Shaping and improving radiography through research with Christina Malamateniou

Professor Christina Malamateniou has lived a radiography research career spanning across immensely different disciplines and fields, from paediatric MRI to artificial intelligence and beyond.

Not only a co-founder and director of the City St George's Research Radiographer Group (CRRAG) but also an associate professor of technology-enabled care at City St. George’s, University of London, Christina holds half a dozen honorary positions across universities and professional bodies, both in the UK and internationally.

Her passion for the profession has led her from the Technological Institute of Athens, to London and to Liverpool, from clinical practice to research leadership at the highest echelons.

Last year, Christina was awarded with a Fellowship of the College of Radiographers, for her significant contributions to the radiography profession in education and research.

Even outside her day-to-day, Christina is committed to improving radiography, as she and her daughter, Katerina, are working together to write a textbook about AI in healthcare for children.

Throughout such a long and varied career, she’s maintained one constant mantra: put research at the centre of everything.

Synergy spoke to Christina to hear her journey, her passions, and what she’s discovered over the years.

Developing best practice

Like many radiographers, Christina’s first encounter with radiography came as a child when a family member fell ill, while living in her native Greece – her grandfather was diagnosed with lung cancer. In the wake of treatment, she saw many of those first scans, and realised their importance for diagnosis and treatment.

Being able to see the details firsthand appealed to Christina as a visual learner, she explained. “[With images] you could identify pathology and potentially help someone, or relieve their pain,” she added. “That was a big plus for radiography.”

Coupled with her own passion for technology, radiography sounded like the perfect profession. Once she had input from her sister, a physiotherapist, and her aunt, a paediatrician, Christina felt confident in applying to the Technological Institute of Athens, in Greece, for a diagnostic radiography course in 1998.

She graduated as valedictorian in the wider School of Health and Care amongst 950 students after completing the four-year Bachelor's course in 2002, and worked for two years at the University Hospital of Athens, 'Attikon', as an MRI radiographer. But her interest in learning more, in research, had grown. Unfortunately, Athens had no opportunities for further education in radiography at the time, so in 2003 Christina turned her attention abroad, and moved to England.

She said: “I wanted to be part of the people who shape healthcare. I wanted to shape, to change, to improve, and to be part of the decision-making – not just an implementer of best practice, but a developer of best practices.

“That’s why I came to the UK, because the UK has always been, and is to this day, the best place to do research in radiography, and the best place to practise radiography as a profession. I was very fortunate to get a scholarship back then, from the Greek State Scholarships foundation (IKY) for my PhD studies in the UK.”

Studying hard for the application tests secured her a scholarship to complete a doctorate at Imperial College London (ICL), where she worked on perinatal magnetic resonance angiography research. Her expertise led her to join a research team investigating the effects of premature birth on the brains of neonatal babies in the world-renowned Robert Steiner MRI unit. Her research completed the picture, by identifying unique vascular phenotypes of the preterm infants compared to their full-term counterparts, a project she later successfully explored in preterm adults, in collaboration with colleagues at The University of Oxford.

Coming to a new country was made doubly hard by the fact that she was one of the few radiographers actively pursuing PhDs.

“I missed my family,” she recalled. “I missed the Greek sunshine. It was a very hard first few years. Many times I felt like giving up. The only thing that kept me going was knowing that if I went back, I would have to repay my scholarship. I didn’t have that capacity – I really had to make it work!”

Christina completed her PhD in 2006, and she went on for the next two years to work as a lecturer in medical imaging at the University of Liverpool. But her passion for research remained: in 2009, Christina returned to ICL as a research fellow in fetal and neonatal MRI optimisation and clinical applications, a role which propelled her on to a myriad of other positions and jobs, at King’s College London and, latest, at City St George’s.

In 2012, she kickstarted a series of visiting academic roles – as a visiting lecturer in MRI/CT for the Erasmus Radiography programme at the Technological Educational Institute of Athens, then as a visiting lecturer for the MSc in advanced MRI at University College Dublin, as well as a visiting professor at HESAV in Switzerland. More recently she was announced as Adjunct Professor at University College Cork in Ireland, on a 3-year term, supporting strong European research collaborations.

