Towards the end of April, a global shortage of iodinated contrast media began. UNC Radiology worked collaboratively with leaders from other departments to quickly conserve existing supplies, reduce waste, and triage patients to continue to provide clinical excellence.
Towards the end of April, a global shortage of iodinated contrast media began. This would severely impact the patient care delivered by the UNC Department of Radiology in addition to several other departments and service lines within UNC Health, and other healthcare organizations across the country. UNC Radiology worked collaboratively with leaders from other departments to quickly conserve existing supplies, reduce waste, and triage patients to continue to provide clinical excellence. UNC Radiology’s innovative approaches were published in peer-reviewed journals to help guide colleagues across the country and worldwide on conservation strategies.
How did the shortage start?
Two companies, GE and Bracco, hold more than 90% of the market share for iodinated contrast media. The majority of hospitals in the UNC Health system, including UNC Medical Center, use GE as the sole supplier of iodinated contrast agent.
The primary GE facility producing iodinated contrast media, located in Shanghai, China, had closed due to a government-mandated lockdown of the city during a recent COVID-19 outbreak. While the plant was able to re-open in April 2022, it operated only at 20% capacity and the request to expand capacity was denied by the Chinese Government. Since then, production has ramped up with an expected return to full capacity at the end of June 2022, but that delay in production means it could take some time for contrast media to become fully available to the various healthcare facilities worldwide, including UNC radiology.
UNC Radiology Leads in Contrast Conservation
In addition to UNC Radiology’s heavy utilization of iodinated contrast media, other Departments and service areas, such as Interventional Cardiology, Vascular Surgery, Urology, Radiation Oncology, Orthopedic Surgery, among others also use iodinated contrast media for diagnostic and therapeutic imaging and procedures. As a result, UNC Radiology partnered with these Departments to develop a plan to conserve the existing supply of iodinated contrast media and work together, both intra-department and cross-department, to ensure that everyone had enough supply of iodinated contrast agent to care for patients. UNC radiology also established multi-institutional collaborations with other Departments of Radiology that are facing this same crisis.
The shortage continues to be an issue for UNC Health as well as several hospitals across the country. Amongst Radiology Departments nationwide, UNC Radiology took the lead in establishing and publishing recommendations to mitigate this crisis. Not only did faculty members create a conservation strategy for UNC Health, but they also are leading the way nationally and internationally, sharing effective strategies to mitigate the crisis through three separate publications in some of the most impactful radiology journals.
- Maureen P. Kohi, MD, Professor and Chair of UNC Radiology Department, and Mahmud Mossa-Basha, MD, Professor and Vice Chair of Quality and Safety at UNC, along with Thomas M Grist, MD, Professor and Chair of Radiology, University of Wisconsin, Cheri L Canon, MD, Professor and Chair of Radiology, University of Alabama-Birmingham, and Elliot K Fishman,. MD from Johns Hopkins University published a special report in Radiology titled “Short‐, Mid‐, and Long‐Term Strategies to Manage the Shortage of Iohexol.”
- Gloria Salazar, MD, Associate Professor and Chief of Vascular-Interventional Radiology at UNC, Mahmud Mossa-Basha, MD, Professor and Vice Chair of Quality and Safety at UNC, Maureen P. Kohi, MD, Professor and Chair of UNC Radiology, and Lauren M. Burke, MD, Associate Professor and Executive Vice Chair at UNC wrote “Short-Term Mitigation Steps During the Iohexol Contrast Shortage: A Single Institution’s Approach,” in the Journal of American College of Radiology.
- Nicole A. Keefe, MD, Assistant Professor at UNC, Kush R. Desai, MD, Associate Profess of Radiology at Northwestern University Feinberg School of Medicine, Maureen P. Kohi, MD, Professor and Chair of UNC Radiology Gloria M. Salazar, MD, Associate Professor and Chief of Vascular-Interventional Radiology at UNC published their article, “Interventional Radiology Approach to Contrast Media Preservation Strategies,” in the Journal of Vascular and Interventional Radiology.
Each publication provides important preservation strategies and mitigation efforts, including information on how to create a priority matrix for diagnostic imaging and procedures that require iodinated contrast media versus those that can be deferred, those that can be performed with alternative imaging modalities, and those that can be performed with alternative contrast media. These efforts would not have been possible without the cross-departmental collaborations and partnerships that is representative of our values as One Great Team.
For questions about the shortage or how the strategies UNC Radiology is implementing across the system, contact Executive Vice Chair of the Department of Radiology Lauren Burke, MD.