# The Asian Oceanian Society of Radiology (AOSR) green radiology survey: a catalyst for action

## TL;DR

This paper presents a survey on green radiology practices in Asia-Oceania, highlighting the high carbon footprint of radiological services and the need for sustainable strategies.

## Contribution

The study provides a regional assessment of radiology's environmental impact and proposes actionable steps for sustainable practices.

## Key findings

- Radiological services in Asia-Oceania have a high carbon footprint due to energy-intensive scanners.
- Few societies have integrated sustainability into training or research.
- A checklist is proposed to help implement eco-friendly radiology practices.

## Abstract

Approximately 5% and 1% of global greenhouse gas emissions originate from the healthcare sector and medical imaging respectively. These are not insignificant. Despite this, the medical field has been slow to adopt sustainable practices. Green radiology is a sustainable, innovative, and responsible approach in radiological practice that focuses on minimising the negative environmental impact of our technologies and procedures. The Asian Oceanian Society of Radiology (AOSR) conducted a survey across Asia-Oceania to better understand current operations and identify opportunities for meaningful progress toward more sustainable radiological practices. From the 123 institutions that responded, it was found that collectively the carbon footprint of Asia-Oceania’s radiological services are high in some of the countries/regions because of the high density of high energy consumption scanners (such as computed tomography and magnetic resonance imaging scanners). Our survey showed that less than half of the 15 societies that responded had specific academic or research activities related to sustainable radiology and less than a third reported that sustainability had been incorporated in the training curriculum. The AOSR is committed to facilitating the sharing of best practices in green radiology and recommends that Asia-Oceania use an “As Low As Reasonably Achievable” principle, traditionally used in radiation safety and extend this in the approach to the issues of environmental impact of radiological services. The AOSR as a cross-regional professional society, has the mandate to partner with our counterpart societies and industry stakeholders, to emphasise the importance of sustainability as a critical agenda, through our various activities. We foresee that influencing radiology leaders in the region to urgently formulate strategies, implement policies towards adopting eco-friendly approaches including reducing inappropriate imaging and encouraging academic efforts will help to reduce the environmental impact in each country/region. A checklist has been included to help kickstart the process.

The online version contains supplementary material available at 10.1007/s11604-025-01918-y.