For the next few years, Christina also worked with a multitude of research projects for a variety of organisations and universities, before in 2019 becoming an associate professor at City St. George’s University of London, as programme director of the Master's in radiography and establishing the radiography doctorate programme.

While there, she continued participating in research projects while also founding the CRRAG – an organisation Christina has been working with for eight years.

Christina opening the CRRAG research group launch event September 2025 and presenting the values, vision and mission of the group

Christina opening the CRRAG research group launch event September 2025 and presenting the values, vision and mission of the group

Her work continues across different universities and professional associations, despite the promise she made to her parents back when she first came to the UK.

“I was going to go back to Greece to apply what I learned [from the ICL PhD] in my home country,” she admitted. “After I got the job at the University of Liverpool, I promised just another couple of years, to gain some experience. This year, I’ll have lived in the UK the same length of time as I lived in Greece. 23 years! I think my parents have resigned themselves to it now - but they are equally so proud of what I have achieved. We do make sure, though, to visit each other as frequently as it is possible.”

Students from Greece (radiographers and radiologists) meeting Christina in London after attending one of her courses

‘Research is not an add-on’

Christina’s extensive experience in and passion for research have taken her all across the globe, and all the way from MRI to AI and back – but nowhere has that passion been put more on display than in the founding of CRRAG.

At City St. George’s, Christina has been able to develop in parallel both research capacity and postgraduate courses to enable students to study and explore a number of different topics, including artificial intelligence, person-centred care and accessibility, workforce development, educational research and more.

CRRAG is part of those efforts to shape practice: a radiographer-led multidisciplinary research group, which includes radiologists, medical physicists, data scientists and engineers.

Christina amongst many of her PhD students and closest collaborators in a team away day in London

Christina amongst many of her PhD students and closest collaborators in a team away day in London

She explained: “I was very fortunate to have amazing research supervisors, line managers and heads of departments in my career, because they really wanted research to thrive. In radiography, people don't generally do research as a core practice, but it is rather considered a side job to other academic work. The idea of CRRAG was that research had to take front position.”

With funding from the College of Radiographers, including doctoral fellowships and the CoR Industry Partnership Scheme as well as the UK Research and Innovation (UKRI) fund and the Economic and Social Research Council (ESRC), Christina was able to help CRRAG grow. Now, seven years on from its inception, it boasts 10 permanent academic members of staff, six PhD students, and more than 56 associate members– not just in the UK but across the globe.

In the last 18 months alone, CRRAG has secured half a million pounds in funding, which mainly goes into research fellowships, PhD studentships, employment of research assistants, and more.

Compared to other disciplines of clinical research, even this amount isn’t much – but for radiography, it's a huge success, Christina emphasised. And that money is well-used once received, with the group maintaining five research priorities, including:

AI and new technologies, with more than 50 papers being published by the group over the last five years
Person-centred care, which covers people who find it difficult to access healthcare, including neurodivergent and paediatric patients
Workforce challenges, where the team is currently running a worldwide survey on recruitment, retention and attrition for radiographers with more than 5,000 participants
Education intervention, focusing on what works for students and staff, and applying it if they actually prove to be useful
Safety in imaging, in which the team has contributed research across MRI, CT, ultrasound, and more

“Research is part of our professional responsibility,” Christina says. “It’s not a luxury– it’s not just for those of us in academia. Research is not an add-on, it absolutely shapes practice. It’s made radiotherapy treatment shorter for some cancers, and it creates new technologies that massively improve accuracy of diagnoses. Radiographers are so central in both diagnosis and treatment, they are very talented researchers and with some support can be accomplished innovators and clinical entrepreneurs. They graduate with innovative minds – they need to be engaged in research to ensure all their varied talents can be translated for patient and public benefit.

Professor Christina Malamateniou with several members of the CRRAG team – a strong, safe and supportive structure to conduct high quality research

Professor Christina Malamateniou with several members of the CRRAG team – a strong, safe and supportive structure to conduct high quality research

“If you want to conduct research, you need to seek out the places that support it. It’s very hard as a single person to change local culture– you need a critical mass of like-minded people. If your environment doesn’t work for you, find one that’s going to support research. I was blessed to work in spaces that fostered research, that’s why I thrived. I would also recommend the Formal Radiography Research Mentoring scheme (FoRRM).”

