making among stakeholders. IMPLICATIONS FOR PRACTICE Several strategies are already possible to implement to reduce the environmental impact of MIDs and improve the healthcare outcomes for patients.
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Affiliation(s)
- S S Ghotra
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland; Department of Radiology, Hospital of Yverdon-les-Bains (eHnv), 1400, Yverdon-les-Bains, Switzerland.
| | - M Champendal
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
| | - L Flaction
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
| | - R T Ribeiro
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
| | - C Sá Dos Reis
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, 1011, Switzerland.
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2
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Debnath M, Ojha S, Sharma DA, Shah S, Boora N. Role of green and sustainable practices in shaping the future of medical imaging technology: A cross-sectional multi-stakeholder analysis among students, radiographers, and academic experts. Radiography (Lond) 2024; 30:1332-1341. [PMID: 39084131 DOI: 10.1016/j.radi.2024.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 07/19/2024] [Accepted: 07/22/2024] [Indexed: 08/02/2024]
Abstract
INTRODUCTION The detection and treatment of diseases like COVID, diabetes, cancer, cardiovascular conditions, etc., have made medical imaging technology more necessary, so it is expected that the demands of imaging modalities are also increasing and are major contributors to carbon emissions in the healthcare industry. Hence, the Radiology departments, like the rest of the healthcare industry should adapt the procedures to become more sustainable. METHODS A total of 1016 respondents completed the online survey to assess the perception, current practices, and challenges in adopting green and sustainable practices in medical imaging. The radio technologists, teaching faculties, and students of medical imaging were recruited for the study. The survey tool was distributed to the closed groups through social media and emails. RESULTS The majority of participants (66.6%) highlighted the importance of green and sustainable practices in medical imaging whereas only 21.06% of participants seem to have implemented these practices. Most of the participants give positive responses on the use of zero-lead aprons (77%), refurbished medical systems (85.8%), and eco-friendly packaging (89.5%). The mixed response was received from waste segregation and energy-saving measures. The majority (60.3%) of them have no formal education or training. However, they have a good attitude towards the willingness to adopt green practices. CONCLUSIONS There is a gap between perception and implementation of green and sustainable practices due to leadership and information barriers. Comprehensive training for stakeholders of medical imaging is crucial to fully integrate sustainability practices, possibly through webinars or educational modules. IMPLICATIONS FOR PRACTICE The study's findings shed light on how important medical imaging stakeholders view green and sustainable practices as well as potential obstacles to their implementation at the local level whilst suggesting the need for exclusive training on these practices to promote sustainability.
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Affiliation(s)
- M Debnath
- Department of Medical Imaging Technology, Bapubhai Desaibhai Patel Institute of Paramedical Sciences (BDIPS), Charotar University of Science and Technology, Changa, Anand, Gujarat, India.
| | - S Ojha
- Department of Medical Imaging Technology, Bapubhai Desaibhai Patel Institute of Paramedical Sciences (BDIPS), Charotar University of Science and Technology, Changa, Anand, Gujarat, India.
| | - D A Sharma
- Department of Medical Imaging Technology, Bapubhai Desaibhai Patel Institute of Paramedical Sciences (BDIPS), Charotar University of Science and Technology, Changa, Anand, Gujarat, India.
| | - S Shah
- Department of Medical Imaging Technology, Bapubhai Desaibhai Patel Institute of Paramedical Sciences (BDIPS), Charotar University of Science and Technology, Changa, Anand, Gujarat, India.
| | - N Boora
- Radio-Imaging Department, College of Paramedical Sciences, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India.
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3
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Doshi S, Vuppula S, Jaggi P. Healthcare Sustainability to Address Climate Change: Call for Action to the Infectious Diseases Community. J Pediatric Infect Dis Soc 2024; 13:306-312. [PMID: 38758197 DOI: 10.1093/jpids/piae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/05/2024] [Indexed: 05/18/2024]
Abstract
The US healthcare system's contribution to greenhouse gas emissions and climate change is disproportionately high and harms the public. Several medical specialties are now reassessing how they can mitigate healthcare's harmful environmental impact. Healthcare sustainability is broadly defined as measures to decrease greenhouse gas emissions, waste, and other pollutants generated during the healthcare delivery process. Prior efforts and programs by infectious diseases (ID) professionals, such as antimicrobial stewardship and infection prevention and control can form a framework for ID professionals to help apply this expertise to healthcare environmental sustainability more broadly. This call to action proposes strategies for ID societies and professionals to incorporate climate change education for trainees, increase research and funding opportunities in healthcare sustainability, and calls for action by ID societies to champion system changes to decrease greenhouse gas emissions.
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Affiliation(s)
- Shreya Doshi
- Division of Infectious Diseases, Children's National Medical Center, Washington, DC, USA
| | - Sharon Vuppula
- Division of Infectious Diseases, Boston Medical Center, Boston, MA, USA
| | - Preeti Jaggi
- Division of Infectious Diseases and Children's Healthcare of Atlanta, Department of Pediatrics, Emory University, Atlanta, GA, USA
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4
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Ohene-Botwe B, Amedu C, Antwi WK, Abdul-Razak W, Kyei KA, Arkoh S, Mudadi LS, Mushosho EY, Bwanga O, Chinene B, Nyawani P, Mutandiro LC, Piersson AD. Promoting sustainability activities in clinical radiography practice and education in resource-limited countries: A discussion paper. Radiography (Lond) 2024; 30 Suppl 1:56-61. [PMID: 38905726 DOI: 10.1016/j.radi.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVE Urgent global action is required to combat climate change, with radiographers poised to play a significant role in reducing healthcare's environmental impact. This paper explores radiography-related activities and factors in resource-limited departments contributing to the carbon footprint and proposes strategies for mitigation. The rationale is to discuss the literature regarding these contributing factors and to raise awareness about how to promote sustainability activities in clinical radiography practice and education in resource-limited countries. KEY FINDINGS The radiography-related activities and factors contributing to the carbon footprint in resource-limited countries include the use of old equipment and energy inefficiency, insufficient clean energy to power equipment, long-distance commuting for radiological examinations, high film usage and waste, inadequate training and research on sustainable practices, as well as limited policies to drive support for sustainability. Addressing these issues requires a multifaceted approach. Firstly, financial assistance and partnerships are needed to adopt eco-friendly technologies and clean energy sources to power equipment, thus tackling issues related to old equipment and energy inefficiency. Transitioning to digital radiography can mitigate the environmental impact of high film usage and waste, while collaboration between governments, healthcare organisations, and international stakeholders can improve access to radiological services, reducing long-distance commuting. Additionally, promoting education programmes and research efforts in sustainability will empower radiographers with the knowledge to practice sustainably, complemented by clear policies such as green imaging practices to guide and incentivise the adoption of sustainable practices. These integrated solutions can significantly reduce the carbon footprint of radiography activities in resource-limited settings while enhancing healthcare delivery. CONCLUSION Radiography-related activities and factors in resource-limited departments contributing to the carbon footprint are multifaceted but can be addressed through concerted efforts. IMPLICATIONS FOR PRACTICE Addressing the challenges posed by old equipment, energy inefficiency, high film usage, and inadequate training through collaborative efforts and robust policy implementation is essential for promoting sustainable radiography practices in resource-limited countries. Radiographers in these countries need to be aware of these factors contributing to the carbon footprint and begin to work with the relevant stakeholders to mitigate them. Furthermore, there is a need for them to engage in education programmes and research efforts in sustainability to empower them with the right knowledge and understanding to practice sustainably.
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Affiliation(s)
- B Ohene-Botwe
- Department of Midwifery & Radiography, School of Health & Psychological Sciences, City, University of London, Northampton Square, London EC1V 0HB, United Kingdom.
| | - C Amedu
- Department of Midwifery & Radiography, School of Health & Psychological Sciences, City, University of London, Northampton Square, London EC1V 0HB, United Kingdom.
| | - W K Antwi
- Department of Radiography, School of Biomedical & Allied Health Sciences, University of Ghana, Ghana.
| | - W Abdul-Razak
- Department of Medical Imaging, Fatima College of Health Sciences, AI Ain, United Arab Emirates.
| | - K A Kyei
- Department of Radiography, School of Biomedical & Allied Health Sciences, University of Ghana, Ghana.
| | - S Arkoh
- Department of Radiology, York and Scarborough Teaching Hospitals NHS Trust, United Kingdom.
| | - L-S Mudadi
- Royal Papworth Hospital, NHS Foundation Trust, Cambridge, United Kingdom.
| | - E Y Mushosho
- Harare Institute of Technology, School of Allied Health Sciences, Harare, Zimbabwe.
| | - O Bwanga
- Radiology Department, Midlands University Hospital Tullamore, Ireland.
| | - B Chinene
- Harare Institute of Technology, School of Allied Health Sciences, Harare, Zimbabwe.
| | - P Nyawani
- Harare Institute of Technology, School of Allied Health Sciences, Harare, Zimbabwe.
| | - L C Mutandiro
- Harare Institute of Technology, School of Allied Health Sciences, Harare, Zimbabwe.
| | - A D Piersson
- Department of Imaging Technology & Sonography, University of Cape Coast, Central Region, Ghana.
