Philadelphia, June 23, 2022 – GE Healthcare was forced to shut a production plant in April because of a COVID-19 outbreak in Shanghai, China. This plant supplies most of the iodinated contrast media (ICM) used in the United States for imaging studies and image-guided treatments. Over 40% of computerized tomography (CT) studies use these agents, and many healthcare systems only have limited supplies.

Recommendations from the American College of Radiology® (ACR®) that guide imaging providers and their institutions on how to address this emergency locally appear in the Journal of the American College of Radiology (JACR), published by Elsevier. JACR also presents case studies from two healthcare systems that were able to reduce their ICM usage by at least 50%, providing helpful data to help practices prioritize and inform health system decision making during the crisis.

In the statement from the ACR, lead author Carolyn L. Wang, MD, University of Washington, Department of Radiology, Seattle, WA, USA, and colleagues stated, “Our recommendations are not exhaustive or prescriptive. They are intended as a resource for healthcare providers to provide high-quality patient care during times of shortage of contrast media.”
Recommended risk mitigation strategies include:

Use alternative studies, such as non-contrast CT, MR with or without gadolinium-based contrast media, and ultrasound with or without ultrasound contrast agents, and use of PET/CT when feasible.
Look for alternative vendors and versions of contrast agents, which may be marketed under a different brand name or clinical use.
Use a single vial for more than one patient only under the guidance of qualified healthcare personnel from the institutional pharmacy because of the risk of contamination and infection.
Minimize individual dosages to reduce waste. Options include weight-based dosing for CT in available vial sizes and/or using lower doses in conjunction with low peak kilovoltage protocols or dual-energy protocols to improve contrast brightness.
Reserve higher concentration agents for angiographic and multiphase studies, which require optimal vascular visualization.
Use alternatives to nonionic contrast for oral, rectal, and genitourinary administration.
According to Dr. Wang, it is important to note that these agents are used by departments other than radiology, including urology, radiation oncology, pain management, gastroenterology, vascular surgery, and cardiology. Prioritization of limited supplies must be coordinated throughout the system.

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