Qaelum’s CONTRAST as a Tool to Monitor Usage and Manage the Contrast Media Shortage

By Anna Romanyukha, PhD and Niki Fitousi, PhD, MPE, Research Department, Qaelum

A COVID-19 related shutdown of the Shanghai GE Healthcare plant due to the city lockdown in April caused a global shortage of iodinated contrast media iohexol (Omnipaque) and iodixanol (Visipaque). Diminished contrast media availability has strained medical imaging facilities all over the world, prompting radiological societies and government healthcare agencies to recommend immediate conservation of contrast stocks. Hospitals have been forced to postpone non-urgent medical imaging examinations, which, similar to initial pandemic-related measures, may result in the aftermath of late patient diagnoses. Possible ways to mitigate the crisis have been offered by various radiology associations around the world.

Qaelum is a forward thinking company that developed a contrast management solution before the contrast shortage took place. Contrast Management is one of the multiple modules of Qaelum’s comprehensive quality platform FOQAL, and is a powerful software solution to be relied upon when following the recommended mitigation strategies (FOQAL-CONTRAST, Qaelum). The module allows clinics to evaluate existing contrast stocks and usage trends, and track the impact of introduced actions and conservation measures over time.

One strategy to limit the risk, according to expert advice for healthcare providers, is to set up a diversified network of contrast media suppliers; FOQAL-CONTRAST is a vendor-neutral software that allows to centralize and handle data from injectors of different vendors. Contrast volumes and costs can be tracked for each brand and concentration combination in order to have an overview of the consumed contrast distribution among suppliers and avoid relying on a single one.

Another important recommendation for contrast conservation is ensuring that weight-based protocols are used. This can be performed by monitoring contrast volumes with respect to patient weight, as indicated in the example shown below for different locations.

When managing multiple facilities, contrast consumption can be evaluated by location to correctly assess inventory needs and identify approaches tailored to the hospital type. Cumulated contrast volume can be evaluated by site, program name, scheduled procedure, or contrast agent group to calculate daily consumption and forecast how long stocks will satisfy imaging needs under normal and critical conditions. Average contrast volume or number of studies are among the multiple data types that can be plotted, and specific procedures can be selected to estimate contrast consumption for critical conditions.

The most frequently performed contrast enhanced procedures can be identified and targeted for contrast volume reduction, as shown below in the analysis of average contrast volumes by study description.

Where optimization is needed, Improvements can be created with automatic population of the relevant data, possibility to assign users, and track improvement progress, ensuring consistent communication between staff. The data can also be exported to customized templates or used for further analysis.

Contrast waste can be assessed by tracking used contrast volume pertaining to various contrast media container sizes. Single use packages can be repackaged to optimize contrast use in lower volume studies.

Contrast usage can be correlated and monitored with respect to radiation dose when the corresponding CT study data is also collected.

Time snapshots before and after optimization allow to monitor the impact of activities, like adherence to weight-based protocols, repackaging for waste reduction, reducing the number of exams requiring contrast or extra training of technologists. Customized targets can be set and automated insights help to identify outliers.

Not only contrast usage, but also site-, program name-, and study description- specific financial contrast costs are tracked to increase the efficiency of the department or facility.

The American College of Radiology urges in a statement released in May regarding contrast media shortage: “Do not sacrifice image quality by using suboptimal doses”. Qaelum’s FOQAL platform combines the Contrast management module with other advanced quality related tools. Use FOQAL-FORMS to get direct feedback from radiologists regarding image quality issues when reducing contrast volumes in protocols. Combine CONTRAST with the CT Repeat software to identify and optimize excess contrast and radiation dose resulting from superfluous repeated scans.

Qaelum’s vendor-neutral Contrast Management solution is a comprehensive, customizable, and powerful tool for managing contrast usage in the medical imaging department. Several healthcare channels question whether this supply disruption is in reality the new norm, and medical imaging departments should be prepared for the future. Contact us for a demo of Qaelum’s products that ensure quality and efficiency in the radiology department- from patient radiation dose management to contrast media usage, CT repeat scan analysis, and remote monitoring of quality tasks.

References

 “Statement from the ACR Committee on Drugs and Contrast Media”. American College of Radiology,   May 6, 2022. https://www.acr.org/Advocacy-and-Economics/ACR-Position-Statements/Contrast-Media-Shortage.

Authors

Anna Romanyukha received her Ph.D. degree in medical physics from the Centre of Medical Radiation Physics (UOW, Australia) and her M.Sc. degree in health physics from Georgetown University (Washington DC, USA). She worked as a post baccalaureate and pre doctoral fellow at the National Cancer Institute (NIH, Washington DC) on various projects including radiation dose estimation from diagnostic exposures. She now works in Qaelum NV, focusing on advanced software tools in patient radiation dose management and quality.

Niki Fitousi, PhD, is a certified medical physicist from Greece, currently working in Belgium. She is a member of the Hellenic Association of Medical Physicists (member of EFOMP). Her professional experience includes work in all fields of Medical Physics (Radiation Therapy, Diagnostic Radiology and Nuclear Medicine). She is now the Head of Research in Qaelum, focusing mostly in the field of dosimetry and image quality in medical imaging