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5
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Kjelle E, Brandsæter IØ, Andersen ER, Hofmann B. Sustainability in healthcare by reducing low-value imaging - A narrative review. Radiography (Lond) 2024; 30 Suppl 1:30-34. [PMID: 38870571 DOI: 10.1016/j.radi.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/23/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVES This narrative review aims to present the concept of value in imaging and explore why we conduct low-value procedures, how to reduce this wasteful use, and what we could gain from reducing low-value imaging. KEY FINDINGS Imaging of low value to the patient contributes to thousands of metric tons of CO2 emissions, costing several billion US dollars annually. With a 20% reduction in low-value imaging, we would reduce the waste of resources related to 7.2 million procedures and, at the same time, reduce the risk of incidentalomas, overdiagnosis, and overtreatment and reduce wait times for patients in need of imaging services of high value. Multi-component initiatives targeting barriers in all levels of society and healthcare are needed to reduce low-value imaging. Radiographers are key actors in medical imaging and can make substantial contributions to this effort by, together with the radiologists, referrers, and managers, ensuring that all imaging procedures conducted are sustainable along four dimensions of sustainability: value, cost, risk, and environment. CONCLUSION Efforts to secure sustainable imaging considering the four crucial dimensions (value, cost, radiation, and environment) should be made at all levels of society and healthcare, from governmental management to the individual healthcare worker. Radiographers are vital in obtaining sustainability to ensure only sustainable imaging procedures are conducted. IMPLICATIONS FOR PRACTICE When assessing the appropriateness of imaging procedures, we need to consider the environment, safety, effectiveness, and efficiency. To obtain this, we need a collective and coordinated effort locally, nationally, and internationally to deliver sustainable imaging services.
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Affiliation(s)
- E Kjelle
- Department of Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, Postbox 191, 2802 Gjøvik Norway; Department of Optometry, Radiography, and Lighting Design at the University of South-Eastern Norway (USN) at Drammen, Post Office Box 4, 3199 Borre, Norway.
| | - I Ø Brandsæter
- Department of Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, Postbox 191, 2802 Gjøvik Norway
| | - E R Andersen
- Department of Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, Postbox 191, 2802 Gjøvik Norway
| | - B Hofmann
- Department of Health Sciences at the Norwegian University of Science and Technology (NTNU) at Gjøvik, Postbox 191, 2802 Gjøvik Norway; Centre of Medical Ethics at the University of Oslo, Centre of Medical Ethics, Postbox 1130, Blindern, 0318 Oslo, Norway
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6
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Schoen JH, Scheel JR. Planetary Health: Should We Care? J Am Coll Radiol 2024; 21:969-972. [PMID: 37473856 DOI: 10.1016/j.jacr.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/01/2023] [Accepted: 07/08/2023] [Indexed: 07/22/2023]
Abstract
The delivery of radiologic services and other health care produces a large amount of environmental pollution, which increases human morbidity and mortality. Planetary health looks for sustainable strategies to deliver high-quality health care and reduce environmental impact. Radiologists should consider the sustainability and resilience of their practice in the face of limited natural resources and increasing extreme weather events. Additionally, there is a strong business case for including planetary health in radiology given the financial benefits of sustainability efforts. The extent of radiology's environmental impact and the central role radiologists play in patient care should encourage radiologists to lead these efforts in health care.
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Affiliation(s)
- Julia H Schoen
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina; and Co-Chair, ACR Task Force on Sustainability and Climate.
| | - John R Scheel
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Chair, Association of University Radiologists Task Force on Sustainability; and Vice Chair of Global and Planetary Health. https://twitter.com/JohnRScheel
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7
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Gunasekaran S, Szava-Kovats A, Battey T, Gross J, Picano E, Raman SV, Lee E, Bissell MM, Alasnag M, Campbell-Washburn AE, Hanneman K. Cardiovascular Imaging, Climate Change, and Environmental Sustainability. Radiol Cardiothorac Imaging 2024; 6:e240135. [PMID: 38900024 PMCID: PMC11211952 DOI: 10.1148/ryct.240135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/03/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024]
Abstract
Environmental exposures including poor air quality and extreme temperatures are exacerbated by climate change and are associated with adverse cardiovascular outcomes. Concomitantly, the delivery of health care generates substantial atmospheric greenhouse gas (GHG) emissions contributing to the climate crisis. Therefore, cardiac imaging teams must be aware not only of the adverse cardiovascular health effects of climate change, but also the downstream environmental ramifications of cardiovascular imaging. The purpose of this review is to highlight the impact of climate change on cardiovascular health, discuss the environmental impact of cardiovascular imaging, and describe opportunities to improve environmental sustainability of cardiac MRI, cardiac CT, echocardiography, cardiac nuclear imaging, and invasive cardiovascular imaging. Overarching strategies to improve environmental sustainability in cardiovascular imaging include prioritizing imaging tests with lower GHG emissions when more than one test is appropriate, reducing low-value imaging, and turning equipment off when not in use. Modality-specific opportunities include focused MRI protocols and low-field-strength applications, iodine contrast media recycling programs in cardiac CT, judicious use of US-enhancing agents in echocardiography, improved radiopharmaceutical procurement and waste management in nuclear cardiology, and use of reusable supplies in interventional suites. Finally, future directions and research are highlighted, including life cycle assessments over the lifespan of cardiac imaging equipment and the impact of artificial intelligence tools. Keywords: Heart, Safety, Sustainability, Cardiovascular Imaging Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Suvai Gunasekaran
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Andrew Szava-Kovats
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Thomas Battey
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Jonathan Gross
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Eugenio Picano
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Subha V. Raman
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Emil Lee
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Malenka M. Bissell
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Mirvat Alasnag
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Adrienne E. Campbell-Washburn
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
| | - Kate Hanneman
- From the Biomedical Imaging Research Institute, Cedars-Sinai Medical
Center, Los Angeles, Calif (S.G.); Department of Radiology, Feinberg School of
Medicine, Northwestern University, Chicago, Ill (S.G.); Department of Nuclear
Medicine, Peter Lougheed Hospital, Alberta Health Services, Calgary, Canada
(A.S.K.); Department of Radiology, University of Calgary, Calgary, Canada
(A.S.K.); Department of Radiology & Medical Imaging, University of
Virginia, Charlottesville, Va (T.B.); Department of Radiology, Texas
Children’s Hospital, Baylor School of Medicine, Houston, Tex (J.G.);
Division of Cardiology, University Clinical Center of Serbia, University of
Belgrade, Belgrade, Serbia (E.P.); OhioHealth, Columbus, Ohio (S.V.R.); Langley
Memorial Hospital, British Columbia, Canada (E.L.); Department of Biomedical
Imaging Science, University of Leeds, Leeds, United Kingdom (M.M.B.); Cardiac
Center, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (M.A.);
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung,
and Blood Institute, National Institutes of Health, Bethesda, Md (A.E.C.W.);
Joint Department of Medical Imaging, Peter Munk Cardiac Centre and Toronto
General Hospital Research Institute, University Medical Imaging Toronto,
University Health Network (UHN), 585 University Avenue, 1 PMB-298, Toronto, ON,
Canada M5G 2N2 (K.H.); and Department of Medical Imaging, University of Toronto,
Toronto, Canada (K.H.)
