Overutilization of medical imaging not only contributes to unnecessary expenses and exams, but also contributes significantly to healthcare’s total carbon footprint.

At the CleanMed 2023 conference in Pittsburgh, a group of radiologists broke down tactics for addressing this issue while also highlighting the severity of radiology's total energy consumption and its impact on the environment. Their presentation was called Sustainable Radiology: Bringing climate-smart medical imaging into focus.

Tamping down on unnecessary exams
According to diagnostic radiology resident Dr. Julia Schoen, of Atrium Wake Forest Baptist Health, an estimated 30% of imaging is unnecessary and leads to more visits and a larger carbon footprint. These machines and their heating, ventilation and air conditioning (HVAC) systems make electricity the primary driver.

“It’s not just the carbon footprint of that scan that was ordered unnecessarily," said Schoen. "It’s the carbon footprint of all of the additional healthcare utilization that came as a result of the decision to order that scan."

Providers should abide by screening guidelines, such as ACR’s Appropriateness Criteria; invest in less invasive care procedures and equipment to avoid unnecessary follow-up scanning; and keep in mind that imaging can both increase and reduce waste when developing new tools such as AI.

“As we think about how we implement tools, we need to start thinking about how we avoid rapidly adopting them and accidentally driving wasteful care,” said Schoen.

Reducing power consumption
In a recent study, the University of California, San Francisco found that putting MR scanners in off mode reduced power consumption by about 25% to 33%, and using power save modes saved an additional 22% to 28%.

“If we think about implementing this overnight on all of our MR scanners, it would save the U.S. healthcare system somewhere between $8 million and $11 million and 41,606 to 54,088 megatons of Co2 equivalence,” Dr. Sean Woolen, assistant professor and director of UCSF Radiology’s sustainability initiative, said during the presentation.

Studies on CT and workstation optimization have shown similar results, according to Woolen. Adding command centers in future smart hospitals can also optimize energy consumption in imaging centers and ORs, as can using sterilizable reusable items.

Other potential measures, he says, include adding sustainability requirements to appropriateness guidelines and creating more collaborations among operational change experts and hospital leaders.

“Ultimately, none of this is going to be fixed as an individual," he said. "It really comes to a group of people with diverse backgrounds coming down to work toward a more sustainable future.”

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