Reporting radiographers in CT and MRI: A literature review with a systematic approach

Objectives: The aim of this literature review is to provide an overview and synthesize the evidence on the role of reporting radiographers in CT and MRI, with a focus on their diagnostic accuracy, the education and training required for this role, and the challenges and opportunities associated with their integration into clinical practice. Key findings: Radiographers in CT and MRI reporting roles often achieve diagnostic accuracy comparable to radiologists, particularly for straightforward pathologies and as first readers. However, discrepancies are more common in complex cases, such as extracolonic findings in CT colonography or smaller polyps in MR colonography. Structured training, including postgraduate certificates, tele-training, and technology-enhanced learning, enhances radiographers' diagnostic accuracy and confidence. However, regional variation in training availability and standardisation limits broader implementation. Challenges to integration include legal and regulatory constraints, geographical training disparities, and concerns about misdiagnosis. Regular audits and mentoring are crucial to ensuring quality and addressing these concerns. Conclusion: Radiographers have demonstrated the ability to achieve diagnostic performance comparable to radiologists in specific contexts, particularly when supported by structured training and mentorship. However, challenges such as variability in training opportunities, legal and regulatory constraints, and the risk of misdiagnosis persist. While the evidence highlights the potential of radiographer-led reporting to enhance diagnostic workflows, reduce radiologist workloads, and improve patient care, further research is needed to address these challenges and evaluate long-term impacts on clinical outcomes. Implications for practice: Healthcare organisations should implement standardised training pathways to prepare radiographers for reporting roles. Collaborative models, where radiographers support rather than replace radiologists, can improve efficiency while maintaining quality. Policymakers must provide clear guidelines and funding to expand these roles, particularly in radiologist-shortage areas. Technological tools, such as AI-assisted reporting, can help radiographers manage complex cases. Equitable training opportunities, including remote learning and mobile apps, should address geographical disparities. Robust quality assurance protocols are essential to sustain confidence in radiographer-led reporting and enhance patient care outcomes.