Advancing circular economy practices in radiography: a narrative review of sustainable medical imaging

The healthcare sector, particularly radiography, plays a notable role in environmental degradation due to high energy consumption, resource-intensive manufacturing, and significant electronic waste (e-waste). Circular economy (CE) principles, centred on reducing waste, extending equipment lifecycles, and improving recycling, offer a promising framework for promoting sustainability in radiographic practice. This literature review employs a narrative synthesis approach informed by systematic search methods to explore CE principles, waste reduction, lifecycle extension, and improved recycling, as a framework for promoting environmental sustainability in radiographic practice whilst maintaining diagnostic quality. This review employed a narrative synthesis approach with systematic search methodology to explore the integration of CE practices in radiography. Peer-reviewed articles, industry reports, and case studies from 2018 to 2024 were analysed using structured database searches across PubMed, Scopus, and IEEE Xplore (127 articles screened, 89 included) to identify key themes, challenges, and emerging innovations. Findings reveal that CE applications in radiography are gaining traction through sustainable equipment design, energy-efficient technologies, modular components, and end-of-life recycling strategies. Quantitative analysis shows that artificial intelligence (AI)-driven imaging solutions can reduce scan times by up to 50% and energy consumption by 25-40%, whilst modular system upgrades can extend equipment lifespan by 30-50%. Lifecycle assessments (LCAs) have highlighted the environmental burden of imaging devices, with MRI machines generating approximately 30 tons of CO -equivalent emissions during manufacturing alone. Major barriers to adoption include regulatory limitations, cost constraints, and inadequate recycling infrastructure. However, ongoing innovations, such as AI-driven imaging solutions, the use of sustainable materials, and modular system upgrades, alongside policy mechanisms like extended producer responsibility (EPR), are advancing the circular agenda in medical imaging. Adopting CE principles in radiography can significantly lower the sector's ecological footprint without compromising diagnostic quality or patient safety. Although challenges remain, growing research, supportive policy frameworks, and stakeholder engagement offer viable pathways for sustainable transformation. Immediate priorities include establishing manufacturer take-back programmes, implementing energy-efficient protocols, and developing specialised medical device recycling infrastructure within the next 5 years. [Abstract copyright: © AME Publishing Company.]