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8
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Currie GM, Hawk KE, Rohren EM. Challenges confronting sustainability in nuclear medicine practice. Radiography (Lond) 2024; 30 Suppl 1:1-8. [PMID: 38797115 DOI: 10.1016/j.radi.2024.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Sustainability can be defined as the state in which consumption or depletion do not exceed regeneration. It can further be considered in five dimensions: environmental, economic, social, human resources, and ecological. KEY FINDINGS There are a number of key issues that threaten sustainability across nuclear medicine clinical and research practices, and across the five dimensions of sustainability there is a requirement for compromise between conflicting priorities. Nonetheless, the field of nuclear medicine benefits from an inherent culture of innovation and forethought which fosters adaptation in order to achieve sustainability. CONCLUSION The principles of sustainability are particularly challenging to navigate due to resource scarcity in nuclear medicine associated with both workforce shortages and supply disruptions. Specific challenges and adaptations are outlined for each of the five dimensions of sustainability. IMPLICATIONS FOR PRACTICE There are opportunities for improving sustainability of nuclear medicine practice although success is reliant on a deeper understanding of the interplay across the five dimensions of sustainability.
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Affiliation(s)
- G M Currie
- Charles Sturt University, NSW, Australia; Baylor College of Medicine, Texas, USA.
| | - K E Hawk
- Stanford University, California, USA
| | - E M Rohren
- Charles Sturt University, NSW, Australia; Baylor College of Medicine, Texas, USA
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9
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Hanneman K, McKee H, Nguyen ET, Panet H, Kielar A. Greenhouse Gas Emissions by Diagnostic Imaging Modality in a Hospital-Based Radiology Department. Can Assoc Radiol J 2024:8465371241253314. [PMID: 38742437 DOI: 10.1177/08465371241253314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Affiliation(s)
- Kate Hanneman
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
- University Medical Imaging Toronto, Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada
- Toronto General Hospital Research Institute, University Health Network (UHN), University of Toronto, Toronto, ON, Canada
| | - Hayley McKee
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Elsie T Nguyen
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
- University Medical Imaging Toronto, Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada
| | - Hayley Panet
- University Medical Imaging Toronto, Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada
| | - Ania Kielar
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
- University Medical Imaging Toronto, Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada
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10
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Kim HHR, Leschied JR, Lall N, Otero HJ, Kadom N. That's GROSS! Practical steps towards sustainability in pediatric radiology. Pediatr Radiol 2024; 54:1036-1039. [PMID: 38374438 DOI: 10.1007/s00247-024-05878-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/26/2024] [Accepted: 02/06/2024] [Indexed: 02/21/2024]
Affiliation(s)
- Helen H R Kim
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way NE, MA.7.220, Seattle, WA, 98105, USA.
| | - Jessica R Leschied
- Department of Radiology, Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Neil Lall
- Department of Radiology and Imaging Sciences, Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - Hansel J Otero
- Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | - Nadja Kadom
- Department of Radiology and Imaging Sciences, Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
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11
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Lojo-Lendoiro S, Rovira À, Morales Santos Á. Green radiology: How to develop sustainable radiology. RADIOLOGIA 2024; 66:248-259. [PMID: 38908886 DOI: 10.1016/j.rxeng.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/22/2023] [Indexed: 06/24/2024]
Abstract
The phenomenon of global warming due to the increased emission of greenhouse gases makes it necessary to raise public awareness about the importance of promoting sustainable practices. The field of radiology is not an exception, as it consumes a large amount of energy and resources to operate equipment and generate images. Green radiology is a sustainable, innovative, and responsible approach in radiology practice that focuses on minimizing the negative environmental effects of the technologies and procedures used in radiology. Its primary goal is to reduce the carbon, water and ecological footprint in our services based on four strategic pillars: decreasing energy, water, and helium usage; properly recycling and/or disposing of waste and residues (including contrast media); minimizing the environmental impact of ionizing radiation; and promoting eco-friendly radiology practices.
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Affiliation(s)
- S Lojo-Lendoiro
- Servicio de Radiodiagnóstico, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
| | - À Rovira
- Sección de Neurorradiología, Servicio de Radiodiagnóstico, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Á Morales Santos
- Servicio de Radiodiagnóstico, Hospital Universitario Donostia, San Sebastián, Spain
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12
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McKee H, Brown MJ, Kim HHR, Doo FX, Panet H, Rockall AG, Omary RA, Hanneman K. Planetary Health and Radiology: Why We Should Care and What We Can Do. Radiology 2024; 311:e240219. [PMID: 38652030 DOI: 10.1148/radiol.240219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Climate change adversely affects the well-being of humans and the entire planet. A planetary health framework recognizes that sustaining a healthy planet is essential to achieving individual, community, and global health. Radiology contributes to the climate crisis by generating greenhouse gas (GHG) emissions during the production and use of medical imaging equipment and supplies. To promote planetary health, strategies that mitigate and adapt to climate change in radiology are needed. Mitigation strategies to reduce GHG emissions include switching to renewable energy sources, refurbishing rather than replacing imaging scanners, and powering down unused scanners. Radiology departments must also build resiliency to the now unavoidable impacts of the climate crisis. Adaptation strategies include education, upgrading building infrastructure, and developing departmental sustainability dashboards to track progress in achieving sustainability goals. Shifting practices to catalyze these necessary changes in radiology requires a coordinated approach. This includes partnering with key stakeholders, providing effective communication, and prioritizing high-impact interventions. This article reviews the intersection of planetary health and radiology. Its goals are to emphasize why we should care about sustainability, showcase actions we can take to mitigate our impact, and prepare us to adapt to the effects of climate change. © RSNA, 2024 Supplemental material is available for this article. See also the article by Ibrahim et al in this issue. See also the article by Lenkinski and Rofsky in this issue.
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Affiliation(s)
- Hayley McKee
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Maura J Brown
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Helen H R Kim
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Florence X Doo
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Hayley Panet
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Andrea G Rockall
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Reed A Omary
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Kate Hanneman
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
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13
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Chaban YV, Vosshenrich J, McKee H, Gunasekaran S, Brown MJ, Atalay MK, Heye T, Markl M, Woolen SA, Simonetti OP, Hanneman K. Environmental Sustainability and MRI: Challenges, Opportunities, and a Call for Action. J Magn Reson Imaging 2024; 59:1149-1167. [PMID: 37694980 DOI: 10.1002/jmri.28994] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023] Open
Abstract
The environmental impact of magnetic resonance imaging (MRI) has recently come into focus. This includes its enormous demand for electricity compared to other imaging modalities and contamination of water bodies with anthropogenic gadolinium related to contrast administration. Given the pressing threat of climate change, addressing these challenges to improve the environmental sustainability of MRI is imperative. The purpose of this review is to discuss the challenges, opportunities, and the need for action to reduce the environmental impact of MRI and prepare for the effects of climate change. The approaches outlined are categorized as strategies to reduce greenhouse gas (GHG) emissions from MRI during production and use phases, approaches to reduce the environmental impact of MRI including the preservation of finite resources, and development of adaption plans to prepare for the impact of climate change. Co-benefits of these strategies are emphasized including lower GHG emission and reduced cost along with improved heath and patient satisfaction. Although MRI is energy-intensive, there are many steps that can be taken now to improve the environmental sustainability of MRI and prepare for the effects of climate change. On-going research, technical development, and collaboration with industry partners are needed to achieve further reductions in MRI-related GHG emissions and to decrease the reliance on finite resources. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 6.
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Affiliation(s)
- Yuri V Chaban
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jan Vosshenrich
- Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Hayley McKee
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Suvai Gunasekaran
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Maura J Brown
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael K Atalay
- Department of Diagnostic Imaging, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Tobias Heye
- Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Michael Markl
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, USA
| | - Sean A Woolen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | | | - Kate Hanneman
- Department of Medical Imaging, University Medical Imaging Toronto, University of Toronto, Toronto, Ontario, Canada
- Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
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14
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Rovira À, Ben Salem D, Geraldo AF, Cappelle S, Del Poggio A, Cocozza S, Saatci I, Zlatareva D, Lojo S, Quattrocchi CC, Morales Á, Yousry T. Go Green in Neuroradiology: towards reducing the environmental impact of its practice. Neuroradiology 2024; 66:463-476. [PMID: 38353699 DOI: 10.1007/s00234-024-03305-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/03/2024] [Indexed: 02/23/2024]
Abstract
Raising public awareness about the relevance of supporting sustainable practices is required owing to the phenomena of global warming caused by the rising production of greenhouse gases. The healthcare sector generates a relevant proportion of the total carbon emissions in developed countries, and radiology is estimated to be a major contributor to this carbon footprint. Neuroradiology markedly contributes to this negative environmental effect, as this radiological subspecialty generates a high proportion of diagnostic and interventional imaging procedures, the majority of them requiring high energy-intensive equipment. Therefore, neuroradiologists and neuroradiological departments are especially responsible for implementing decisions and initiatives able to reduce the unfavourable environmental effects of their activities, by focusing on four strategic pillars-reducing energy, water, and helium use; properly recycling and/or disposing of waste and residues (including contrast media); encouraging environmentally friendly behaviour; and reducing the effects of ionizing radiation on the environment. The purpose of this article is to alert neuroradiologists about their environmental responsibilities and to analyse the most productive strategic axes, goals, and lines of action that contribute to reducing the environmental impact associated with their professional activities.
