The Increased Source to Image-receptor Distance Technique: What Is Preventing Implementation in Clinical Practice?

Evidence in the literature shows that increasing the source to image-receptor distance (SID) can optimize specific radiographic projections; yet, despite this evidence base, the technique is not commonly practiced within all radiology departments. The present work aimed to bridge the gap between evidence and practice by interviewing allied health professionals to investigate the feasibility of implementing the technique in clinical practice. Opinions were sought from multiple sources to triangulate the data including radiographers, medical physicists, professional body council members, and university lecturers. Data were collected via telephone and departmental surveys, self-administered questionnaires, focus groups, and individual interviews. Analysis via keywords and themes was undertaken. Tradition, the capacity to change practice, and radiographic equipment were perceived as the main obstacles against clinical implementation. Seventy-five percent of radiographers working with modern equipment did not perceive any disadvantage to the radiographer in extending the SID by 30-50 cm compared with 59% of radiographers working with older equipment. However, when radiographer perceptions of implementing the technique were analysed, 100% of radiographers responded positively to increased SID implementation, especially "if given more information." The key to effective clinical implementation is to adopt a multidisciplinary approach and to actively disseminate information among hospital management and radiographers. There are no insurmountable issues preventing the implementation of the increased SID technique in clinical practice, and encouraging radiographers to explore optimization strategies has the potential to advance evidence-based practice within the profession.