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Afat S, Wohlers J, Herrmann J, Brendlin AS, Gassenmaier S, Almansour H, Werner S, Brendel JM, Mika A, Scherieble C, Notohamiprodjo M, Gatidis S, Nikolaou K, Küstner T. Reducing energy consumption in musculoskeletal MRI using shorter scan protocols, optimized magnet cooling patterns, and deep learning sequences. Eur Radiol 2024:10.1007/s00330-024-11056-0. [PMID: 39242400 DOI: 10.1007/s00330-024-11056-0] [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: 03/15/2024] [Revised: 06/25/2024] [Accepted: 08/14/2024] [Indexed: 09/09/2024]
Abstract
OBJECTIVES The unprecedented surge in energy costs in Europe, coupled with the significant energy consumption of MRI scanners in radiology departments, necessitates exploring strategies to optimize energy usage without compromising efficiency or image quality. This study investigates MR energy consumption and identifies strategies for improving energy efficiency, focusing on musculoskeletal MRI. We assess the potential savings achievable through (1) optimizing protocols, (2) incorporating deep learning (DL) accelerated acquisitions, and (3) optimizing the cooling system. MATERIALS AND METHODS Energy consumption measurements were performed on two MRI scanners (1.5-T Aera, 1.5-T Sola) in practices in Munich, Germany, between December 2022 and March 2023. Three levels of energy reduction measures were implemented and compared to the baseline. Wilcoxon signed-rank test with Bonferroni correction was conducted to evaluate the impact of sequence scan times and energy consumption. RESULTS Our findings showed significant energy savings by optimizing protocol settings and implementing DL technologies. Across all body regions, the average reduction in energy consumption was 72% with DL and 31% with economic protocols, accompanied by time reductions of 71% (DL) and 18% (economic protocols) compared to baseline. Optimizing the cooling system during the non-scanning time showed a 30% lower energy consumption. CONCLUSION Implementing energy-saving strategies, including economic protocols, DL accelerated sequences, and optimized magnet cooling, can significantly reduce energy consumption in MRI scanners. Radiology departments and practices should consider adopting these strategies to improve energy efficiency and reduce costs. CLINICAL RELEVANCE STATEMENT MRI scanner energy consumption can be substantially reduced by incorporating protocol optimization, DL accelerated acquisition, and optimized magnetic cooling into daily practice, thereby cutting costs and environmental impact. KEY POINTS Optimization of protocol settings reduced energy consumption by 31% and imaging time by 18%. DL technologies led to a 72% reduction in energy consumption of and a 71% reduction in time, compared to the standard MRI protocol. During non-scanning times, activating Eco power mode (EPM) resulted in a 30% reduction in energy consumption, saving 4881 € ($5287) per scanner annually.
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Affiliation(s)
- Saif Afat
- Department of Radiology, Tuebingen University Hospital, University of Tuebingen, Tuebingen, Germany
| | - Julian Wohlers
- Department of Magnetic Resonance Product Management, Siemens Healthineers, Erlangen, Germany
| | - Judith Herrmann
- Department of Radiology, Tuebingen University Hospital, University of Tuebingen, Tuebingen, Germany
| | - Andreas S Brendlin
- Department of Radiology, Tuebingen University Hospital, University of Tuebingen, Tuebingen, Germany
| | - Sebastian Gassenmaier
- Department of Radiology, Tuebingen University Hospital, University of Tuebingen, Tuebingen, Germany
| | - Haidara Almansour
- Department of Radiology, Tuebingen University Hospital, University of Tuebingen, Tuebingen, Germany
| | - Sebastian Werner
- Department of Radiology, Tuebingen University Hospital, University of Tuebingen, Tuebingen, Germany
| | - Jan M Brendel
- Department of Radiology, Tuebingen University Hospital, University of Tuebingen, Tuebingen, Germany
| | - Alexander Mika
- Radiologische, Strahlentherapeutische und Nuklearmedizinische Partnerschaftsgesellschaft Muenchen, DIE RADIOLOGIE, Munich, Germany
| | - Christoph Scherieble
- Radiologische, Strahlentherapeutische und Nuklearmedizinische Partnerschaftsgesellschaft Muenchen, DIE RADIOLOGIE, Munich, Germany
| | - Mike Notohamiprodjo
- Radiologische, Strahlentherapeutische und Nuklearmedizinische Partnerschaftsgesellschaft Muenchen, DIE RADIOLOGIE, Munich, Germany
| | - Sergios Gatidis
- Department of Radiology, Tuebingen University Hospital, University of Tuebingen, Tuebingen, Germany
| | - Konstantin Nikolaou
- Department of Radiology, Tuebingen University Hospital, University of Tuebingen, Tuebingen, Germany
| | - Thomas Küstner
- Department of Radiology, Tuebingen University Hospital, University of Tuebingen, Tuebingen, Germany.
