Radiographers lighten load for busy U.K. radiologists

A record of nearly perfect test assessments suggests that radiographers (technologists) in the U.K. can successfully perform cranial CT reports, easing the increased radiology workload resulting from staff shortages, according to researchers at the University of Wales in Bangor.

The accuracy of radiographers' reporting in some European countries compares favorably with that of radiologists. But extending the role of the radiographer is a contentious topic throughout Europe, according to Dr. Gabriel P. Krestin, radiology chair at Erasmus MC Medical Center in Rotterdam, the Netherlands.

"The consensus is that reporting of findings has to be performed by radiologists," Krestin said. "My personal opinion is that radiographers can be very well trained to perform specific procedures and even give a first, limited interpretation of images if supervision for more complex clinical questions is always granted."

Krestin's opinion is supported by statistics. Barry Carver, a senior postgraduate tutor at the School of Radiography of the University of Wales, and his colleagues evaluated 23 students enrolled in the university's training module for cranial CT reporting for radiographers. The module consists of two assessment methods to test the accuracy of students who complete the training: an objective structured clinical exam and a clinical portfolio that contains comments from mentor radiologists. All students successfully passed the clinical exam without any errors that would have altered patient treatment.

In 4800 reports from the clinical portfolio, the radiographers achieved an accuracy rate of 97.2%. Most changes to radiographers' reports involved recommendations for follow-up scans, either MR or CT with contrast. Carver reported the results at the 2004 RSNA meeting.

Developing the radiographer's role offers one solution to the chronic shortage of radiologists in the U.K., but that isn't the only justification for radiographer reporting, said Dr. Adrian M.K. Thomas, a consultant radiologist at the Princess Royal University in Farnborough, Kent.

"Reporting is a legitimate role for radiographers whether there is a shortage of radiologists or not. In the U.K., radiographers have always been trained to a high standard," Thomas said.

Reporting radiographers at his university, who are all at the graduate level, work with an agreed-upon protocol and under a supervising radiologist mentor.

But departmental politics, along with inconsistent guidelines within the European Union, may hinder the expansion of the radiographer's role, Carver said.

"Failing to use these trained members of the staff is a great shame. The results of our study demonstrate that radiographers have the ability to undertake the role, even if initially used only for second reporting. A second pair of eyes is often useful," Carver said.