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Affiliation(s)
- Àlex Rovira
- Section of Neuroradiology, Department of Radiology (IDI), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
| | | | - Ana Filipa Geraldo
- Diagnostic Neuroradiology Unit, Department of Radiology, Centro Hospitalar Vila Nova de Gaia/Espinho (CHVNG/E), Porto, Portugal
| | - Sarah Cappelle
- Department of Radiology, University Hospitals Leuven, Louvain, Belgium
| | - Anna Del Poggio
- Department of Neuroradiology and CERMAC, San Raffaele Hospital, Milan, Italy
| | - Sirio Cocozza
- Department of Advanced Biomedical Sciences, University of Naples, "Federico II", Naples, Italy
| | - Isil Saatci
- Section of Neurointervention, Neuroradiology, Private Koru Hospitals, Ankara, Turkey
| | - Dora Zlatareva
- Department of Radiology, Medical University Sofia, Sofia, Bulgaria
| | - Sara Lojo
- Department of Radiology, Hospital Álvaro Cunqueiro, Vigo, Spain
| | - Carlo Cosimo Quattrocchi
- Centre for Medical Sciences CISMed, University of Trento, Trento, Italy
- Radiology, Multizonal Unit of Rovereto and Arco, APSS Provincia Autonoma Di Trento, Trento, Italy
| | - Ángel Morales
- Department of Radiology, Hospital Universitario Donostia, San Sebastián, Spain
| | - Tarek Yousry
- Lysholm Department of Neuroradiology, UCLH National Hospital for Neurology and Neurosurgery, Neuroradiological Academic Unit, UCL Institute of Neurology, London, UK
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15
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Anneveldt KJ, Nijholt IM, Schutte JM, Hehenkamp WJK, Veersema S, Huirne JAF, Boomsma MF. Waste analysis and energy use estimation during MR-HIFU treatment: first steps towards calculating total environmental impact. Insights Imaging 2024; 15:83. [PMID: 38517607 PMCID: PMC10959896 DOI: 10.1186/s13244-024-01655-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/15/2024] [Indexed: 03/24/2024] Open
Abstract
OBJECTIVES To assess the environmental impact of the non-invasive Magnetic Resonance image-guided High-Intensity Focused Ultrasound (MR-HIFU) treatment of uterine fibroids, we aimed to perform a full Life Cycle Assessment (LCA). However, as a full LCA was not feasible at this time, we evaluated the CO2 (carbon dioxide) emission from the MRI scanner, MR-HIFU device, and the medication used, and analyzed solid waste produced during treatment. METHODS Our functional unit was one uterine fibroid MR-HIFU treatment. The moment the patient entered the day care-unit until she left, defined our boundaries of investigation. We retrospectively collected data from 25 treatments to assess the CO2 emission based on the energy used by the MRI scanner and MR-HIFU device and the amount and type of medication administered. Solid waste was prospectively collected from five treatments. RESULTS During an MR-HIFU treatment, the MRI scanner and MR-HIFU device produced 33.2 ± 8.7 kg of CO2 emission and medication administered 0.13 ± 0.04 kg. A uterine fibroid MR-HIFU treatment produced 1.2 kg (range 1.1-1.4) of solid waste. CONCLUSIONS Environmental impact should ideally be analyzed for all (new) medical treatments. By assessing part of the CO2 emission and solid waste produced, we have taken the first steps towards analyzing the total environmental impact of the MR-HIFU treatment of uterine fibroids. These data can contribute to future studies comparing the results of MR-HIFU LCAs with LCAs of other uterine fibroid therapies. CRITICAL RELEVANCE STATEMENT In addition to (cost-) effectiveness, the environmental impact of new treatments should be assessed. We took the first steps towards analyzing the total environmental impact of uterine fibroid MR-HIFU. KEY POINTS • Life Cycle Assessments (LCAs) should be performed for all (new) medical treatments. • We took the first steps towards analyzing the environmental impact of uterine fibroid MR-HIFU. • Energy used by the MRI scanner and MR-HIFU device corresponded to 33.2 ± 8.7 kg of CO2 emission.
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Affiliation(s)
- Kimberley J Anneveldt
- Department of Radiology, Isala Hospital, Dokter Van Heesweg 2, Zwolle, 8025 AB, The Netherlands.
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands.
| | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Dokter Van Heesweg 2, Zwolle, 8025 AB, The Netherlands
- Image Sciences Institute, Division of Imaging & Oncology, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
| | - Joke M Schutte
- Department of Gynecology, Isala Hospital, Dokter Van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - Wouter J K Hehenkamp
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centre, Location AMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Sebastiaan Veersema
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
| | - Judith A F Huirne
- Department of Obstetrics and Gynecology and Amsterdam Research Institute Reproduction and Development, Amsterdam University Medical Centre, Location AMC, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Martijn F Boomsma
- Department of Radiology, Isala Hospital, Dokter Van Heesweg 2, Zwolle, 8025 AB, The Netherlands
- Image Sciences Institute, Division of Imaging & Oncology, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, 3584 CX, The Netherlands
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16
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Roletto A, Zanardo M, Bonfitto GR, Catania D, Sardanelli F, Zanoni S. The environmental impact of energy consumption and carbon emissions in radiology departments: a systematic review. Eur Radiol Exp 2024; 8:35. [PMID: 38418763 PMCID: PMC10902235 DOI: 10.1186/s41747-024-00424-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/18/2023] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVES Energy consumption and carbon emissions from medical equipment like CT/MRI scanners and workstations contribute to the environmental impact of healthcare facilities. The aim of this systematic review was to identify all strategies to reduce energy use and carbon emissions in radiology. METHODS In June 2023, a systematic review (Medline/Embase/Web of Science) was performed to search original articles on environmental sustainability in radiology. The extracted data include environmental sustainability topics (e.g., energy consumption, carbon footprint) and radiological devices involved. Sustainable actions and environmental impact in radiology settings were analyzed. Study quality was assessed using the QualSyst tool. RESULTS From 918 retrieved articles, 16 met the inclusion criteria. Among them, main topics were energy consumption (10/16, 62.5%), life-cycle assessment (4/16, 25.0%), and carbon footprint (2/16, 12.5%). Eleven studies reported that 40-91% of the energy consumed by radiological devices can be defined as "nonproductive" (devices "on" but not working). Turning-off devices during idle periods 9/16 (56.2%) and implementing workflow informatic tools (2/16, 12.5%) were the sustainable actions identified. Energy-saving strategies were reported in 8/16 articles (50%), estimating annual savings of thousand kilowatt-hours (14,180-171,000 kWh). Cost-savings were identified in 7/16 (43.7%) articles, ranging from US $9,225 to 14,328 per device. Study quality was over or equal the 80% of high-quality level in 14/16 (87.5%) articles. CONCLUSION Energy consumption and environmental sustainability in radiology received attention in literature. Sustainable actions include turning-off radiological devices during idle periods, favoring the most energy-efficient imaging devices, and educating radiological staff on energy-saving practices, without compromising service quality. RELEVANCE STATEMENT A non-negligible number of articles - mainly coming from North America and Europe - highlighted the need for energy-saving strategies, attention to equipment life-cycle assessment, and carbon footprint reduction in radiology, with a potential for cost-saving outcome. KEY POINTS • Energy consumption and environmental sustainability in radiology received attention in the literature (16 articles published from 2010 to 2023). • A substantial portion (40-91%) of the energy consumed by radiological devices was classified as "non-productive" (devices "on" but not working). • Sustainable action such as shutting down devices during idle periods was identified, with potential annual energy savings ranging from 14,180 to 171,000 kWh.