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Chinene B, Mudadi LS, Bwanga O, Nyawani P, Mutandiro L, Kafwimbi S, Matika W, Ohene-Botwe B. Sustainability in radiography: Knowledge, practices, and barriers among radiographers in Zimbabwe and Zambia. J Med Imaging Radiat Sci 2024; 55:101438. [PMID: 38870634 DOI: 10.1016/j.jmir.2024.101438] [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: 02/28/2024] [Revised: 05/01/2024] [Accepted: 05/21/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION As the global demand for radiography services increases, departments need to be aware of the environmental impact of their practices and strive to reduce their carbon footprint. However, sustainability in radiography, particularly in low-resource settings, remains underexplored. This study aimed to investigate the knowledge, practices, and barriers to sustainability in radiography practice among radiographers in Zimbabwe and Zambia. METHODS A quantitative cross-sectional study involving 216 consecutively sampled radiographers who completed an online questionnaire was conducted. Data analysis was performed using descriptive statistics, the Chi-square test, and exploratory factor analysis using principal component analysis. RESULTS Overall, 81.49 % of the radiographers had some familiarity with the concept of sustainability. The radiography educational curriculum was singled out as lacking sufficient content on sustainability (44.44 %). More than half of the radiographers reported the absence of deliberate sustainable practices in place in their respective departments (Zambia 51.02 %, Zimbabwe 54.69 %). The top reported barriers to sustainability include; a lack of priority for sustainability from leadership and organization (73.61 %), a lack of incentives for sustainability (75.46 %), and a lack of partnerships between suppliers and consumers on ways to improve diagnosis, patient safety and sustainability (82.4 %). CONCLUSION This study offers valuable insights into the current state of sustainability in radiography in Zambia and Zimbabwe, highlighting the need for academic reforms, intentional departmental practices, and systemic changes to drive sustainable efforts in the field. Future research should aim to enhance the sustainability of radiographic examinations and procedures, thereby advancing the core practice of radiographers.
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Affiliation(s)
- Bornface Chinene
- Harare Institute of Technology, Department of Radiography, Belvedere, Harare, Zimbabwe.
