Shortage of contrast dye for medical scans improving in Alberta

A global shortage of contrast dye that led to thousands of imaging procedure delays in Alberta is improving, and while it's still having an impact on patient care, supply levels are slowly returning to normal.

One of Canada's main suppliers of the contrast material — GE Healthcare — had to temporarily close its production plant due to COVID-19 lockdowns in Shanghai earlier this year, leading to ongoing supply problems.

According to Alberta Health Services (AHS), the scans for 7,200 patients were postponed in June and July, and most of those tests have now been completed. AHS conducts an average of about 40,000 scans a month.

"I feel a lot more comfortable than I did before," said Dr. Manish Joshi, head of diagnostic imaging for the Calgary zone.

"On the urgent side, there's no delays. I think it's pretty much back up to where our standard times were. Emergency: I don't believe there's any delays for those patients either."

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Contrast dye is used in roughly half of the CT scans performed in Alberta. According to Joshi, supplies are now back up to roughly 90 per cent of usual levels.

That means outpatients are still feeling some impacts. While they're no longer having scans postponed, some are waiting longer to get in. 

"We're not deferring more patients. We're booking whatever we can. We just don't have the same booking slots," he said.

Joshi said doctors continue to use different kinds of diagnostic tests when they can.

"And sometimes to address wait-lists we do surge scanning, where we try to book extra shifts [and] we try to get more patients in. And we're constrained in that regard," he said.

According to Joshi, it's unclear exactly when full shipments will resume. He has heard it could be anywhere from the end of October to early 2023.

Dr. Eddy Lang, department head of emergency services in Calgary, said physicians in the ER are still in the dye-sparing mode and opting for tests that don't require contrast dye when they can.

"We have very safely and effectively modified our practice," he said.

"It's a little bit more cumbersome. Some of the testing now takes longer to organize, and it means patients stay in the emergency department longer. But in terms of getting the right diagnosis, even if there's a dye shortage, we're managing to do it as well as we did when dye levels were normal."

Joshi said he's confident those patients have not been negatively impacted because doctors have opted for comparable or better tests when needed.

But what isn't clear yet is if less urgent patients, who had their tests postponed, have become sicker or had missed diagnoses as a result.

"There was definitely delayed care, and I don't think we're going to be able to figure out exactly what the impact of that was until we go forward and we look back and we say 'hey, this is something that we could have caught earlier.'"

Meanwhile, AHS said staff and doctors have worked hard to minimize the impact of the shortage, and CT volumes are back to 2021 levels.

"They're [about] 15 per cent higher than 2018-19, thanks to dedicated funding to do more scans and improve access," spokesperson Kerry Williamson said in an emailed statement.

Despite the shortage, he said, 84 per cent of urgent CT scans are getting done within the target of one week, compared with 71 per cent in 2018-19.