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Updated: Jul 3, 2025

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Published on: September 11, 2011
A stake in the game: Can radiographer image interpretation improve X-ray quality? A scoping review
1Medical Image Optimisation and Perception Group, Discipline of Medical Imaging Science, Susan Wakil Health Building, Western Ave, Camperdown, NSW, 2050, Australia.
Background:
Image quality is an important factor in imaging optimisation and diagnosis. Many determinants of image quality are controlled by the radiographer; therefore, radiographer-led strategies may be key to improving X-ray image quality. This review examines the literature on radiographer-led diagnostic evaluation to establish its potential to improve X-ray image quality.
Methods:
The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews and the Joanna Briggs Institute Manual for Evidence Synthesis Scoping Review were used to review studies relevant to the impact of radiographer-led diagnostic evaluation on image quality. CINHAL, Embase, Scopus, Web of Science and Medline databases were searched for relevant articles. Search terms synonymous with radiographer, commenting, and image quality were used and studies that examined any type of radiographer-led image interpretation and its relationship to image quality in X-ray based modalities were reviewed.
Results:
Fourteen studies that met the inclusion criteria were reviewed. All the studies reviewed unanimously reported a positive association between radiographer image interpretation and image quality in X-ray based modalities. Five emerging themes were identified to be responsible for the improvement in image quality: increased understanding of image quality requirements, improved technical skills, enhanced ability to utilise supplementary imaging and repeats, collaborative upskilling of colleagues, and a complementary interaction between diagnostic and radiographic skills that serves to enhance image quality.
Conclusions:
The findings demonstrate that radiographer image interpretation is a useful strategy to optimise the quality of X-ray examinations.
Implications For Practice:
The findings highlight a new avenue to improve X-ray quality in the clinical environment and support evidence-based uptake of preliminary image evaluation systems. These findings also support the integration of radiographer commenting alongside technical image quality in teaching curricula.
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