E2349. A Review of Alternatives to Iodinated Contrast in Interventional Radiology
  1. Timothy Nobbee; University of Rochester
  2. Devang Butani; University of Rochester
  3. Andrew Cantos; University of Rochester
In early 2022, there was a global shortage of iodinated contrast medium (ICM) iohexol (Omnipaque; GE Healthcare), which is the dominant supplier of ICM in the United States. This severe shortage forced many radiology practices to alter their use of ICM by changing techniques, using noniodinated contrast agents, or alternative modalities to accomplish diagnostic imaging. A few consensus papers and guidelines have been published in reaction to this supply shortage; most of the literature pertains to diagnostic radiology exams. There is less clarity about lower doses of ICM, use of different procedural modalities (such as ultrasound or CT), or alternative contrast agents in procedural specialties such as interventional radiology.

Educational Goals / Teaching Points
The goal of this educational exhibit is to review the alternatives to ICM including noniodinated contrast agents and the use of various imaging modalities to maintain high quality care in interventional radiology. We will review the alternative contrast media or imaging modality, it’s uses in procedures, and several pertinent examples. We will also briefly discuss the role of these alternative agents and/or modalities and their use going forward in the face of ongoing and intermittent supply chain issues.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Imaging findings of noniodinated contrast agents and the use of various imaging modalities in interventional radiology will be most of the content of the educational exhibit. This will be presented in a pictorial and bulleted review style with high yield information relevant to procedural radiologists. Techniques of the alternative modalities or agents will be discussed; specifically, how imaging of the alternative agent or modality should be optimized to perform a given procedure.

The severe shortage of Iohexol contrast as a result of the global supply chain issues in early 2022 forced many radiology practices to alter their use of ICM, including during procedures. Noniodinated contrast agents and alternative imaging modalities can be used to perform diagnostic and therapeutic procedures. It is important to review these alternative methods, so that procedural radiologists can continue to provide high quality patient care in the setting of ongoing global supply chain issues.