Evaluating contrast agent waste and costs of weight-based CT contrast bolus protocols using single- or multiple-dose...

Although weight-based contrast agent injection protocols can improve contrast-enhanced CT, one disadvantage is waste caused by differences between the amount of contrast material required for a weight-based algorithm and full-package protocols used with single-use packaging of contrast material. The availability of 500-mL multiple-use packaging of contrast material should facilitate the implementation of weight-based contrast bolus protocols for CT because arbitrary volumes of contrast agent can be loaded without significant waste. Our hypothesis was that multiple-use packaging when used with a weight-based contrast bolus protocol would reduce costs compared with single-use packaging.

Contrast agent volume loaded and volume actually delivered to 1304 patients undergoing abdominal and pelvic CT were recorded. Model 1 used volume loaded to estimate contrast material cost, model 2 used volume delivered, and model 3 assumed that patients received either 100 or 150 mL from a single-use package, depending on weight.

Model 1 required 368 packages of 500 mL contrast material ($23,000). Model 2 required 353 packages of 500 mL contrast material ($22,062.50). Model 3 required 863 and 478 packages of 100 and 150 mL contrast material, respectively ($22,120).

Cost containment can be realized while improving the quality of contrast opacification by employing 500-mL multiple-use packaging of contrast materials. Care must be taken by the technologists to load only the volume of contrast agent that is needed, or the resulting contrast agent waste will negate the savings and even result in cost increases.