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Affiliation(s)
- Andrea Roletto
- Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Via Branze 38, 25123, Brescia, Italy.
| | - Moreno Zanardo
- Radiology Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy
| | - Giuseppe Roberto Bonfitto
- Department of Information Engineering, Università degli Studi di Brescia, Via Branze 38, 25123, Brescia, Italy
| | - Diego Catania
- Health Professions Leadership and Management Unit, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Francesco Sardanelli
- Radiology Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy
| | - Simone Zanoni
- Department of Civil, Environmental, Architectural Engineering and Mathematics, Università degli Studi di Brescia, Via Branze 43, 25123, Brescia, Italy
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17
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Vanolli K, Jost ML, Clerc O, Genné D, John G. Radiological Explorations of Patients with Upper or Febrile Urinary Tract Infection. Infect Dis Rep 2024; 16:189-199. [PMID: 38525762 PMCID: PMC10961809 DOI: 10.3390/idr16020015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/26/2024] Open
Abstract
Recent European Association of Urology (EAU) guidelines and a clinical prediction rule developed by Van Nieuwkoop et al. suggest simple criteria for performing radiological imaging for patients with a febrile urinary tract infection (UTI). We analysed the records of patients with a UTI from four hospitals in Switzerland. Of 107 UTI patients, 58% underwent imaging and 69% (95%CI: 59-77%) and 64% (95%CI: 54-73%) of them were adequately managed according to Van Nieuwkoop's clinical rule and EAU guidelines, respectively. However, only 47% (95%CI: 33-61%) and 57% (95%CI: 44-69%) of the imaging performed would have been recommended according to their respective rules. Clinically significant imaging findings were associated with a history of urolithiasis (OR = 11.8; 95%CI: 3.0-46.5), gross haematuria (OR = 5.9; 95%CI: 1.6-22.1) and known urogenital anomalies (OR = 5.7; 95%CI: 1.8-18.2). Moreover, six of 16 (38%) patients with a clinically relevant abnormality displayed none of the criteria requiring imaging according to Van Nieuwkoop's rule or EAU guidelines. Thus, adherence to imaging guidelines was suboptimal, especially when imaging was not recommended. However, additional factors associated with clinically significant findings suggest the need for a new, efficient clinical prediction rule.
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Affiliation(s)
- Katia Vanolli
- Department of Internal Medicine, Neuchâtel Hospital Network, Rue de la Maladière 45, CH-2000 Neuchâtel, Switzerland; (K.V.)
| | - Mike Libasse Jost
- Department of Internal Medicine, Bienne Hospital Center, Chante-Merle 84, CH-2501 Bienne, Switzerland (D.G.)
| | - Olivier Clerc
- Department of Internal Medicine, Neuchâtel Hospital Network, Rue de la Maladière 45, CH-2000 Neuchâtel, Switzerland; (K.V.)
| | - Daniel Genné
- Department of Internal Medicine, Bienne Hospital Center, Chante-Merle 84, CH-2501 Bienne, Switzerland (D.G.)
- Department of Medicine, Geneva University, Michel-Servet 1, CH-1206 Geneva, Switzerland
| | - Gregor John
- Department of Internal Medicine, Neuchâtel Hospital Network, Rue de la Maladière 45, CH-2000 Neuchâtel, Switzerland; (K.V.)
- Department of Medicine, Geneva University, Michel-Servet 1, CH-1206 Geneva, Switzerland
- Department of Internal Medicine, Geneva University Hospitals (HUG), Gabrielle-Perret-Gentil 4, CH-1205 Geneva, Switzerland
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18
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Zigmund B. Health Care Feels the Heat: A Primer for Radiologists on Climate Change-Related Regulatory and Policy Trends. J Am Coll Radiol 2024; 21:257-264. [PMID: 37952809 DOI: 10.1016/j.jacr.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023]
Abstract
In the ensuing decade, health care will encounter risks and opportunities stemming from a regulatory and policy environment that is increasingly shaped by the climate crisis. The startling multiplication of climate change-related extreme weather events has increased public support for action, creating pressure on policymakers and regulatory agencies to provide solutions. Health care must decarbonize along with other sectors of the economy; therefore, health care organizations should be prepared to respond to climate-related regulations and take advantage of abundant green energy incentives to achieve the largest greenhouse gas emissions reductions possible and capture financial opportunities related to the national green energy transition. Radiology is an energy-intensive specialty; therefore, radiologists can have a powerful voice in efforts to decarbonize their organizations and will be more effective advocates if they have a basic understanding of the broader national and international climate change-related regulatory and policy trends. The necessity to address climate change is ever clearer; we can either help our organizations lead in these efforts, or we can wait for policymakers and health care regulators to dictate our actions.
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Affiliation(s)
- Beth Zigmund
- Larner College of Medicine, University of Vermont, Burlington, Vermont; Division Chief of Cardiothoracic Radiology and Director of Lung Cancer Screening, University of Vermont Medical Center, Burlington, Vermont.
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Schoen JH, Burdette JH, West TG, Geer CP, Lipford ME, Sachs JR. Savings in CT Net Scan Energy Consumption: Assessment Using Dose Report Metrics and Comparison With Savings in Idle State Energy Consumption. AJR Am J Roentgenol 2024; 222:e2330189. [PMID: 37937836 DOI: 10.2214/ajr.23.30189] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND. CT scanners' net scan state (i.e., image acquisition period) represents a potential target for energy savings through protocol adjustments. However, gauging CT energy savings is difficult without installing costly energy monitors. OBJECTIVE. The purpose of this article was to assess correlations between CT dose report metrics and energy consumption during the system net scan state and to compare theoretic energy savings from matching percentage reductions in energy consumption during net scan and idle system states. METHODS. Current sensors were installed on a single CT scanner. A phantom was scanned at varying kilovoltage settings and effective tube current-rotation time settings. A retrospective assessment was performed in 32 patients (mean age, 61.2 ± 17.9 [SD] years; 17 men, 15 women) who underwent 32 single-energy noncontrast abdominopelvic CT examinations from September 22, 2021, to September 27, 2021, on the same scanner. Correlations between dose report metrics and net scan energy consumption were assessed in the phantom and clinical scans, and equations were generated to derive net scan energy consumption from DLP. An additional retrospective assessment was performed in 1355 patients (mean age, 59.3 ± 16.9 years; 663 men, 692 women) who underwent 1728 single-energy noncontrast abdominopelvic CT examinations from January 1, 2021, through December 31, 2021, on the same scanner to estimate net scan energy consumption per examination. This information was integrated with literature-derived values to compare estimated annual national energy savings resulting from 20% reductions in net scan and idle state energy consumption. RESULTS. Net scan energy consumption in the phantom scans showed high linear correlation with DLP (R2 = 0.87), and, in the clinical scans, high linear correlation with CTDIvol (R2 = 0.89) and very high linear correlation with DLP (R2 = 0.92). When combining mean DLP in examinations performed in the 1-year interval, an equation relating DLP and net scan energy consumption and literature values estimated that annual national energy savings was 14.9 times greater (40,437,870 kWh/2,704,000 kWh) by targeting the idle state rather than net scan state. CONCLUSION. CT net scan energy savings can be inferred from reductions in dose report metrics. However, targeting net scan energy consumption has modest impact relative to targeting idle state energy consumption. CLINICAL IMPACT. Environmental sustainability efforts should target the idle state energy consumption of CT.
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Affiliation(s)
- Julia H Schoen
- Department of Radiology, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27157
| | - Jonathan H Burdette
- Department of Radiology, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27157
| | - Thomas G West
- Department of Radiology, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27157
| | - Carol P Geer
- Department of Radiology, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27157
| | - Megan E Lipford
- Department of Radiology, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27157
| | - Jeffrey R Sachs
- Department of Radiology, Wake Forest School of Medicine, One Medical Center Blvd, Winston-Salem, NC 27157
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20
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Barloese M, Petersen CL. Sustainable health care: a real-world appraisal of a modern imaging department. Clin Imaging 2024; 105:110025. [PMID: 37989018 DOI: 10.1016/j.clinimag.2023.110025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/27/2023] [Accepted: 11/05/2023] [Indexed: 11/23/2023]
Abstract
RATIONALE AND OBJECTIVES There is universal interest in increasing sustainability in health care, including in imaging. We studied and characterized energy consumption in a representative imaging department in Denmark to identify and quantify the effect of specific optimizations. METHODS Protocols and energy parameters for the three main scanner modalities along with supportive systems and workflows were monitored and scrutinized. Potential savings were measured and/or calculated. RESULTS Only few optimizations were identified at the protocol level. However, examination of usage patterns and cooling systems revealed numerous potential optimizations which fell into three categories. 1) Optimizations requiring minimal changes in installations or workflows, for example, reduction of bed-position time, 2) optimizations requiring altered work flows such as strict adherence to timed shut-down procedures and 3) optimizations requiring retro-fitting equipment, typically at considerable monetary expense, for example fitting variable flow control on pumps. The single biggest identified optimization was raising the temperature of the circulating cooling water. CONCLUSION This study highlights the complexity of increasing sustainability in health care, specifically in imaging. We identified multiple potential optimizations but also technical, monetary and organizational barriers preventing immediate implementation.
