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Of the diagnostic modalities, MRI is the most energy-intensive modality, consuming up to 60 kWh per scan, followed by CT, which ranges from 1.0 to 11.4 kWh per scan. Lifecycle analyses show that operational energy use far exceeds manufacturing emissions, highlighting the need for energy-saving strategies. Implementing standby and power-off modes, optimizing scan protocols, and using AI-driven efficiency improvements can significantly reduce unnecessary energy use. Additionally, sustainable infrastructure, such as variable-flow cooling systems and strategic equipment placement, can further minimize environmental impact. Nuclear medicine, while relatively lower in energy consumption, relies on energy-intensive radioisotope production, often requiring fossil fuel-powered reactors and extensive transport logistics. Contrast agents in MRI and CT pose contamination risks in wastewater, as they are inadequately removed via conventional treatment plants methods. This results in the accumulation of gadolinium and iodinated byproducts in drinking water sources, posing potential human and ecological risks. Nuclear medicine radioisotopes, including Tc-99, also contribute to long-term contamination concerns. Strategies to mitigate these impacts include urine recycling, contrast separation, and advanced wastewater treatment. Sustainable practices in medical imaging require a multi-pronged approach, combining operational efficiency, renewable energy adoption, and stricter waste management protocols. 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