| | - Leon-Say Mudadi
- Royal Papworth Hospital, NHS Foundation Trust, Cambridge, United Kingdom
| | - Osward Bwanga
- Midland University Hospital Tullamore, Radiology Department, Co., Offaly, Ireland
| | - Paridzai Nyawani
- Harare Institute of Technology, Department of Radiography, Belvedere, Harare, Zimbabwe
| | - Lavin Mutandiro
- Harare Institute of Technology, Department of Radiography, Belvedere, Harare, Zimbabwe
| | - Stefan Kafwimbi
- University of Zambia, School of Health Sciences, Department of Radiography, Lusaka, Zambia
| | - Waneta Matika
- Harare Institute of Technology, Department of Radiography, Belvedere, Harare, Zimbabwe
| | - Benard Ohene-Botwe
- Department of Midwifery and Radiography, City University of London Northampton Square London, EC1V 0HB, United Kingdom
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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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Limphaibool N, Bowden K, Walters H. Shutdown protocols for IT-reducing energy waste in medical practice. BMJ 2024; 386:e079056. [PMID: 39079717 DOI: 10.1136/bmj-2023-079056] [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: 08/10/2024]
Affiliation(s)
| | - Kevin Bowden
- Oxford University Hospitals NHS Foundation Trust
| | - Huw Walters
- Oxford University Hospitals NHS Foundation Trust
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Roletto A, Catania D, Rainford L, Savio A, Zanardo M, Bonfitto GR, Zanoni S. Sustainable radiology departments: A European survey to explore radiographers' perceptions of environmental and energy sustainability issues. Radiography (Lond) 2024; 30 Suppl 1:81-90. [PMID: 38996669 DOI: 10.1016/j.radi.2024.06.022] [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: 05/15/2024] [Revised: 06/20/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024]
Abstract
INTRODUCTION The environmental impact of radiology and radiotherapy activities is influenced by the energy consumption of equipment, the life cycle of consumables, waste generation, and CO2 emissions caused by staff travel. This study aims to investigate radiographers' perception and knowledge of environmental sustainability issues. METHODS An online survey was created and distributed to European radiographers and therapeutic radiographers. The survey questions (n = 43) include demographic data; questions on their perceptions and actions regarding environmental sustainability in healthcare, energy consumption, emissions from staff travel, waste generation from radiological procedures; the role of radiographers in addressing sustainability issues within their departments. RESULTS A total of 253 responses were collected from 27 European countries. About their perception on sustainability issues, most participants considered environmental sustainability in healthcare as very important. According to 63.6% (n = 161) of respondents, the energy consumption of radiological equipment is the major source of environmental footprints from radiology activities. Additionally, 44.7% (n = 113) believe that conducting diagnostic examinations remotely could reduce environmental footprints from staff commuting About their actions at workplace, over 70% (n = 192) reported turning off devices after use. Attention to waste recycling is high, but limited to paper, plastic and glass. Contrast agents recycling procedures are implemented by 13% (n = 33). The absence or unawareness of environmental sustainability procedures in the workplace was reported by 66% (n = 167). Radiographers could play an active role in environmental sustainability programs for 243 (96.1%) participants. CONCLUSION This study provides a comprehensive overview of European radiographers' knowledge and perceptions concerning environmental sustainability issues. While radiographers recognize the importance of a green radiology department, significant gaps remain in their understanding of eco-friendly initiatives in radiology units' activities. IMPLICATION FOR PRACTICE Enhancing radiographers' skills with sustainability expertise could promote a greener culture within radiology departments.
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Affiliation(s)
- A Roletto
- Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Via Branze 38, 25123, Brescia, Italy.
| | - D Catania
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - L Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - A Savio
- Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Via Branze 38, 25123, Brescia, Italy.
| | - M Zanardo
- Radiology Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy.
| | - G R Bonfitto
- Department of Information Engineering, Università degli Studi di Brescia, Via Branze 38, 25123, Brescia, Italy.
| | - S Zanoni
- Department of Civil, Environmental, Architectural Engineering and Mathematics, Università degli Studi di Brescia, Via Branze 43, 25123, Brescia, Italy.
