Professional practice, training, and role development of radiographers in interventional radiology and cardiology: An international survey across Europe

INTRODUCTION: Radiographers are now key members of interventional radiology (IR) and interventional cardiology (IC) teams, taking on tasks that go beyond image acquisition. These include radiation protection, assisting in procedures and patient care. However, training and regulation for these expanded roles are variable, leading to differences in practice and raising concerns for safety and mobility. METHODS: A cross-sectional survey design was used to investigate radiographers' training, practice scope and technology access in IR and IC across Europe. A 31-item online questionnaire was distributed via professional networks, social media and EFRS research hubs at the European Congress of Radiology (2024-2025). Descriptive statistics were utilised, and open-text comments thematically grouped. RESULTS: Ninety-one radiographers from 12 countries responded, with the majority based in the UK (46 %) and Ireland (19 %). Marked differences were noted in training, with 23 % reporting no formal IR/IC education. Technology access also varied, as nearly half worked with fluoroscopy systems older than five years, limiting dose-saving options. Radiation protection practice was inconsistent; just over half (53 %) used pulsed fluoroscopy routinely, while 27 % reported not removing anti-scatter grids for paediatric cases. Scope of practice showed further fragmentation, with advanced clinical functions only reported by a minority. CONCLUSION: This study demonstrates wide variations in training, equipment quality, and role scope among radiographers practicing in IR and IC across Europe. Such inconsistencies directly impact radiation safety, patient outcomes and the ability of staff to move freely across borders. Without structured frameworks, radiographers may lack key competences in dose optimisation, paediatric safety and procedural support, exposing patients and staff to avoidable risks. IMPLICATIONS OF PRACTICE: A harmonised European framework is needed to support safe radiation practice and improve care consistency.