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The environmental impact of magnetic resonance imaging (MRI) has recently come into focus. This includes its enormous demand for electricity compared to other imaging modalities and contamination of water bodies with anthropogenic gadolinium related to contrast administration. Given the pressing threat of climate change, addressing these challenges to improve the environmental sustainability of MRI is imperative. The purpose of this review is to discuss the challenges, opportunities, and the need for action to reduce the environmental impact of MRI and prepare for the effects of climate change. The approaches outlined are categorized as strategies to reduce greenhouse gas (GHG) emissions from MRI during production and use phases, approaches to reduce the environmental impact of MRI including the preservation of finite resources, and development of adaption plans to prepare for the impact of climate change. Co‐benefits of these strategies are emphasized including lower GHG emission and reduced cost along with improved heath and patient satisfaction. Although MRI is energy‐intensive, there are many steps that can be taken now to improve the environmental sustainability of MRI and prepare for the effects of climate change. On‐going research, technical development, and collaboration with industry partners are needed to achieve further reductions in MRI‐related GHG emissions and to decrease the reliance on finite resources. Level of Evidence: 5 Technical Efficacy: Stage 6 [ABSTRACT FROM AUTHOR]

Immediate and strategic action is needed to improve environmental sustainability and reduce the detrimental effects of climate change. Climate change is already adversely affecting the health of Canadians related to worsening air pollution and wildfire smoke, increasing frequency and intensity of extreme weather events, and expansion of vector-borne and infectious illnesses. On one hand, radiology contributes to the climate crisis by generating greenhouse gas emissions and waste during the production, manufacture, transportation, and use of medical imaging equipment and supplies. On the other hand, radiology departments are also susceptible to equipment and infrastructure damage from flooding, extreme temperatures, and power failures, as well as workforce shortages due to injury and illness, potentially disrupting radiology services and increasing costs. The Canadian Association of Radiologists' (CAR) advocacy for environmentally sustainable radiology in Canada encompasses both minimizing the detrimental effects that delivery of radiology services has on the environment and optimizing the resilience of radiology departments to increasing health needs and changing patterns of disease on imaging related to climate change. This statement provides specific recommendations and pathways to help guide radiologists, medical imaging leadership teams, industry partners, governments, and other key stakeholders to transition to environmentally sustainable, net-zero, and climate-resilient radiology organizations. Specific consideration is given to unique aspects of medical imaging in Canada. Finally, environmentally sustainable radiology programs, policies, and achievements in Canada are highlighted. [ABSTRACT FROM AUTHOR]

Background Climate change adversely affects human health, resulting in higher demand for health care services. However, the impact of climate-related environmental exposures on medical imaging utilization is currently unknown. Purpose To determine associations of short-term exposures to ambient heat and particulate air pollution with utilization of emergency department medical imaging. Materials and Methods In this retrospective time-stratified case-crossover study, daily imaging utilization counts from four emergency departments were linked to local daily environmental data-including fine particulate matter with 2.5-µm or smaller aerodynamic diameter (PM 2.5 ) and ambient temperature-over 10 years (January 2013 to December 2022). Conditional Poisson regression models were used to evaluate the associations between daily imaging utilization and environmental exposures on the same day and each of the 7 days preceding imaging, lag days 0-7, controlling for day of the week, month, and year. Moving averages of mean daily PM 2.5 and temperature were calculated to account for lagged exposure effects. Imaging counts were also stratified by modality (CT, radiography, US, and MRI). Results In an analysis of 1 666 420 emergency department imaging studies, a rise of 10 °C in the 2-day moving average of mean daily temperature and a rise of 10 μg/m 3 in the 3-day moving average of mean daily PM 2.5 were associated with overall imaging utilization increases of 5.1% (incidence rate ratio [IRR], 1.051; 95% CI: 1.045, 1.056) and 4.0% (IRR, 1.040; 95% CI: 1.035, 1.046), respectively. Heat exposure days (mean temperature >20 °C) and air pollution exposure days (mean PM 2.5 >12 μg/m 3 ) were associated with same-day excess absolute risk of 5.5 and 6.4 imaging studies per 1 million people at risk per day, respectively. Heat exposure days and air pollution exposure days were associated with increased utilization of radiography (excess relative risk, 2.7% [ P < .001] and 2.1% [ P < .001], respectively) and CT (excess relative risk, 2.0% [ P = .001] and 2.7% [ P < .001]) but not US ( P = .14 and P = .14) or MRI ( P = .70 and P = .65). Conclusion Short-term exposures to ambient heat and particulate air pollution were associated with increased utilization of radiography and CT but not US or MRI. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Vosshenrich in this issue.

The health of Canadians is already impacted by climate change due to wildfire smoke, heat domes, floods, droughts, and the changing distribution of vector borne disease. The healthcare sector contributes to climate change, accounting for approximately 4.6% of annual greenhouse gas emissions in Canada. Healthcare teams have a responsibility and opportunity to reduce harm by limiting emissions and waste, and engaging the public in understanding the planetary health links between clean air and water, a stable climate, a healthy planet and human health. Transformation of Canadian healthcare to a low carbon, climate resilient system will be enhanced by physician engagement and leadership. Cornerstones to physician participation include knowledge of the anthropogenic etiology of the climate crisis, the human health impacts, and the contribution providing healthcare makes to the climate crisis. Integration of climate change knowledge into the Canadian Radiology educational curricula is essential to position radiologists to lead transformative change in mitigation and adaptation of the healthcare system to the climate crisis. This statement is intended to provide guidelines to optimize education and research for current and future Canadian radiologists, and builds on existing planetary healthcare education publications and the Canadian Association of Radiologists Statement on Environmental Sustainability in Medical Imaging., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: MJB: Co-Chair CAR Environmental Sustainability Working Group; Co-Chair BC Cancer Planetary Health Unit; Member, AUR Sustainability Committee; Member, Canadian Association of Physicians for the Environment. KH: Co-Chair CAR Environmental Sustainability Working Group; Chair, ISMRM Environmental Sustainability Working Group; Deputy Lead Sustainability Joint Department of Medical Imaging.