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Rawashdeh M, Ali MA, McEntee M, El-Sayed M, Saade C, Kashabash D, Englend A. Green radiography: Exploring perceptions, practices, and barriers to sustainability. Radiography (Lond) 2024; 30 Suppl 1:62-73. [PMID: 38981301 DOI: 10.1016/j.radi.2024.06.019] [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: 04/27/2024] [Revised: 06/12/2024] [Accepted: 06/24/2024] [Indexed: 07/11/2024]
Abstract
INTRODUCTION Previous research has delved into the attitudes and behaviors of diverse professions regarding environmental sustainability. However, there needs to be more research specifically targeting radiographers. This study aims to survey radiographers' perceptions, practices, and barriers to change concerning environmental sustainability in radiology. METHODS Institutional ethical approval was obtained (IRB-COHS-FAC-110-2024) and data collection was conducted using Google Forms (Google Inc., Mountain View, CA). The survey targeted 104 practicing radiographers across several countries. Questions were structured around five domains to gather insights into demographics, training in global warming and climate change, perceptions of sustainability and climate change, sustainability barriers, and current radiology practices on sustainability. Data analysis utilized descriptive and d inferential statistics. RESULTS One hundred and four radiographers completed the study. Females had a significantly higher attendance rate in environmental protection campaigns (P = 0.01). The majority of respondents (68%) believe in climate change's knowledge and impact on the natural world. Our survey findings demonstrate that 74% of respondents believe there's a need to improve sustainability practices. The most commonly used strategies to decrease energy consumption and emissions were low-energy lighting (60%), real-time power monitoring tools (41%), and energy-efficient heating systems (32%). A significant concern regarding sustainability emerges among respondents: time (50%) and lack of leadership (48%) are prevalent concerns among the identified barriers. CONCLUSION Participants are recognising the importance of environmental sustainability in radiology, but lack of leadership, support, authority, and facility limitations hinder their adoption. IMPACT ON PRACTICE Radiology must prioritize environmental sustainability by providing resources and training for radiographers and collaborating with healthcare professionals, policymakers, and environmental experts to develop comprehensive strategies for a sustainable healthcare system.
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Affiliation(s)
- M Rawashdeh
- Medical Imaging Sciences, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates; Faculty of Health Sciences, Jordan University of Sciences and Technology, Irbid, Jordan.
| | - M A Ali
- Medical Imaging Sciences, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates
| | - M McEntee
- The Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Cork, Ireland; Institute of Regional Health Research, University of Southern Denmark, Denmark
| | - M El-Sayed
- Faculty of Applied Health Sciences Technology, Galala University, Suez, 43511, Egypt
| | - C Saade
- The Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Cork, Ireland
| | - D Kashabash
- Medical Imaging Sciences, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates
| | - A Englend
- The Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Cork, Ireland
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7
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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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Bastian S, André E, Jesús FL, Doreen K, Yvonne K, Michael T, Rahel A KH, Tilo N. Assessing Environmental Sustainability in Dual-Energy CT: Exploring Energy Consumption and Ecological-Economic Impact in Low Utilization Times. Acad Radiol 2024:S1076-6332(24)00288-5. [PMID: 38806373 DOI: 10.1016/j.acra.2024.05.004] [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: 03/26/2024] [Revised: 05/05/2024] [Accepted: 05/05/2024] [Indexed: 05/30/2024]
Abstract
RATIONALE AND OBJECTIVES Within global sustainable resource management efforts, reducing healthcare energy consumption is of public concern. This study aims to analyze the energy consumption of three Dual-Energy computed tomography (DECT) scanners and to predict the power consumption based on scan acquisition parameters. MATERIALS AND METHODS This study consisted of two parts assessing three DECT scanners: one Dual-Source and two Single-Source DECT. In Part A, the energy consumption for various single- and DECT scans with different acquisition parameters using a chest phantom was measured. The measurements were compared to the calculated power consumption. In Part B, the energy consumption baselines during nonutilization states of the DECT devices: idle (ready to scan), low-power (incomplete shutdown), and system-off mode (complete shutdown) were measured. Descriptive statistics were used. RESULTS The phantom study revealed a positive correlation between measured and calculated energy consumption (r2 =0.82), except for single-source split-filter DECT acquisitions, indicating a relationship between scan parameters and energy consumption. The baseline study results showed a mean energy consumption of 2.6kWh/hour ± 1.34kWh in idle, 0.89kWh/hour ± 0.42kWh in low-power, and < 0.01kWh/hour ± 0.003kWh in the system-off state. The potential total annual CO2 savings for the assessed DECT scanners amounted to 3767kg CO2 (low power) and 5868kg CO2 (system off) compared to the idle state. Time-related calculations indicated energy savings starting after 5 min in low-power- and after 2 min in the system-off state. Therefore, switching off the scanner, even during shorter periods of non-utilization, can be efficient. CONCLUSION Our results emphasize a positive correlation between scan parameters and energy consumption in DECT. Complete shutdown of DECT devices can have a significant ecological-economic impact.
