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Woernle A, Moore CM, Allen C, Giganti F. Footprints in the scan: reducing the carbon footprint of diagnostic tools in urology. Curr Opin Urol 2024; 34:390-395. [PMID: 38847801 PMCID: PMC11309339 DOI: 10.1097/mou.0000000000001196] [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] [Indexed: 08/07/2024]
Abstract
PURPOSE OF REVIEW There is an ever-growing focus on climate change and its impact on our society. With healthcare contributing a sizeable proportion of carbon emissions, the sector has a duty to address its environmental impact. We highlight the recent progress, current challenges, and future prospects for reducing the carbon footprint in diagnostic urology, specifically for imaging, without compromising patient care. RECENT FINDINGS The review is separated into four key areas of recent research: the design of a green radiology department, considering both infrastructural as well as behavioural changes that promote sustainability; individual scanners, where we provide an update on recent technological advancements and changes in behaviour that may enhance sustainable use; responsible resource allocation, where it is important to derive the maximal benefit for patients through the smallest use of resources; the recent research regarding single versus reusable urologic endoscopes as a case example. SUMMARY We offer an overview of the present sustainability landscape in diagnostic urology with the aim of encouraging additional research in areas where existing practices may be challenged. To protect the environment, attention is drawn to both more simple steps that can be taken as well as some more complex and expensive ones.
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Affiliation(s)
- Alexandre Woernle
- Faculty of Medical Sciences
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London
| | - Caroline M. Moore
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London
- Department of Urology
| | - Clare Allen
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
| | - Francesco Giganti
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
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2
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Furlan L, Kawatkar AA, Sun BC, Montano N, Costantino G. Environmental costs of noninvasive cardiac testing for acute chest pain after ED discharge. Eur J Intern Med 2024; 126:137-139. [PMID: 38719724 DOI: 10.1016/j.ejim.2024.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 04/23/2024] [Accepted: 04/30/2024] [Indexed: 08/04/2024]
Affiliation(s)
- Ludovico Furlan
- Department of Clinical Sciences and Community Health, University of Milan, Via Francesco Sforza 35, Milan 20124, Italy.
| | - Aniket A Kawatkar
- Research and Evaluation Department, Bernard J. Tyson School of Medicine, Kaiser Permanente Southern California, Pasadena, CA, United States
| | - Benjamin C Sun
- Leonard Davis Institute of Health Economics, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, United States
| | - Nicola Montano
- Department of Clinical Sciences and Community Health, University of Milan, Via Francesco Sforza 35, Milan 20124, Italy
| | - Giorgio Costantino
- Department of Clinical Sciences and Community Health, University of Milan, Via Francesco Sforza 35, Milan 20124, Italy
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3
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Hanneman K, Szava-Kovats A, Burbridge B, Leswick D, Nadeau B, Islam O, Lee EJY, Harris A, Hamel C, Brown MJ. Canadian Association of Radiologists Statement on Environmental Sustainability in Medical Imaging. Can Assoc Radiol J 2024:8465371241260013. [PMID: 39080832 DOI: 10.1177/08465371241260013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024] Open
Abstract
Immediate and strategic action is needed to improve environmental sustainability and reduce the detrimental effects of climate change. Climate change is already adversely affecting the health of Canadians related to worsening air pollution and wildfire smoke, increasing frequency and intensity of extreme weather events, and expansion of vector-borne and infectious illnesses. On one hand, radiology contributes to the climate crisis by generating greenhouse gas emissions and waste during the production, manufacture, transportation, and use of medical imaging equipment and supplies. On the other hand, radiology departments are also susceptible to equipment and infrastructure damage from flooding, extreme temperatures, and power failures, as well as workforce shortages due to injury and illness, potentially disrupting radiology services and increasing costs. The Canadian Association of Radiologists' (CAR) advocacy for environmentally sustainable radiology in Canada encompasses both minimizing the detrimental effects that delivery of radiology services has on the environment and optimizing the resilience of radiology departments to increasing health needs and changing patterns of disease on imaging related to climate change. This statement provides specific recommendations and pathways to help guide radiologists, medical imaging leadership teams, industry partners, governments, and other key stakeholders to transition to environmentally sustainable, net-zero, and climate-resilient radiology organizations. Specific consideration is given to unique aspects of medical imaging in Canada. Finally, environmentally sustainable radiology programs, policies, and achievements in Canada are highlighted.
