In a video interview with Radiology Business, Alan H. Matsumoto, MD, chair of the department of radiology at the University of Virginia and vice-chair of the American College of Radiology Board of Chancellors, explains the iodinated contrast shortage situation and the tough decisions providers are being forced to make on who and how the contrast would be allocated.
Dr. Matsumoto describes the complex ramifications of this critical supply chain disruption and the draconian steps that were taken to use scarce contrast primarily for those patients facing life-threatening, organ-threatening, limb-threatening circumstances. He described the radiology department's work with the pharmacist at UVA to adopt a multidose option for contrast conservation of excess contrast in single-dose vials as long as they didn’t use the contrast after it had been spiked for more than four hours. Even then, contrast that was not utilized for intravascular injections could be administered to image the gastrointestinal tracks.
Particularly fascinating is his description of considering alternative studies and revised imaging protocols that would make use of less contrast. My counsel to radiologists is such decisions should be made in concert with the patient's treating physician and that those joint decisions be documented.
To better understand this issue, I recommend that you invest 15 minutes to watch this excellent interview.