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Affiliation(s)
- Mads Barloese
- Centre for Functional and Diagnostic Imaging and Research, Hvidovre Hospital, Kettegaards Alle 30, DK-2650 Hvidovre, Copenhagen, Denmark.
| | - Claus Leth Petersen
- Centre for Functional and Diagnostic Imaging and Research, Hvidovre Hospital, Kettegaards Alle 30, DK-2650 Hvidovre, Copenhagen, Denmark
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21
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Pohl H, Baddeley R, Hayee B. Carbon footprint of gastroenterology practice. Gut 2023; 72:2210-2213. [PMID: 37977578 DOI: 10.1136/gutjnl-2023-331230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 10/03/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Heiko Pohl
- Gastroenterology and Hepatology, White River Junction VA Medical Center, White River Junction, Vermont, USA
| | - Robin Baddeley
- Wolfson Unit for Endoscopy, St Mark's the National Bowel Hospital and Academic Institute, London, UK
- King's Health Partners Institute for Therapeutic Endoscopy, King's College Hospital NHS Foundation Trust, London, UK
| | - Bu'Hussain Hayee
- King's Health Partners Institute for Therapeutic Endoscopy, King's College Hospital NHS Foundation Trust, London, UK
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22
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Mariampillai J, Rockall A, Manuellian C, Cartwright S, Taylor S, Deng M, Sheard S. The green and sustainable radiology department. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:21-26. [PMID: 37721584 PMCID: PMC10689521 DOI: 10.1007/s00117-023-01189-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 09/19/2023]
Abstract
As manmade climate change threatens the health of the planet, it is important that we understand and address the contribution of healthcare to global emissions. Medical imaging is a significant contributor to overall emissions. This article aims to highlight key issues and examples of sustainable practices, in order to empower radiologists to make a change within their department.
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Affiliation(s)
| | - Andrea Rockall
- Clinical Chair of Radiology, Department of Cancer and Surgery, Faculty of Medicine, Imperial College London, London, UK.
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23
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Anudjo MNK, Vitale C, Elshami W, Hancock A, Adeleke S, Franklin JM, Akudjedu TN. Considerations for environmental sustainability in clinical radiology and radiotherapy practice: A systematic literature review and recommendations for a greener practice. Radiography (Lond) 2023; 29:1077-1092. [PMID: 37757675 DOI: 10.1016/j.radi.2023.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/01/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Environmental sustainability (ES) in healthcare is an important current challenge in the wider context of reducing the environmental impacts of human activity. Identifying key routes to making clinical radiology and radiotherapy (CRR) practice more environmentally sustainable will provide a framework for delivering greener clinical services. This study sought to explore and integrate current evidence regarding ES in CRR departments, to provide a comprehensive guide for greener practice, education, and research. METHODS A systematic literature search and review of studies of diverse evidence including qualitative, quantitative, and mixed methods approach was completed across six databases. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and the Quality Assessment Tool for Studies with Diverse Designs (QATSDD) was used to assess the included studies. A result-based convergent data synthesis approach was employed to integrate the study findings. RESULTS A total of 162 articles were identified. After applying a predefined exclusion criterion, fourteen articles were eligible. Three themes emerged as potentially important areas of CRR practice that contribute to environmental footprint: energy consumption and data storage practices; usage of clinical consumables and waste management practices; and CRR activities related to staff and patient travel. CONCLUSIONS Key components of CRR practice that influence environmental impact were identified, which could serve as a framework for exploring greener practice interventions. Widening the scope of research, education and awareness is imperative to providing a holistic appreciation of the environmental burden of healthcare. IMPLICATIONS FOR PRACTICE Encouraging eco-friendly travelling options, leveraging artificial Intelligence (AI) and CRR specific policies to optimise utilisation of resources such as energy and radiopharmaceuticals are recommended for a greener practice.
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Affiliation(s)
- M N K Anudjo
- Institute of Medical Imaging & Visualisation, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, UK
| | - C Vitale
- Institute of Medical Imaging & Visualisation, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, UK; IRCCS San Raffaele Hospital, Milan, Italy
| | - W Elshami
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, United Arab Emirates
| | - A Hancock
- Department of Medical Imaging, University of Exeter, Exeter, UK
| | - S Adeleke
- School of Cancer & Pharmaceutical Sciences, King's College London, Queen Square, London WC1N 3BG, UK; High Dimensional Neurology, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - J M Franklin
- Institute of Medical Imaging & Visualisation, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, UK
| | - T N Akudjedu
- Institute of Medical Imaging & Visualisation, Department of Medical Science & Public Health, Faculty of Health & Social Sciences, Bournemouth University, UK.
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Perleth M, Spranger A, Wabnitz K, Panteli D, Kolominsky-Rabas P. [Report on the workshop "Environmental Impact: A new dimension in health technology assessment? A workshop focussing on medical devices", EbM Congress in Potsdam on March 23, 2023]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2023; 181:76-79. [PMID: 37596159 DOI: 10.1016/j.zefq.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 08/20/2023]
Affiliation(s)
- Matthias Perleth
- Verein zur Förderung der Technologiebewertung im Gesundheitswesen (HTA.de), Berlin, Deutschland.
| | | | | | - Dimitra Panteli
- European Observatory on Health Systems and Policies, Brüssel, Belgien
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25
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Ledoux F. [Towards teaching eco-design of care in the initial training of future health professionals]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2023; 68:34-36. [PMID: 37321780 DOI: 10.1016/j.soin.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Our society is regularly faced with new dangers, linked to the evolution of living conditions, production, work, consumption and housing. Health systems are no stranger to this. On the contrary, they have a real impact on the environment, which needs to be mitigated. Professionals can contribute to this by changing their practices (prescribing certain examinations that consume less energy, using low-impact therapeutic methods, teaching patients not to over-consume, etc.). For this eco-design of care to work, it is essential to make students aware of it as early as their initial training.
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Affiliation(s)
- Félix Ledoux
- École des hautes études en santé publique, 15 avenue du Professeur-Léon-Bernard, CS 74312, 35043 Rennes cedex, France.
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Slanetz PJ, Schoen JH, Maturen KE, Zigmund B. Green Is Rad: Engaging Radiologists in Building More Sustainable Radiology Practices. J Am Coll Radiol 2023; 20:282-284. [PMID: 35397228 DOI: 10.1016/j.jacr.2022.02.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 02/19/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Priscilla J Slanetz
- Vice Chair, Academic Affairs and Associate Program Director, Diagnostic Radiology Residency, Department of Radiology, Boston University Medical Center, Boston, Massachusetts; Department of Radiology Boston University School of Medicine, Boston, Massachusetts; Director, Early Career Faculty Development and Co-Director of the Academic Writing Program, Boston University Medical Group, Boston, Massachusetts; President of Massachusetts Radiological Society; Vice President, Association of University Radiologists; and Subspecialty Chair, ACR Appropriateness Criteria® Breast Imaging Panels.
| | - Julia H Schoen
- Department of Radiology, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina; and Chair, Radiologists for a Sustainable Future
| | - Katherine E Maturen
- Associate Chair for Ambulatory Care and Strategy, Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan; and Board of Directors for the Society of Abdominal Radiology and the Board of Trustees for the American Board of Radiology
| | - Beth Zigmund
- Director, Lung Cancer Screening and Education Director, Cardiothoracic Imaging, Department of Radiology, University of Vermont Medical Center, Burlington, Vermont; Department of Radiology, Larner College of Medicine at the University of Vermont, Burlington, Vermont; and Leader, Advocacy Team for Radiologists for a Sustainable Future
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Climate Change, Carbon Dioxide Emissions, and Medical Imaging Contribution. J Clin Med 2022; 12:jcm12010215. [PMID: 36615016 PMCID: PMC9820937 DOI: 10.3390/jcm12010215] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/05/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
Human activities have raised the atmosphere's carbon dioxide (CO2) content by 50% in less than 200 years and by 10% in the last 15 years. Climate change is a great threat and presents a unique opportunity to protect cardiovascular health in the next decades. CO2 equivalent emission is the most convenient unit for measuring the greenhouse gas footprint corresponding to ecological cost. Medical imaging contributes significantly to the CO2 emissions responsible for climate change, yet current medical guidelines ignore the carbon cost. Among the common cardiac imaging techniques, CO2 emissions are lowest for transthoracic echocardiography (0.5-2 kg per exam), increase 10-fold for cardiac computed tomography angiography, and 100-fold for cardiac magnetic resonance. A conservative estimate of 10 billion medical examinations per year worldwide implies that medical imaging accounts for approximately 1% of the overall carbon footprint. In 2016, CO2 emissions from magnetic resonance imaging and computed tomography, calculated in 120 countries, accounted for 0.77% of global emissions. A significant portion of global greenhouse gas emissions is attributed to health care, which ranges from 4% in the United Kingdom to 10% in the United States. Assessment of carbon cost should be a part of the cost-benefit balance in medical imaging.