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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
| | | | - Brent Burbridge
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada
| | - David Leswick
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada
| | - Brandon Nadeau
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | - Omar Islam
- Department of Diagnostic Radiology, Queen's University, Kingston, ON, Canada
| | - Emil J Y Lee
- Department of Medical Imaging, Fraser Health Authority, Vancouver, BC, Canada
| | - Alison Harris
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Candyce Hamel
- Canadian Association of Radiologists, Ottawa, ON, Canada
| | - Maura J Brown
- Diagnostic Imaging, BC Cancer, University of British Columbia, Vancouver, BC, Canada
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Ali KJ, Ehsan S, Tran A, Haugstetter M, Singh H. Diagnostic Excellence in the Context of Climate Change: A Review. Am J Med 2024:S0002-9343(24)00403-0. [PMID: 38925497 DOI: 10.1016/j.amjmed.2024.06.010] [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: 06/14/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
Climate change is leading to a rise in heat-related illnesses, vector-borne diseases, and numerous negative impacts on patients' physical and mental health outcomes. Concurrently, healthcare contributes about 4.6% of global greenhouse gas emissions. Low-value care, such as overtesting and overdiagnosis, contributes to unnecessary emissions. In this review, we describe diagnostic excellence in the context of climate change and focus on two topics. First, climate change is affecting health, leading to the emergence of certain diseases, some of which are new, while others are increasing in prevalence and/or becoming more widespread. These conditions will require timely and accurate diagnosis by clinicians who may not be used to diagnosing them. Second, diagnostic quality issues, such as overtesting and overdiagnosis, contribute to climate change through unnecessary emissions and waste and should be targeted for interventions. We also highlight implications for clinical practice, research, and policy. Our findings call for efforts to engage healthcare professionals and policymakers in understanding the urgent implications for diagnosis in the context of climate change and reducing global greenhouse gas emissions to enhance both patient and planetary outcomes.
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Affiliation(s)
- Kisha J Ali
- MedStar Institute for Quality and Safety, MedStar Health Research Institute, Columbia, MD
| | - Sara Ehsan
- Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas
| | - Alberta Tran
- MedStar Institute for Quality and Safety, MedStar Health Research Institute, Columbia, MD
| | - Monika Haugstetter
- Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality, Rockville, MD
| | - Hardeep Singh
- Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas.
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Jackson MR. Re: Imaging inequality: exploring the differences in radiology between high- and low-income countries. Clin Radiol 2024:S0009-9260(24)00296-4. [PMID: 38991892 DOI: 10.1016/j.crad.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 07/13/2024]
Affiliation(s)
- M R Jackson
- Royal Hospital for Children and Young People, Edinburgh, UK.
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6
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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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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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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: 0] [Impact Index Per Article: 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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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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10
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Chodorowski M, Ognard J, Rovira À, Gentric JC, Bourhis D, Ben Salem D. Energy consumption in MRI: Determinants and management options. J Neuroradiol 2024; 51:182-189. [PMID: 38065429 DOI: 10.1016/j.neurad.2023.12.001] [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: 09/21/2023] [Revised: 11/22/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Energy consumption awareness is a known concern, and radiology departments have energy-intensive consuming machines. The means of energy consumption management in MRI scanners have yet to be evaluated. PURPOSE To measure the MRI energy consumption and to evaluate the means to reduce it. MATERIALS AND METHODS Data was retrieved for two MRI scanners through the hospital's automated energy consumption measurement software. After correlation with picture archiving and communication system (PACS) files, they were segmented by machine and mode (as follows: stand-by, idle and active) and analyzed. Active mode data for a specific brain MRI protocol have been isolated, and equivalent low energy consuming protocol was made. Both were performed on phantom and compared. Same protocol was performed on a phantom using 3.0T 16 and 32 head channels coils. Multiples sequences were acquired on phantom to evaluate power consumption. RESULTS Stand-by mode accounted for 60 % of machine time and 40 % of energy consumption, active mode accounted for 20 % machine time and 40 % energy consumption, idle mode for 20 % imachine time and 20 % consumption. DWI and TOF sequences were the most consuming in our brain-MRI protocol. The low energy consuming protocol allowed a saving of approximately 10 % of energy consumption, which amounted for 0.20€ for each examination. This difference was mainly due to an energy consumption reduction of the DWI sequence. There were no difference in consumption between a 3.0T 16 and 32 channels head coils. Sequence's active power and duration (especially considering slice thickness) have to be taken into account when trying to optimize energy consumption. CONCLUSION There are two key factors to consider when trying to reduce MRI scan energy consumption. Stand-by mode energy consumption has to be taken into account when choosing an MRI scan, as it can't be changed further on. Active mode energy consumption is dependent of the MRI protocols used, and can be reduced with sequences adaptation, which must take into account sequence's active power and duration, on top of image quality.