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Affiliation(s)
- Schulz Bastian
- Kantonsspital Baden AG, Department of Radiology, affiliated Hospital for Research and Teaching of the Faculty of Medicine of the University of Zurich, Im Ergel 1, 5404 Baden, Switzerland (S.B., E.A., K.H.R., N.T.); University of Zurich, Department of Forensic Medicine Zurich, Winterthurerstrasse 190/52, 8057 Zurich, Switzerland (S.B., T.M.)
| | - Euler André
- Kantonsspital Baden AG, Department of Radiology, affiliated Hospital for Research and Teaching of the Faculty of Medicine of the University of Zurich, Im Ergel 1, 5404 Baden, Switzerland (S.B., E.A., K.H.R., N.T.)
| | - Fernández León Jesús
- Siemens Healthineers AG, Siemensstrasse 3, 91301 Forchheim, Germany (F.L.J., K.D.)
| | - Kraft Doreen
- Siemens Healthineers AG, Siemensstrasse 3, 91301 Forchheim, Germany (F.L.J., K.D.)
| | - Käser Yvonne
- PhysMed Consulting GmbH, Uetikon am See 8707, Switzerland (K.Y.)
| | - Thali Michael
- University of Zurich, Department of Forensic Medicine Zurich, Winterthurerstrasse 190/52, 8057 Zurich, Switzerland (S.B., T.M.)
| | - Kubik-Huch Rahel A
- Kantonsspital Baden AG, Department of Radiology, affiliated Hospital for Research and Teaching of the Faculty of Medicine of the University of Zurich, Im Ergel 1, 5404 Baden, Switzerland (S.B., E.A., K.H.R., N.T.)
| | - Niemann Tilo
- Kantonsspital Baden AG, Department of Radiology, affiliated Hospital for Research and Teaching of the Faculty of Medicine of the University of Zurich, Im Ergel 1, 5404 Baden, Switzerland (S.B., E.A., K.H.R., N.T.).
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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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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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11
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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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12
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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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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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14
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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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15
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Toia GV, Rose SD, Brown Z, Dovalis D, Bartels CM, Bladorn RM, Schluter KL, Lubner MG, Szczykutowicz TP. Consumable Material Waste and Workflow Efficiency Comparison Between Multi-use Syringeless and Single-use Syringe-Based Injectors in Computed Tomography. Acad Radiol 2023; 30:2340-2349. [PMID: 37380534 DOI: 10.1016/j.acra.2023.05.038] [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: 03/22/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/30/2023]
Abstract
RATIONALE AND OBJECTIVES Syringeless power injectors obviate the need for reloading iodinated contrast media (ICM) and plastic consumable pistons between exams. This study evaluates the potential time and material waste (ICM, plastic, saline, and total) saved using a multi-use syringeless injector (MUSI) compared to a single-use syringe-based injector (SUSI). MATERIALS AND METHODS Two observers recorded technologist time spent using a SUSI and a MUSI over three clinical workdays. CT technologists (n = 15) were polled on their experience between the systems using a 5-point Likert scale survey. ICM, plastic, and saline waste data from each system were collected. A mathematical model was created to estimate total and categorical waste from each injector system over a 16-week period. RESULTS On average, CT technologists spent 40.5 seconds less per exam with MUSI compared to SUSI (p < .001). Technologists rated MUSI work efficiency, user-friendliness, and overall satisfaction (strongly or somewhat improved) higher relative to SUSI (p < .05). Iodine waste was 31.3 L and 0.0 L for SUSI and MUSI, respectively. Plastic waste was 467.7 kg and 71.9 kg for SUSI and MUSI, respectively. Saline waste was 43.3 L and 52.5 L for SUSI and MUSI, respectively. Total waste was 555.0 kg and 124.4 kg for SUSI and MUSI respectively. CONCLUSION Switching from SUSI to MUSI resulted in a 100%, 84.6%, and 77.6% reduction in ICM, plastic, and total waste. This system may fortify institutional endeavors toward green radiology initiatives. The potential time saved administering contrast using MUSI may improve CT technologist efficiency.