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Drew J, Christie SD, Rainham D, Rizan C. HealthcareLCA: an open-access living database of health-care environmental impact assessments. Lancet Planet Health 2022; 6:e1000-e1012. [PMID: 36495883 DOI: 10.1016/s2542-5196(22)00257-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 08/17/2022] [Accepted: 10/18/2022] [Indexed: 06/17/2023]
Abstract
Anthropogenic environmental change negatively effects human health and is increasing health-care system demand. Paradoxically, the provision of health care, which itself is a substantial contributor to environmental degradation, is compounding this problem. There is increasing willingness to transition towards sustainable health-care systems globally and ensuring that strategy and action are informed by best available evidence is imperative. In this Personal View, we present an interactive, open-access database designed to support this effort. Functioning as a living repository of environmental impact assessments within health care, the HealthcareLCA database collates 152 studies, predominantly peer-reviewed journal articles, into one centralised and publicly accessible location, providing impact estimates (currently totalling 3671 numerical values) across 1288 health-care products and processes. The database brings together research generated over the past two decades and indicates exponential field growth.
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Affiliation(s)
- Jonathan Drew
- Department of Surgery (Neurosurgery), Dalhousie University, Halifax, NS, Canada.
| | - Sean D Christie
- Department of Surgery (Neurosurgery), Dalhousie University, Halifax, NS, Canada
| | - Daniel Rainham
- School of Health and Human Performance and the Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | - Chantelle Rizan
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK; Brighton and Sussex Medical School, Brighton, UK
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Woolen SA, Kim CJ, Hernandez AM, Becker A, Martin AJ, Kuoy E, Pevec WC, Tutton S. Radiology Environmental Impact: What Is Known and How Can We Improve? Acad Radiol 2022; 30:625-630. [PMID: 36400705 DOI: 10.1016/j.acra.2022.10.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/12/2022] [Accepted: 10/22/2022] [Indexed: 11/18/2022]
Abstract
The healthcare sector generates approximately 10% of the total carbon emissions in the United States. Radiology is thought to be a top contributor to the healthcare carbon footprint due to high energy-consuming devices and waste from interventional procedures. In this article, we provide a background on Radiology's environmental impact, describe why hospitals should add sustainability as a quality measure, and give a framework for radiologists to reduce the carbon footprint through quality improvement and collaboration.
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Affiliation(s)
- Sean A Woolen
- Department of Radiology and Biomedical Imaging, UC San Francisco, 505 Parnassus Ave, San Francisco California, 94117 (S.A.W., A.B., A.J.M.).
| | - Christine J Kim
- Department of Radiology, UC Los Angeles, Los Angeles California (C.J.K.)
| | - Andrew M Hernandez
- Department of Radiology, UC Davis Health, Sacramento California (A.M.H.)
| | - Amy Becker
- Department of Radiology and Biomedical Imaging, UC San Francisco, 505 Parnassus Ave, San Francisco California, 94117 (S.A.W., A.B., A.J.M.)
| | - Alastair J Martin
- Department of Radiology and Biomedical Imaging, UC San Francisco, 505 Parnassus Ave, San Francisco California, 94117 (S.A.W., A.B., A.J.M.)
| | - Edward Kuoy
- Department of Radiology, UC Irvine, Orange County California (E.K.)
| | - William C Pevec
- Department of Surgery, UC Davis Health, Sacramento California (W.C.P.)
| | - Sean Tutton
- Department of Radiology, UC San Diego, San Diego California (S.T.)
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Lichter KE, Anderson J, Sim AJ, Baniel CC, Thiel CL, Chuter R, Collins A, Carollo E, Berg CD, Coleman CN, Abdel-Wahab M, Grover S, Singer L, Mohamad O. Transitioning to Environmentally Sustainable, Climate-Smart Radiation Oncology Care. Int J Radiat Oncol Biol Phys 2022; 113:915-924. [PMID: 35841919 PMCID: PMC10024638 DOI: 10.1016/j.ijrobp.2022.04.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/28/2022] [Indexed: 10/17/2022]
Affiliation(s)
- Katie E Lichter
- Department of Radiation Oncology, University of California, San Francisco, California.
| | - Justin Anderson
- Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona
| | - Austin J Sim
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida; Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Claire C Baniel
- Department of Radiation Oncology, Stanford University, Palo Alto, California
| | - Cassandra L Thiel
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, New York
| | - Robert Chuter
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, United Kingdom; Division of Cancer Sciences, Faculty of Biology, Medicine and Heath, University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Amy Collins
- Health Care Without Harm, Reston, Virginia; Department of Emergency Medicine, MetroWest Medical Center, Framingham, Massachusetts
| | - Erin Carollo
- Loyola University Chicago-Stritch School of Medicine, Chicago, Illinois
| | | | - C Norman Coleman
- Radiation Research Program, National Cancer Institute, Bethesda, Maryland
| | - May Abdel-Wahab
- Division of Human Health, Radiation Oncology, International Atomic Energy Agency, Vienna, Austria
| | - Surbhi Grover
- Department of Radiation Oncology, University of Pennsylvania, Botswana-UPenn Partnership, Philadelphia, Pennsylvania
| | - Lisa Singer
- Department of Radiation Oncology, University of California, San Francisco, California
| | - Osama Mohamad
- Department of Radiation Oncology, University of California, San Francisco, California; Department of Urology, University of California, San Francisco, California
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Abstract
Environmental impact of medical imaging is ill-defined and poorly recognised but can vary by a factor of 100 or 1 000 between one test or the other. One echocardiogram produces 2 Kg and a 3 Tesla magnetic resonance imaging produces 200 to 300 kg of carbon dioxide (CO2) equivalent. For 2016, CO2 emissions for magnetic resonance imaging and computed tomography calculated in 120 countries accounted for 0.77% of global emissions. In imaging justification, we usually consider benefit, cost, and risk including long-term cancer risk. Environmental footprint should be included, since there is a fourth partner in the imaging deal: not only the patient, the physician, the payer, but also the planet. Medical imaging is an important source of carbon footprint in the global scale. Environmental impact of each imaging examination might be spelled-out and missing data provided to bridge the knowledge gap. Research may develop a catalogue of carbon footprints associated with specific test modalities, and provide an updated estimation of medical imaging impact on global carbon footprint, promoting new approaches towards a progressive de-carbonization of testing with climate-neutral choices.
