Iodinated Contrast Media Shortage

AMA members will be aware of the ongoing shortage of iodinated contrast media (contrast) caused by COVID-19 lockdowns in Shanghai.

In response to the global shortage of iodinated contrast media RANZCR and TGA have released statements with advice for medical practitioners about prioritising use and alternative imaging modalities. 

RANZCR recommends that medical practitioners considering referring a patient for a CT during this time consult with a radiologist for advice on alternative imaging modalities or other strategies that could be used to diagnose and manage their patients. 

RANZCR has endorsed recommendations in the recent article by Cavallo and Pahade, titled Practice Management Strategies for Imaging Facilities Facing an Acute Iodinated Contrast Media Shortage published in the American Journal of Roentgenology which provides details to support practice management during this contrast shortage.  

The following table reproduced from the Cavallo and Pahade article is an example of how practices might prioritise patients based on clinical need. Please note that this list is not an exhaustive and each practice will need to adjust its management strategy based on its patient population and clinical presentations. Read more here

Tier 1
Iodinated Contrast
Media always needed
Tier 2
Non-contrast CT feasible
Tier 3
Alternative modality feasible
Tier 4
Deferment feasible

Emergent Stroke CTP 

Suspected dissection 

Level 1 trauma 

Cardiac catheterization 

Select oncology cases 

Clinical trial patients 




Bowel obstruction 

Fluid collection 

Non-vascular chest imaging 

Select oncology stating examinations 

Gastrointestinal bleed 

Occult infection 

Pulmonary embolism 

Oncology staging 

Focal liver lesions 

Asymptomatic annual staging 

Pulmonary nodules smaller than 8mm 

Incidental finding workups 


Related topics