Radiology departments react to a shortage of iodinated contrast media from GE Healthcare, caused by an unexpected COVID-19 lockdown in Shanghai, China. GE Healthcare’s manufacturing plant in Shanghai produces the iodinated contrast media, Omnipaque (iohexol) and Visipaque (iodixanol), which are used to enhance computed tomography and other imaging methods. These are used in over 50% of CT imaging, and an 80% reduction in supply is expected. Current production capacity is now at 50%. Normal supplies are expected to resume in mid-June 2022.
In Australia and New Zealand, the Royal Australian and New Zealand College of Radiologists (RANZCR) has been to prioritise patients, conserve contrast, and use alternate imaging modalities when possible that do not depend on the agents. Furthermore, alternate sources of comparable iodinated contrast agents should be sought out.
Similar advice authored by a group led by Dr Thomas Grist of the University of Wisconsin in Madison is published in Radiology, a Radiological Society of North America (RSNA) journal. The following recommendations are made to deal with the shortage.
Short-term strategies (weeks): Establish an incident command centre to monitor iodinated contrast agent use. Delay elective contrast-enhanced CT exams. Reduce contrast dose and use. Use alternate imaging modalities (e.g., MRI and ultrasound) which don’t require these agents.
Midterm strategies (next two months): Repackage contrast into smaller doses. Convert single vials into multiuse vials (while preventing contamination). Actively communicate with ordering providers about CT use. Negotiate with payers regarding billing and reimbursement.
Long-term strategies (next two years): Advocate legislation to expand contrast U.S. manufacturing and institutional stockpiling of contrast to avoid shortages caused by disruptions to the global supply chain.
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