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Affiliation(s)
- Giuseppe V Toia
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (G.V.T., C.M.B., R.M.B., K.L.S., M.G.L., T.P.S.); Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (G.V.T., T.P.S.).
| | - Sean D Rose
- Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston, 6431 Fannin St, Houston, TX 77030 (S.D.R.)
| | - Zita Brown
- College of Engineering, University of Wisconsin-Madison, 1415 Engineering Dr, Madison, WI 53792 (Z.B., D.D.)
| | - Dominic Dovalis
- College of Engineering, University of Wisconsin-Madison, 1415 Engineering Dr, Madison, WI 53792 (Z.B., D.D.)
| | - Carrie M Bartels
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (G.V.T., C.M.B., R.M.B., K.L.S., M.G.L., T.P.S.)
| | - Rachel M Bladorn
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (G.V.T., C.M.B., R.M.B., K.L.S., M.G.L., T.P.S.)
| | - Kelsey L Schluter
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (G.V.T., C.M.B., R.M.B., K.L.S., M.G.L., T.P.S.)
| | - Meghan G Lubner
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (G.V.T., C.M.B., R.M.B., K.L.S., M.G.L., T.P.S.)
| | - Timothy P Szczykutowicz
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (G.V.T., C.M.B., R.M.B., K.L.S., M.G.L., T.P.S.); Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 (G.V.T., T.P.S.); Department of Biomedical Engineering, University of Wisconsin-Madison, 1550 Engineering Dr, Madison, WI 53792 (T.P.S.)
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16
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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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Sumner C, Ikuta I, Garg T, Martin JG, Mansoori B, Chalian M, Englander BS, Chertoff J, Woolen S, Caplin D, Sneider MB, Desouches SL, Chan TL, Kadom N. Approaches to Greening Radiology. Acad Radiol 2023; 30:528-535. [PMID: 36114076 DOI: 10.1016/j.acra.2022.08.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/31/2022] [Accepted: 08/09/2022] [Indexed: 01/25/2023]
Abstract
The health care sector is a resource-intensive industry, consuming significant amounts of water and energy, and producing a multitude of waste. Health care providers are increasingly implementing strategies to reduce energy use and waste. Little is currently known about existing sustainability strategies and how they may be supported by radiology practices. Here, we review concepts and ideas that minimize energy use and waste, and that can be supported or implemented by radiologists.
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Affiliation(s)
- Christina Sumner
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Ichiro Ikuta
- Department of Radiology & Biomedical Imaging, Yale Program for Innovation in Imaging Informatics, Department of Radiology, Yale University School of Medicine, New Haven, CT; Mayo Clinic Arizona, Phoenix, Arizona
| | - Tushar Garg
- Division of Vascular and Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jonathan G Martin
- Department of Radiology, Duke University School of Medicine, Durham, North Carolina
| | - Bahar Mansoori
- Department of Radiology, University of Washington, Seattle, Washington
| | - Majid Chalian
- Department of Radiology, University of Washington, Seattle, Washington
| | - Brian S Englander
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jocelyn Chertoff
- Department of Radiology, Dartmouth Health and the Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Sean Woolen
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California
| | - Drew Caplin
- Division of Interventional Radiology, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, New Hyde Park, New York
| | - Michael B Sneider
- Department of Radiology & Medical Imaging, University of Virginia, Charlottesville, Virginia
| | | | - Tiffany L Chan
- Department of Radiology, University of California, Los Angeles, California
| | - Nadja Kadom
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; Department of Radiology, Children's Healthcare of Atlanta- Egleston Campus, Atlanta, Georgia.
