Decision tree for manual review of currently scheduled contrast-enhanced CT examinations in the event that iodinated contrast supply is critically low. CECT = contrast-enhanced CT. GBCA = gadolinium-based contrast agent. NCCT = non-contrast CT. US = ultrasound.

Decision tree for manual review of currently scheduled contrast-enhanced CT examinations in the event that iodinated contrast supply is critically low. CECT = contrast-enhanced CT. GBCA = gadolinium-based contrast agent. NCCT = non-contrast CT. US = ultrasound.


May 18, 2022 —According to ARRS’ American Journal of Roentgenology (AJR), to ensure that patients with emergent or life-threatening imaging indications can continue receiving care, radiology practice leaders need to quickly assess their contrast inventories, prioritize examination findings, and reduce overall iodinated contrast media (ICM) usage.

“Establishing awareness of the ICM shortage throughout the hospital system is an important first step,” wrote coauthors Joseph Cavallo, MD, MBA, and Jay Pahade, MD, from the department of radiology and biomedical imaging at Yale’s School of Medicine.

Alerting frequent referrers for CECT (ED, oncology, surgery) and concomitant users of ICM (cardiology, vascular surgery, GI, radiation oncology, urology) can align preservation strategies throughout the institution.

Additionally, common indications for CECT can be stratified, according to necessity, with three primary strategies for reducing ICM usage:

  1. direct ICM dose reduction;
  2. alternative diagnostic imaging modalities or CT contrast agents;
  3. deferment of imaging.

Drs. Cavallo and Pahade also provide examples of dose reduction that have been implemented at their institution—noting that the feasibility of any dose reduction depends on the specific equipment and imaging protocols at individual facilities.

“Unfortunately,” the two AJR authors added, “departments may need to resort to deferment of CECT examinations.” Ideally, rescheduling should be limited to certain low-risk examinations (i.e., annual staging examinations in patients without clinical evidence of recurrence), as well as follow-up examinations of incidental findings not posing an immediate threat to the patient.

However, in the most critical of shortages, manual review of all pending CECT examinations may be necessary.

 The unanticipated, albeit severe shortage in ICM currently affecting practices around the world is expected to continue into late June of this year.

For more information: www.arrs.org

Related Content of MRI Gadolinium Safety Concerns

Voluntary Dismissal of Chuck Norris Gadolinium Case Involving Bracco

VIDEO: How Serious is MRI Gadolinium Retention in the Brain and Body? An interview with Max Wintermark, M.D.

VIDEO “Big Concerns Remain for MRI Gadolinium Contrast Safety at RSNA 2017,” An interview with Emanuel Kanal, M.D.

Radiology Has Failed to Properly Assess or Track MRI Gadolinium Contrast Safety

Recent Developments in Contrast Media

FDA Committee Votes to Expand Warning Labels on Gadolinium-Based Contrast Agents

European Medicines Agency Issues Update on Gadolinium Contrast Agents


Related Content

News | Clinical Trials

March 30, 2023 —According to an accepted manuscript published in ARRS’ own American Journal of Roentgenology (AJR) ...

Time March 30, 2023
arrow
News | Molecular Imaging

March 29, 2023 — A newly published literature review sheds light on how nuclear medicine brain imaging can help evaluate ...

Time March 29, 2023
arrow
News | PET Imaging

March 29, 2023 — Ratio Therapeutics Inc., a pharmaceutical company that employs a suite of innovative technologies to ...

Time March 29, 2023
arrow
News | Molecular Imaging

March 28, 2023 — A new article in The Journal of Nuclear Medicine explores the potential for using ChatGPT, an ...

Time March 28, 2023
arrow
News | Lung Imaging

March 27, 2023 — On Target Laboratories, Inc., a privately held biotechnology company developing intraoperative ...

Time March 27, 2023
arrow
News | PET Imaging

March 23, 2023 — Nuclidium announced that the Neuroendocrine Tumors Research Foundation (NETRF) has selected the company ...

Time March 24, 2023
arrow
News | Nuclear Imaging

March 22, 2023 — A novel imaging modality that can visualize the distribution of medical radiopharmaceuticals with very ...

Time March 22, 2023
arrow
News | PET-CT

March 21, 2023 — Positron Corporation, a molecular imaging device company that offers PET imaging systems and clinical ...

Time March 21, 2023
arrow
News | Radiopharmaceuticals and Tracers

March 20, 2023 — RayzeBio, Inc., a targeted radiopharmaceutical company developing an innovative pipeline against ...

Time March 20, 2023
arrow
News | Radiopharmaceuticals and Tracers

March 16, 2023 — A supply problem with Pluvicto [177Lu-vipivotide tetraxetan; Novartis], the radiopharmaceutical used to ...

Time March 16, 2023
arrow
Subscribe Now