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 March 2, 2024 3 mins read

Green Radiology: RSNA Sustainability Task Force Recommends Approaches to Sustainable Imaging

Francis Horan

Sustainability and reducing carbon emissions are existential responsibilities for anyone who intends to live on the planet Earth. It is also an opportunity for institutions to reduce costs by eliminating wasteful practices. The healthcare sector constitutes 4.6% of global emissions and nearly 10% of US emissions, and imaging is a significant portion of that. An independent RSNA Sustainability Task Force, including Christopher Hess, MD, PhD, and Sean Woolen, MD, MS, announced its official recommendations at December’s annual conference.

As Chair of the RSNA Task Force, Hess said that cleaning up energy sources will be the key, as “turn it off” only goes so far, but radiology has many areas where we can take great strides. “We have moved past the ‘I can’t do anything myself’ instinct,” Hess said. In their talks, Hess and Woolen highlighted four areas for sustainability efforts to target.

Turn it Off, Set to Standby

Woolen led the research sub-group, collaborating with Charles Goh, FRCR, MBBS, MMed. They outlined the RSNA's role in promoting sustainability research, with a focus on standardizing terminology and evaluation metrics. As Woolen stated, "To solve a problem, we must first measure it and agree on its definition." His work in this area earned him the RSNA grant for Emerging Issues in Environmental Impact and Sustainability of Radiology.

In 2021, UCSF and Siemens partnered to measure and mitigate energy usage. The energy date helped identify periods when imaging facilities were inactive but still consuming significant electricity. By comparing these "on but inactive" periods with scanner startup times, they could optimize energy consumption by implementing low-power standby mode or complete shutdowns.

Woolen said, “You can turn it off.  Powering down equipment during long inactive time periods saves you money and the planet.”

Spot the Energy Efficiency

Hess and the committee also noted the progress made with the EPA's Energy Star Group. Energy Star, responsible for the energy efficiency ratings on appliances like refrigerators and washing machines, is now exploring the possibility of extending these ratings to medical imaging equipment, including MRI systems. The Energy Star Group has shown keen interest and is actively seeking more data from industry and healthcare partners to establish a robust framework for evaluating the energy efficiency of medical imaging devices.

Reimagine the Supply Chain

While the high energy consumption of imaging systems is a major contributor to radiology's environmental impact, Hess highlighted that the supply chain is, in fact, the primary source of CO2 emissions (CO2e). To address this, a systemic overhaul of radiology's procurement and transportation processes is necessary, requiring collaboration and innovation from all stakeholders. Hess shared UCSF's proactive approach, implementing agreements that mandate the use of sustainable air fuels for the delivery of new scanners.

Hess said, “This is a blue-horizon opportunity for healthcare and industry to work together.”

Remember What AI Costs

As healthcare professionals make significant progress in reducing emissions, new challenges are emerging. AI and other computational resources, which have potential to revolutionize some aspects of medical care, are incredibly energy intensive. This burgeoning demand for AI, which is projected to consume a substantial portion of the US's electricity, could undermine recent strides in energy efficiency. Radiology in particular must be mindful of its role in both leveraging AI's benefits and mitigating its environmental impact. Hess urged RSNA attendees to be cognizant of AI's hidden energy costs and to avoid unnecessary usage, much like the simple act of turning off lights to conserve energy.

Hess noted that “The task force convened virtually multiple times throughout its one-year charge to produce a prioritized recommendation report to the Board in December 2024. The task force’s work is divided into different strategic domains where the RSNA is anticipated to have the greatest impact and influence.”  The task force’s recommendations addressed four key pillars: research, education, collaborations with imaging and industry, and assessing gaps and opportunities in the landscape of current sustainability efforts in medicine.