Christina is one of the co-founders of FoRRM, a scheme at the SoR, alongside Dr Rachel Harris, Dr Charlotte Beardmore, and Professor Heidi Probst in 2017.

The scheme brings on average 10 to 12 mentors each year to support applicants one-to-one, building the future research leaders of the profession.

“Never give up,” she added. “You have to be passionate to go through all of these challenges and still be doing the research. I was once told it might be easier to get promoted if I focused solely on education. As much as I love teaching and igniting the sparkle in the minds of young radiographers, in my heart, I’m always a researcher. I won’t accept things for what they are, I ask questions, I want to understand why we are doing things in a certain way, and how we can make them better.”

UKIO 2023 conference, with Christina’s PhD students and then-president Ross McGhee

Part of something bigger

During her PhD, Christina was part of a team validating AI tools for fetal motion correction, hopefully to improve MRI imaging.

She said: “At the time, I didn’t realise I was part of something so much bigger. As AI got bigger, I looked back and realised I had been contributing to its development all this time, for the last 23 years. There is not enough to study in AI for radiographers, so I had to get into a course somewhere beyond my comfort zone, which was not easy, but it helped me learn. I had experience with the practical side of AI, I just needed the theory behind it.”

To get that knowledge, Christina participated in a course on the subject of AI in Barcelona, Spain, and came back to City St. George’s to create from whole cloth an entirely new module at the University: Introduction to AI for medical imaging and oncology professionals. That course will this year mark its seventh year running.

This course’s goal is to develop AI literacy for researchers the world over and improve the entire downstream development, governance and implementaiton of this technology in healthcare.

First day of the Introduction to AI course for radiographers, created by Christina

First day of the Introduction to AI course for radiographers, created by Christina

“I want to create AI literacy for radiographers, because we are the best placed professionals to carrry this agenda forward; we are at the crossroads between technology and patient care,” she continued. “That’s what I found so intriguing about the profession in the first place. But we have to be doing more on AI, we need to be leading innovation, procurement, implementation, entrepreneurship from our own corner and expertise, while working within multidisciplinary teams. The success of AI depends not on one person or one profession, it depends on all of us.”

In her many years interacting with, studying, and using AI, Christina has had time to develop her own conclusions about the technology. Is it a threat? Is it a blessing? In her view, that all depends on how it is used going forward.

“Like any tool, if it’s used right, it can save lives at scale,” she said. “Trials right now show that AI can predict breast cancer five years before its actual development. Imagine if we could do the same for all the big killers of our society: heart disease, pancreatic cancer, glioblastoma, brain cancer?

“It’s everyone’s responsibility – not just radiographers, not just healthcare professionals, but every citizen’s, to ensure that we step up when it comes to responsible, safe, ethical use of AI. It’s important for everyone to be knowledgeable about AI.”

The future of AI remains unsure, without clear governance about its usage, risks or direction, but Christina is confident a firmer strategic position will be coming within the next 18 months in the UK.

CRRAG, alongside the SoR, other professional associations and learning societies in the UK and Europe are all in conversation, working towards the creation of an event in September 2027 focused on AI and other technologies, including digital twinning, virtual reality, and remote scanning.

“We want to see not just how we’re going to keep more radiographers in the profession, but also how we can better prepare radiographers to work with new technologies,” she explained. “We want to maximise the benefits of these technologies for patients, for students, and for practitioners.”

Ongoing work from researchers in this area, Christina added, will be vital to safe, secure, and efficient implementation of the technology – after all, that’s the core of the profession.

“Radiography as discipline is about exactly that,” she affirmed. “It's about helping others, about giving back to society, as a caring professional in healthcare.”

Find out more about the FoRRM scheme

The Formal Radiography Research Mentoring (FoRRM) scheme aims to increase the capacity and quality of radiographers involved in research in the UK by granting applicants the opportunity to study under and learn from experienced researchers from a variety of disciplines.

Find out more about the scheme online here.

Find out more about CRRAG

The City St George's Research Radiographer Group (CRRAG) conducts high-quality, world-renowned research dedicated to the advancement of medical imaging and therapeutic radiography in clinical practice at City St George’s, University of London.

Find out more about the group online.

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