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Affiliation(s)
- Mateusz Chodorowski
- Service d'Imagerie Médicale, CHU Brest, Univ. Brest, Boulevard Tanguy Prigent, Brest CEDEX, 29609, France.
| | - Julien Ognard
- Service d'Imagerie Médicale, CHU Brest, Univ. Brest, Boulevard Tanguy Prigent, Brest CEDEX, 29609, France; INSERM UMR 1101, Laboratoire de Traitement de L'Information Médicale - LaTIM, Université de Bretagne Occidentale, 22, Avenue C. Desmoulins, Brest 29238 Cedex 3, France
| | - Àlex Rovira
- Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain
| | - Jean-Christophe Gentric
- Service d'Imagerie Médicale, CHU Brest, Univ. Brest, Boulevard Tanguy Prigent, Brest CEDEX, 29609, France; Inserm, UMR 1304 (GETBO), Western Brittany Thrombosis Study Group, Université de Bretagne Occidentale, Brest, France
| | - David Bourhis
- Inserm, UMR 1304 (GETBO), Western Brittany Thrombosis Study Group, Université de Bretagne Occidentale, Brest, France; Service de Physique Médicale, CHU Brest, France
| | - Douraied Ben Salem
- Service d'Imagerie Médicale, CHU Brest, Univ. Brest, Boulevard Tanguy Prigent, Brest CEDEX, 29609, France; INSERM UMR 1101, Laboratoire de Traitement de L'Information Médicale - LaTIM, Université de Bretagne Occidentale, 22, Avenue C. Desmoulins, Brest 29238 Cedex 3, France
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11
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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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12
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De Vita A, Belmusto A, Di Perna F, Tremamunno S, De Matteis G, Franceschi F, Covino M. The Impact of Climate Change and Extreme Weather Conditions on Cardiovascular Health and Acute Cardiovascular Diseases. J Clin Med 2024; 13:759. [PMID: 38337453 PMCID: PMC10856578 DOI: 10.3390/jcm13030759] [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: 12/05/2023] [Revised: 01/12/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Climate change is widely recognized as one of the most significant challenges facing our planet and human civilization. Human activities such as the burning of fossil fuels, deforestation, and industrial processes release greenhouse gases into the atmosphere, leading to a warming of the Earth's climate. The relationship between climate change and cardiovascular (CV) health, mediated by air pollution and increased ambient temperatures, is complex and very heterogeneous. The main mechanisms underlying the pathogenesis of CV disease at extreme temperatures involve several regulatory pathways, including temperature-sympathetic reactivity, the cold-activated renin-angiotensin system, dehydration, extreme temperature-induced electrolyte imbalances, and heat stroke-induced systemic inflammatory responses. The interplay of these mechanisms may vary based on individual factors, environmental conditions, and an overall health background. The net outcome is a significant increase in CV mortality and a higher incidence of hypertension, type II diabetes mellitus, acute myocardial infarction (AMI), heart failure, and cardiac arrhythmias. Patients with pre-existing CV disorders may be more vulnerable to the effects of global warming and extreme temperatures. There is an urgent need for a comprehensive intervention that spans from the individual level to a systemic or global approach to effectively address this existential problem. Future programs aimed at reducing CV and environmental burdens should require cross-disciplinary collaboration involving physicians, researchers, public health workers, political scientists, legislators, and national leaders to mitigate the effects of climate change.
