AWARD winning research presented at ESR 2025 has spotlighted sustainable diagnostic approaches for metastatic breast cancer (MBC), revealing significant reductions in energy consumption and greenhouse gas (GHG) emissions. The study, conducted at the European Institute of Oncology in Milan, offers a potential blueprint for radiology departments worldwide aiming to balance clinical efficacy with environmental sustainability.
The retrospective study analysed 78 patients aged 32 to 81 years who underwent various imaging modalities between September 2019 and July 2023. Participants received whole-body MRI (WB-MRI) and either FDG-PET/CT or a combination of bone scintigraphy (BS) with CT-CAP as part of three diagnostic lines (DL1, DL2, and DL3).
The findings revealed that DL2 (FDG-PET/CT) was the most energy-efficient approach, consuming 4.92±0.81 kWh per patient, less than half of DL1’s 11.10±1.72 kWh and DL3’s 12.05±1.65 kWh. This resulted in a 55% reduction in GHG emissions for DL2 compared to DL1, highlighting its potential for reducing the environmental impact of diagnostic procedures in oncology. Additionally, DL2 offered the shortest scan time at 0.27±0.04 hours, enhancing both efficiency and patient throughput.
In terms of biological sustainability, DL1 (WB-MRI) proved superior by requiring no ionizing radiation or contrast agents, in contrast to DL2 and DL3, which involved substantial radiopharmaceutical and CT scan doses. The combined radiopharmaceutical dose for DL2 and DL3 was approximately 936 MBq per patient, while CT scans contributed a cumulative dose of around 2480 mGy/cm.
These results show the importance of re-evaluating diagnostic protocols in oncology to reduce the environmental footprint of radiology departments. By identifying DL2 as the most energy-efficient and DL1 as the most biologically sustainable, the study presents a model for integrating environmental priorities into clinical decision-making.
Researchers advocate for further studies to validate these results across broader populations and imaging settings. This approach not only aligns with global sustainability goals but also ensures that patients receive high-quality, eco-friendly care.
Aleksandra Zurowska, EMJ
Reference
Masperi A, Girlando CM. Evaluation of sustainable diagnostic approaches in metastatic breast cancer (MBC). Poster number: C-10194. ESR, 27 February- 2 March, 2025.
