A team from the University of Toronto, led by Dr. Kate Hanneman, has devised a strategy for radiology departments to lower their carbon footprint and adapt to climate change.

Radiology contributes up to 1% of global emissions through the use and production of medical imaging technology. To combat this, Hanneman suggests departments establish a sustainability team and a system to monitor performance indicators. Such teams should include a range of stakeholders like radiologists, technologists, and facilities management to ensure comprehensive policy and protocol development.

Among the key strategies proposed are switching from disposable to reusable medical supplies, optimizing the use of climate control systems, and minimizing the idle time of imaging equipment. For example, powering down MR and CT scanners when not in use could slash emissions significantly, with potential reductions of up to 33% for MR and 80% for CT.
The team also recommends using decision-support tools to select less energy-intensive imaging tests and advocating for low-field MR technology, which is not only more energy-efficient but also more accessible, potentially reducing health disparities.

So, where does one begin? "Leaders can start by inviting a diverse group of department members to participate in sustainability teams and working together to identify high-impact opportunities in their own departments," Hanneman told HCB News.

Moreover, the group calls for collaboration with manufacturers to update or refurbish existing equipment instead of buying new, and they propose switching to multipatient contrast injection systems to cut down on waste.

The research advises that when more than one imaging exam can answer a question, the ones with lower emissions can be prioritized.

"For example, if abdominal ultrasound and abdominal CT are both appropriate for a given indication, ultrasound could be prioritized as the initial imaging test given lower emissions compared to CT," Hanneman said. "Another example: Depending on the context, chest CT and chest MR might both be considered appropriate for evaluation of a suspected mediastinal mass. In this situation, CT could be prioritized given lower emissions compared to MR."

The suggestions in the article are adaptable, allowing each department to tailor solutions to their specific circumstances. This initiative is part of a broader effort, highlighted in a special Earth Day issue of Radiology which also includes studies on reducing emissions through modified MR protocols and the environmental impact of contrast agents.

HCB News asked Hanneman what she and her colleagues tell radiologists who feel they've already got too much on their plate. "Many actions that improve sustainability have associated co-benefits that might be a powerful motivator — including lower cost, potential time-savings, and improved patient comfort," she said. "If individuals are overwhelmed with potential options, they can pick one sustainability action to implement at a time. Once they have implemented that, they can move on to the next."

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