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Affiliation(s)
- Antonio De Vita
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Antonietta Belmusto
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
| | - Federico Di Perna
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
| | - Saverio Tremamunno
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Giuseppe De Matteis
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Francesco Franceschi
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
| | - Marcello Covino
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
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13
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Suleiman N, Apalangya VA, Mensah B, Kan-Dapaah K, Yaya A. Exploring Carbon Monoxide and Carbon Dioxide Adsorption on (5,5) Aluminum Nitride Nanotubes for Enhanced Sensor Applications: A DFT Study. Molecules 2024; 29:557. [PMID: 38338302 PMCID: PMC10856465 DOI: 10.3390/molecules29030557] [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: 07/26/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 02/12/2024] Open
Abstract
This study examined the sensitivity of single-walled (5,5) aluminium nitride nanotubes ((5,5) AlNNTs) to carbon monoxide (CO) and carbon dioxide (CO2) gas molecules by performing DFT calculations using a hybrid functional, specifically, B3LYP (Becke's three-parameter, Lee-Yang-Parr) exchange-correlation functional at a 6-31G* basis set. This research investigates the adsorption behavior of CO2 and CO molecules on pristine and silicon-doped aluminum nitride nanotubes (AlNNTs) and examines their implications for sensor applications. The study assesses each system's adsorption energy, sensing potential, and recovery time to gain insights into their binding strength and practical viability. For CO2 adsorption on (5,5) AlNNT, significant adsorption energy of -24.36 kcal/mol was observed, indicating a strong binding to the nanotube surface, with a sensing potential of 8.95%. However, the slow recovery time of approximately 4.964 days may limit its real-time application. Si-(5,5) AlNNT exhibited a CO2 adsorption energy of -19.69 kcal/mol, a sensing potential of 5.40%, and a relatively short recovery time of approximately 2.978 min, making it a promising candidate for CO2 sensing. CO adsorption on (5,5) AlNNT showed an adsorption energy of -25.20 kcal/mol, a sensing potential of 9.095%, but a longer recovery time of approximately 20.130 days. Si-(5,5) AlNNT displayed a high CO adsorption energy of -20.78 kcal/mol, a sensing potential of 4.29%, and a recovery time of approximately 18.320 min. These findings provide insights into the adsorption characteristics of carbon molecules on AlNNTs, highlighting their potential for CO2 and CO sensing applications.
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Affiliation(s)
- Nafiu Suleiman
- Department of Materials Science and Engineering, College of Basic and Applied Science (CBAS), University of Ghana, Accra P.O. Box LG 77, Ghana; (N.S.); (B.M.)
| | - Vitus Atanga Apalangya
- Department of Food Process Engineering, College of Basic and Applied Science (CBAS), University of Ghana, Accra P.O. Box LG 77, Ghana;
| | - Bismark Mensah
- Department of Materials Science and Engineering, College of Basic and Applied Science (CBAS), University of Ghana, Accra P.O. Box LG 77, Ghana; (N.S.); (B.M.)
| | - Kwabena Kan-Dapaah
- Department of Biomedical Engineering, College of Basic and Applied Science (CBAS), University of Ghana, Accra P.O. Box LG 77, Ghana;
| | - Abu Yaya
- Department of Materials Science and Engineering, College of Basic and Applied Science (CBAS), University of Ghana, Accra P.O. Box LG 77, Ghana; (N.S.); (B.M.)