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18
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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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19
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Shum PL, Kok HK, Maingard J, Zhou K, Van Damme V, Barras CD, Slater LA, Chong W, Chandra RV, Jhamb A, Brooks M, Asadi H. Sustainability in interventional radiology: are we doing enough to save the environment? CVIR Endovasc 2022; 5:60. [PMCID: PMC9703417 DOI: 10.1186/s42155-022-00336-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/31/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
Healthcare waste contributes substantially to the world’s carbon footprint. Our aims are to review the current knowledge of Interventional Radiology (IR) waste generation and ways of reducing waste in practice, to quantify the environmental and financial impact of waste generated and address green initiatives to improve IR waste management.
Methods
A systematic literature search was conducted in July 2022 using the Medline and Embase literature databases. The scope of the search included the field of IR as well as operating theatre literature, where relevant to IR practice.
Results
One-hundred articles were reviewed and 68 studies met the inclusion criteria. Greening initiatives include reducing, reusing and recycling waste, as well as strict waste segregation. Interventional radiologists can engage with suppliers to reformulate procedure packs to minimize unnecessary items and packaging. Opened but unused equipment can be prevented if there is better communication within the team and increased staff awareness of wasted equipment cost. Incentives to use soon-to-expire equipment can be offered. Power consumption can be reduced by powering down operating room lights and workstations when not in use, changing to Light Emitting Diode (LED) and motion sensor lightings. Surgical hand wash can be replaced with alcohol-based hand rubs to reduce water usage. Common barriers to improving waste management include the lack of leadership, misconceptions regarding infectious risk, lack of data, concerns about increased workload, negative staff attitudes and resistance to change. Education remains a top priority to engage all staff in sustainable healthcare practices.
Conclusion
Interventional radiologists have a crucial role to play in improving healthcare sustainability. By implementing small, iterative changes to our practice, financial savings, greater efficiency and improved environmental sustainability can be achieved.
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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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21
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Gendy D, Walters H, O'Mahony E, Zaman S. The scope for radiology to contribute to the NHS net zero target: findings from a survey of radiology staff in the UK. Clin Radiol 2022; 77:e667-e672. [PMID: 35688772 DOI: 10.1016/j.crad.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/04/2022] [Indexed: 11/29/2022]
Abstract
AIM To assess attitudes towards the climate emergency among radiology staff and to identify current practices that may contribute towards the National Health Service (NHS) net zero target. MATERIALS AND METHODS An online survey of radiology staff was conducted assessing current attitudes to the climate emergency. Further questions focused on staff travel, home working, virtual conferences, and recycling. RESULTS Two hundred and forty-two responses were received from all staff groups within radiology. There were high levels of concern about the climate emergency among radiology staff. Active travel accounts for a relatively small proportion of commuting related to provision of radiology services. Some energy-saving measures are implemented commonly in radiology departments but these are likely to account for only a small proportion of energy use within a department. CONCLUSION There is significant scope for reducing the carbon footprint of radiology services by reducing travel, both for work and for radiology education. We discuss the potential for large savings related to energy-saving measures.
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Affiliation(s)
- D Gendy
- St Helens and Knowsley NHS Trust, Warrington Road, Prescot, L35 5DR, UK
| | - H Walters
- Oxford University NHS Trust, Headley Way, Headington, Oxford, OX3 9DU, UK
| | - E O'Mahony
- Bristol Royal Hospital for Children, Paul O'Gorman Building, Upper Maudlin Street, Bristol, BS2 8BJ, UK
| | - S Zaman
- St Helens and Knowsley NHS Trust, Warrington Road, Prescot, L35 5DR, UK.
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22
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Arepally A, Omary RA, Vandenbergh MP. Scanning the Planet: Radiology's Grand Opportunity to Address Climate Change. J Am Coll Radiol 2022; 19:217-219. [PMID: 35033315 DOI: 10.1016/j.jacr.2021.08.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/31/2021] [Indexed: 12/01/2022]
Affiliation(s)
| | - Reed A Omary
- Carol D. & Henry P. Pendergrass Professor and Chair, Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
| | - Michael P Vandenbergh
- David Daniels Allen Distinguished Chair in Law, Director, Climate Change Research Network, and Co-Sirector, Energy, Environment and Land Use Program, School of Law, Vanderbilt University, Nashville, Tennessee
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23
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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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