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Buckley BW, MacMahon PJ. Radiology and the Climate Crisis: Opportunities and Challenges- Radiology In Training. Radiology 2021; 300:E339-E341. [PMID: 34254853 DOI: 10.1148/radiol.2021210851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Bryan W Buckley
- From the Department of Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Peter J MacMahon
- From the Department of Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
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Reshaping of Italian Echocardiographic Laboratories Activities during the Second Wave of COVID-19 Pandemic and Expectations for the Post-Pandemic Era. J Clin Med 2021; 10:jcm10163466. [PMID: 34441762 PMCID: PMC8397129 DOI: 10.3390/jcm10163466] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Cardiology divisions reshaped their activities during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to analyze the organization of echocardiographic laboratories and echocardiography practice during the second wave of the COVID-19 pandemic in Italy, and the expectations for the post-COVID era. METHODS We analyzed two different time periods: the month of November during the second wave of the COVID-19 pandemic (2020) and the identical month during 2019 (November 2019). RESULTS During the second wave of the COVID-19 pandemic, the hospital activity was partially reduced in 42 (60%) and wholly interrupted in 3 (4%) echocardiographic laboratories, whereas outpatient echocardiographic activity was partially reduced in 41 (59%) and completely interrupted in 7 (10%) laboratories. We observed an important change in the organization of activities in the echocardiography laboratory which reduced the operator-risk and improved self-protection of operators by using appropriate personal protection equipment. Operators wore FFP2 in 58 centers (83%) during trans-thoracic echocardiography (TTE), in 65 centers (93%) during transesophageal echocardiography (TEE) and 63 centers (90%) during stress echocardiography. The second wave caused a significant reduction in number of echocardiographic exams, compared to November 2019 (from 513 ± 539 to 341 ± 299 exams per center, -34%, p < 0.001). On average, there was a significant increase in the outpatient waiting list for elective echocardiographic exams (from 32.0 ± 28.1 to 45.5 ± 44.9 days, +41%, p < 0.001), with a reduction of in-hospital waiting list (2.9 ± 2.4 to 2.4 ± 2.0 days, -17%, p < 0.001). We observed a large diffusion of point-of-care cardiac ultrasound (88%), with a significant increase of lung ultrasound usage in 30 centers (43%) during 2019, extended to all centers in 2020. Carbon dioxide production by examination is an indicator of the environmental impact of technology (100-fold less with echocardiography compared to other cardiac imaging techniques). It was ignored in 2019 by 100% of centers, and currently it is considered potentially crucial for decision-making in cardiac imaging by 65 centers (93%). CONCLUSIONS In one year, major changes occurred in echocardiography practice and culture. The examination structure changed with extensive usage of point-of-care cardiac ultrasound and with lung ultrasound embedded by default in the TTE examination, as well as the COVID-19 testing.
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Schoen J, McGinty GB, Quirk C. Radiology in Our Changing Climate: A Call to Action. J Am Coll Radiol 2021; 18:1041-1043. [PMID: 33716017 DOI: 10.1016/j.jacr.2021.02.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/08/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Julia Schoen
- Department of Radiology, Wake Forest Baptist Health, Winston-Salem, North Carolina.
| | - Geraldine B McGinty
- Department of Radiology and the Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - Cody Quirk
- Department of Radiology and Radiological Science, MUSC Health, Charleston, South Carolina
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Toner A, Lewis JS, Stanhope J, Maric F. Prescribing active transport as a planetary health intervention – benefits, challenges and recommendations. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.1876598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Adam Toner
- Physiotherapy Department, Midlands Regional Hospital, Tullamore, Co. Offaly, Ireland
- Rehabilitation Services, UW Health, Madison, WI, USA
| | - Jeremy S. Lewis
- School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, UK
- Therapy Department, Central London Community Healthcare National Health Service Trust, London, UK
| | - Jessica Stanhope
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, South Australia, Australia
| | - Filip Maric
- Institute of Health and Care Sciences, Unviersity of Tromsø, Norway
- Environmental Physiotherapy Association (EPA), Tromsø, Norway
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Hainc N, Brantner P, Zaehringer C, Hohmann J. "Green Fingerprint" Project: Evaluation of the Power Consumption of Reporting Stations in a Radiology Department. Acad Radiol 2020; 27:1594-1600. [PMID: 31843389 DOI: 10.1016/j.acra.2019.11.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/13/2019] [Accepted: 11/16/2019] [Indexed: 11/15/2022]
Abstract
RATIONALE AND OBJECTIVES To quantify the power or energy consumption of reporting stations in a radiology department and to consider a hypothetical scenario to reduce energy waste. METHODS We measured the energy consumption of 36 radiology reporting stations over a mean time frame of about 194 days and then extrapolated results to 1 year. Reporting stations were configured (by default) to enter a stand-by mode after 4 hours of inactivity. A hypothetical scenario was calculated in which stand-by was skipped and the reporting stations were shut down after 1 hour of inactivity. RESULTS Data from four stations was corrupted. The overall power consumption of the 32 remaining reporting stations was 53,170 kWh/a, equivalent to 12 family households (4500 kWh/a per household in Switzerland in 2014) or 97.2 barrels of oil. We identified three main power consumption patterns of the reporting stations: mainly off, mainly on, and always off. The on-mode consumption per year was 40,763 kWh/a, the stand-by consumption was 10,010 kWh/a, and the off-mode consumption was 2397 kWh/a. The reporting stations spent half of their on-mode time awaiting the initiation of stand-by, resulting in a wait-time consumption of 18,243 kWh/a. With the hypothetical scenario, we achieved an energy consumption saving of 23,692 kWh/a, a reduction of about 45% of the initial energy consumption, equivalent to 5 households or 40.8 barrels of oil consumed. CONCLUSION The power consumption of the reporting stations is not negligible. Reducing energy waste in the radiology department can be established through simple changes in device configuration which will simultaneously promote energywise habits. ADVANCES IN KNOWLEDGE Minor changes to the settings of the reporting stations in a radiology department can result in significant long-term energy savings and promote energy-wise habits.
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Affiliation(s)
- Nicolin Hainc
- Department of Medical Imaging, Division of Neuroradiology, Toronto Western Hospital, Toronto, Ontario, M5T 2S8, Canada.
| | - Philipp Brantner
- Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel/CH, Switzerland
| | - Caroline Zaehringer
- Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel/CH, Switzerland
| | - Joachim Hohmann
- Department of Radiology and Nuclear Medicine, Cantonal Hospital, Winterthur/CH, Switzerland; Medical Faculty, University of Basel, Basel/CH, Switzerland
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37
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Martin MF, Maturen KE. On Green Radiology. Acad Radiol 2020; 27:1601-1602. [PMID: 32473782 DOI: 10.1016/j.acra.2020.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
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A comparative carbon footprint analysis of disposable and reusable vaginal specula. Am J Obstet Gynecol 2020; 223:225.e1-225.e7. [PMID: 32067971 DOI: 10.1016/j.ajog.2020.02.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/28/2019] [Accepted: 02/03/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Healthcare systems in the United States have increasingly turned toward the use of disposable medical equipment in an attempt to save time, lower costs, and reduce the transmission of infections. However, the use of disposable instruments is associated with increased solid waste production and may have negative impacts on the environment, such as increased greenhouse gas emissions. OBJECTIVE The purpose of this study was to inform this discussion; we applied life cycle assessment methods to evaluate the carbon footprints of 3 vaginal specula: a single-use acrylic model and 2 reusable stainless steel models. STUDY DESIGN The functional unit of the study was defined as the completion of 20 gynecologic examinations by either type of speculum. The greenhouse gas emissions (eg, carbon dioxide, methane, nitrous oxide) across all life cycle stages, which includes material production and manufacturing, transportation, use and reprocessing, and end-of-life, were analyzed with the use of SimaPro life cycle assessment software and converted into carbon dioxide equivalents. RESULTS The reusable stainless steel grade 304 speculum was found to have a lesser carbon footprint over multiple model scenarios (different reprocessing techniques, autoclave loading/efficiency, and number of uses) than either the reusable stainless steel grade 316 or the disposable acrylic specula. The material production and manufacturing phase contributed most heavily to the total life cycle carbon footprint of the acrylic speculum, whereas the use and reprocessing phase contributed most to the carbon footprints of both stainless steel specula. CONCLUSION The use of disposable vaginal specula is associated with increased greenhouse gas equivalents compared with reusable alternatives with no significant difference in clinical utility. These findings can be used to inform decision-making by healthcare systems, because they weigh a wide range of considerations in making final purchase decisions; similar analytic methods can and should be applied to other components of health systems' waste streams.
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Sam M, Matthew RP, Patel V, Manolea F, Low G. Limitations in US Diagnosis of Adenomysosis. Radiographics 2019; 39:303-304. [DOI: 10.1148/rg.2019180204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Rishi Philip Matthew
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, 8440–112 St, 2A2.41 WMC, Edmonton, AB, Canada T6G 2B7
| | | | - Florin Manolea
- Department of Radiology and Diagnostic Imaging, Royal Alexandra Hospital, Edmonton, AB, Canada
| | - Gavin Low
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, 8440–112 St, 2A2.41 WMC, Edmonton, AB, Canada T6G 2B7
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