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14
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Karout L, Digumarthy SR, Savage C, Fahimi R, Garza-Frias E, Kaviani P, Dasegowda G, Kalra MK. Low Contrast Volume Protocol in Routine Chest CT Amid the Global Contrast Shortage: A Single Institution Experience. Acad Radiol 2023; 30:2913-2920. [PMID: 37164818 DOI: 10.1016/j.acra.2023.03.020] [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: 12/19/2022] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To assess the effectiveness of low contrast volume (LCV) chest CT performed with multiple contrast agents on multivendor CT with varying scanning techniques. METHODS The study included 361 patients (65 ± 15 years; M: F 173:188) who underwent LCV chest CT on one of the six 64-256 detector-row CT scanners using single-energy (SECT) or dual-energy (DECT) modes. All patients were scanned with either a fixed-LCV (LCVf, n = 103) or weight-based LCV (LCVw, n = 258) protocol. Two thoracic radiologists independently assessed all LCV CT and patients' prior standard contrast volume (SCV, n = 263) chest CT for optimality of contrast enhancement in thoracic vasculature, cardiac chambers, and in pleuro-parenchymal and mediastinal abnormalities. CT attenuations were recorded in the main pulmonary trunk, ascending, and descending thoracic aorta. To assess the interobserver agreement, pulmonary arterial enhancement was divided into two groups: optimal or suboptimal. RESULTS There was no significant difference among patients' BMI (p = 0.883) in the three groups. DECT had a significantly higher aortic arterial enhancement (250 ± 99HU vs 228 ± 76 HU for SECT, p < 0.001). Optimal enhancement was present in 558 of 624 chest CT (89.4%), whereas 66 of 624 chest CT with suboptimal enhancement was noted in 48 of 258 LCVw (18.6%) and 14 of 103 LCVf (13.6%). Most patients with suboptimal enhancement with LCVw injection protocol were overweight/obese (30/48; 62.5%), (p < 0.001). CONCLUSION LCV chest CT can be performed across complex multivendor, multicontrast media, multiscanner, and multiprotocol CT practices. However, LCV chest CT examinations can result in suboptimal contrast enhancement in patients with larger body habitus.
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Affiliation(s)
- Lina Karout
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, 75 Blossom Court, Boston, Massachusetts, 02114
| | - Subba R Digumarthy
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, 75 Blossom Court, Boston, Massachusetts, 02114
| | - Cristy Savage
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Roshan Fahimi
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, 75 Blossom Court, Boston, Massachusetts, 02114
| | - Emiliano Garza-Frias
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, 75 Blossom Court, Boston, Massachusetts, 02114
| | - Parisa Kaviani
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, 75 Blossom Court, Boston, Massachusetts, 02114
| | - Giridhar Dasegowda
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, 75 Blossom Court, Boston, Massachusetts, 02114
| | - Mannudeep K Kalra
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, 75 Blossom Court, Boston, Massachusetts, 02114.
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15
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Jackson MR. Sustainable imaging in the era of the climate emergency: a personal view. Clin Radiol 2023; 78:895-896. [PMID: 37734975 DOI: 10.1016/j.crad.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/23/2023]
Affiliation(s)
- M R Jackson
- Imaging Department, Royal Hospital for Children and Young People, Edinburgh, UK.
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16
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Chivers DJ. Energy intensive imaging is a major contributor to healthcare emissions. BMJ 2023; 383:2554. [PMID: 37923342 DOI: 10.1136/bmj.p2554] [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] [Indexed: 11/07/2023]
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17
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Sanpradit P, Byeon E, Lee JS, Peerakietkhajorn S. Ecotoxicological, ecophysiological, and mechanistic studies on zinc oxide (ZnO) toxicity in freshwater environment. Comp Biochem Physiol C Toxicol Pharmacol 2023; 273:109720. [PMID: 37586582 DOI: 10.1016/j.cbpc.2023.109720] [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: 07/06/2023] [Revised: 08/09/2023] [Accepted: 08/13/2023] [Indexed: 08/18/2023]
Abstract
The world has faced climate change that affects hydrology and thermal systems in the aquatic environment resulting in temperature changes, which directly affect the aquatic ecosystem. Elevated water temperature influences the physico-chemical properties of chemicals in freshwater ecosystems leading to disturbing living organisms. Owing to the industrial revolution, the mass production of zinc oxide (ZnO) has been led to contaminated environments, and therefore, the toxicological effects of ZnO become more concerning under climate change scenarios. A comprehensive understanding of its toxicity influenced by main factors driven by climate change is indispensable. This review summarized the detrimental effects of ZnO with a single ZnO exposure and combined it with key climate change-associated factors in many aspects (i.e., oxidative stress, energy reserves, behavior and life history traits). Moreover, this review tried to point out ZnO kinetic behavior and corresponding mechanisms which pose a problem of observed detrimental effects correlated with the alteration of elevated temperature.
