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Radiologists Look for Ways to Conserve amidst the Dye Shortage
With the current dye shortage that began in April 2022, a JAMA letter was published discussing ways radiologists can conserve.
Matthew Davenport, MD, a radiologist at the University of Michigan Health and vice-chair of the commission on quality and safety for the American College of Radiology, recently published a research letter in JAMA on ways to conserve the iodinated intravascular contrast media— also called contrast dye —in Computed Tomography (CT) scans considering the shortage that began in April 2022.
According to the letter, this shortage is due to supply chain issues exacerbated by the COVID-19 pandemic. The deficit is expected to last through the summer, if not longer.
The letter states that, in the United States, 54.4 million scans with contrast are done each year. Physicians and researchers anticipate the dye shortage being a barrier to obtaining scans.
“During this acute shortage, health systems have been forced to compare their stock-on-hand with the anticipated return-to-normal date to determine how aggressively to conserve contrast material," Davenport said to the University of Michigan Health in the article regarding the JAMA letter.
To avoid additional barriers to access to care, healthcare professionals have sought conservation methods for contrast dye. Davenport identifies five different modes of conservation.
The first of these methods includes weight-based contrast. Traditionally, CT scans require a fixed dose of contrast dye dependent on the area being scanned rather than the patient's size. The first method analyzed in this letter proposes that a weight-based contrast approach can conserve 12% of dye.
Despite the potential for conservation, Davenport told the University of Michigan Health that this approach is ineffective for patients over 80 kg.
Other techniques measured included reducing contrast dose while reducing tube voltage, replacing contrast CT with unenhanced CT (on a case-by-case basis), a combination of weight-based contrast and replacing contrast with non-contrast CT, or a variety of all 3 conservation methods.
Reducing contrast dose while reducing tube voltage is projected to lead to 25% conservation. Replacing contrast CT with unenhanced CT is estimated to provide a 78% reduction in contrast dye usage.
Meanwhile, a combination of 2 or more conservation tactics was predicted to lead to a maximum 83 percent reduction in contrast dye usage.
With the proposals being put forth, radiologists must consider if and how they will incorporate conservation strategies in their daily practices. Conservation techniques have the potential to alter the trajectory of radiological care bit during and after the current shortage crisis.
The researchers concluded the letter by saying, “adoption of some of the dose-reduction strategies beyond the current shortage could mitigate supply chain risk and remove waste.”
