Home PACS News PACS Corporate News Michael Friebe on contrast media injection – we need it, but we don't like it! - DOTmed.com
Michael Friebe on contrast media injection – we need it, but we don't like it! - DOTmed.com PDF Print E-mail
Written by PACSMule Administrator   
Monday, 21 March 2016 12:52
By: Michael Friebe
This first appeared in the March 2016 issue of DOTmed HealthCare Business News[1]

Injectors are used for X-ray procedures (mainly in the cath and angio labs), for diagnostic imaging using tomography systems (CT, MRI, hybrid imaging systems like PET/CT or MR/PET) and for use in contrast-enhanced ultrasound (CEUS) examinations. The medical need for contrast media in the enhancement of the diagnostic images is not in question, but the application of the contrast media into the blood stream is not without danger for the patient, and requires a great deal of experience and training for the operators of the injector systems.

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Michael Friebe on contrast media injection – we need it, but we don't like it! - DOTmed.com

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Contrast media injection is generally realized by using power injectors, mainly electromechanical or hydraulic piston or peristaltic drives, with two different injection volumes (syringes, bags or bottles) with the first one, saline, having the task of opening the vein for the second one that injects the contrast media. This is then followed by a flush from the first, thereby again reducing the total contrast media consumption and increasing patient safety through reduced flow rates. Fast imaging, as in multi-slice detector CT imaging or high-field MRI, requires dual volume injector systems.

There are issues with the consumables that are required for the injection, including tubing and syringes, the actual injection pathway, use of the controlling computer system, hardware (batteries, magnetic attraction when used in an MRI suite, servicing, electric safety), variables of the injection (amount of contrast media, timing, injection rate), patient safety and the use of varying injection protocols.

Injector systems are relatively large and complex and need some time for patient setup, all for an apparently easy task of injecting a liquid into the patient's bloodstream at the right point in time with respect to the imaging procedure. Increased complexity means decreased patient safety and usually also comes with increased investment and operational cost. The question is whether they really need to be that complex. So what is really needed, what is nice to have and what are the features that a standard user can do without?

The focus of this story is on electromechanical CT and MRI injectors and on intravenous or intra-arterial injections, but many of the issues also apply to the injection systems used for X-ray and U.S. applications. A medium-sized hospital can easily own and operate 25 of these injectors with an average operational time before replacement of seven to eight years, and an investment from $10,000 (single syringe) to $40,000 (multiphase, multi-contrast media).

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