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Affiliation(s)
- Paweena Sanpradit
- Division of Biological Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Eunjin Byeon
- Department of Biological Sciences, College of Science, Sungkyunkwan University, Suwon 16419, South Korea
| | - Jae-Seong Lee
- Department of Biological Sciences, College of Science, Sungkyunkwan University, Suwon 16419, South Korea.
| | - Saranya Peerakietkhajorn
- Division of Biological Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
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18
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Dan AO, Ștefănescu-Dima A, Bălășoiu AT, Puiu I, Mocanu CL, Ionescu M, Tănasie AC, Târtea AE, Sfredel V. Early Retinal Microvascular Alterations in Young Type 1 Diabetic Patients without Clinical Retinopathy. Diagnostics (Basel) 2023; 13:diagnostics13091648. [PMID: 37175038 PMCID: PMC10177951 DOI: 10.3390/diagnostics13091648] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023] Open
Abstract
The purpose of this study is to identify and quantify preclinical changes with the help of optical coherence tomography angiography (OCTA) within the retinal microcirculation of young type 1 diabetes (T1D) patients without clinical signs of diabetic retinopathy (DR) and to compare these results with those obtained from healthy age-matched subjects. OCTA is currently used for monitoring diabetic retinopathy; however, there is no current consensus on which OCTA parameter alterations predict the first clinical signs of diabetic retinopathy. The main challenge that young patients with T1D face during the course of the disease is that they can rapidly progress to the development of DR, especially during adolescence. Moreover, they also present an increased risk of rapid progression toward advanced stages of DR and vision loss compared to type 2 diabetes patients, indicating the importance of early diagnosis and intervention. The limitations of the currently used screening procedures that led to the conceptualization of our study are the difficulties in performing fluorescein angiography tests for diagnosing the clinical signs of DR on young patients, namely the invasive procedure of dye injection, the risk of allergic reactions and the long duration of the examination. Moreover, given the long life expectancy of young T1D patients, it is essential to identify the preclinical changes in retinal microvasculature before reaching the first clinical signs quantifiable by FFA. The clinical study enrolled 119 subjects aged between 4 and 30 years old with a mean age of 13 years old, comprising 61 T1D patients with a mean duration of the disease of 4 years and 8 months and 58 healthy age-matched subjects for the control group. OCTA scans were performed using the RevoNX 130 OCTA device (Optopol) to evaluate the following retinal parameters: foveal avascular zone (FAZ) area, perimeter and circularity, overall foveal thickness, and superficial and deep vessel densities. Statistically significant differences between the two groups were identified for the following parameters: the FAZ area in the T1D group (0.42 ± 0.17) was larger than the control group (0.26 ± 0.080), the FAZ circularity (0.41 ± 0.11) was decreased compared to the control group (0.61 ± 0.08) and the FAZ perimeter was larger (3.63 ± 0.97) compared to the control group (2.30 ± 0.50). The overall foveal thickness was decreased in the T1D group (222.98 ± 17.33) compared to the control group (230.64 ± 20.82). The total vessel density of the superficial capillary plexus (SCP) on an investigated area of 6 X 6 mm centered around the fovea was decreased in the T1D group (37.4164 ± 2.14) compared to the control group (38.0241 ± 2.44). Our data suggest that specific imaging biomarkers such as FAZ perimeter, area and circularity, decreased overall foveal thickness and decreased vessel density in the SCP precede the clinical diagnosis of DR in young T1D patients and represent useful parameters in quantifying capillary nonperfusion in T1D patients without clinical signs of DR.
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Affiliation(s)
- Alexandra Oltea Dan
- Department of Physiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Alin Ștefănescu-Dima
- Department of Ophthalmology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Andrei Teodor Bălășoiu
- Department of Ophthalmology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ileana Puiu
- Department of Pediatrics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Carmen Luminița Mocanu
- Department of Ophthalmology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mihaela Ionescu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Andreea Cornelia Tănasie
- Department of Physiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Anca Elena Târtea
- Department of Neurology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Veronica Sfredel
- Department of Physiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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19
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Kopparam RV, Redberg RF. The environmental impact of unnecessary imaging: Why less is more. Eur J Intern Med 2023; 111:35-36. [PMID: 36878771 DOI: 10.1016/j.ejim.2023.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 03/07/2023]
Affiliation(s)
- Rohini V Kopparam
- Department of Medicine, University of California, San Francisco, CA, United States
| | - Rita F Redberg
- Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, United States.
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