The Royal College of Radiologists has opened a public consultation for its latest guidance on intravascular iodine and gadolinium-based contrast media.
Radiographers have the opportunity now to offer their feedback and opinions on the document, ensuring the document is appropriate for all members of the imaging workforce who use contrast media in their daily work.
It has been more than 10 years since the Royal College of Radiologists (RCR) published the third edition of its standards for intravascular contrast administration in adults. Since then, evidence and clinical practice have evolved significantly, it said.
Sharpened, clarified or better supported
Sue Johnson, professional officer for the SoR, said: “We’re especially keen to encourage feedback from members who’ve seen first‑hand where patient safety could be strengthened, clarified, or better supported. Honest, constructive challenge is exactly what this process is for. It helps to spot the gaps, reduce risk, and ensure the guidance the SoR will ultimately endorse will be practical, effective, and protect patients in every setting. After all, that’s what we’re here for.”
The document is aimed mainly at radiologists, but much is included that directly affects radiographers and sonographers, including:
- Service delivery expectations – including MRI and CT protocols, availability of staff, and the push for standardised practice.
- Safety messaging – what patients should be told about ultrasound, MRI, CT and contrast in pregnancy.
- Practical workflow – e.g. ALARA principles, sequence selection, avoiding shielding, need for multidisciplinary communication.
- Operational pressure – the guidance openly acknowledges out‑of‑hours variation, gaps in expertise, and availability of trained staff.
The use of medical imaging – including intravascular contrast – has more than doubled in the past decade. While contrast agents play a vital role in diagnosis, potential risks must be balanced against their clinical benefits. The latest standards outline best practice to ensure contrast is used as safely, efficiently and cost-effectively as possible.
Reducing delays and minimising patient inconvenience
Two key recommendations mark significant changes from previous UK guidance and common practice, with potential to reduce imaging delays, lower costs and minimise patient inconvenience:
1. Premedication for patients with prior hypersensitivity reactions: the group concluded there was no strong evidence for routine premedication, and the guidance recommends it is only used in specific emergency situations.
2. Renal function testing prior to modern gadolinium-based agent administration in approved doses: the group concluded it is no longer justifiable to perform routine eGFR testing for adult outpatients and inpatients prior to gadolinium-enhanced MRI, including in known renal impairment.
The guidance was developed by a multidisciplinary, intercollegiate working group with representatives from:
- Royal College of Radiologists
- Society and College of Radiographers
- UK Kidney Association
- British Society for Allergy & Clinical Immunology
- Association of British Clinical Diabetologists
- British Cardiovascular Intervention Society
- Royal Pharmaceutical Society
To provide feedback, complete the form accessible at the following link before the public consultation closes at 5pm on Monday 23 March.
(Image: Gadolinium contrast media in use, via Getty Images)