OBJECTIVE:With health care rapidly expanding and patient accessibility needs increasing, there has been an influx of providers often lacking formal training in venous disease management. The aim of this study was to determine if centers that participate in an accreditation program exhibit increased quality, safety outcomes, and overall practice standards. METHODS:Of 325 accredited vein centers, 287 underwent reaccreditation within 3 years. Fifty-nine of them were compliant with Intersocietal Accreditation Commission (IAC) standards at the time of initial accreditation. Fifty-nine IAC-accredited centers participated in the American Vein and Lymphatic Society Pro Vein registry and had patient-level data. Sixteen were initially compliant with IAC standards (group 1; 4977 patients) and 43 had deficiencies (group 2; 11,179 patients). A stratified before-and-after design was used to analyze center-level and patient-level data (demographics, body mass index, and disease severity scores [Clinical-Etiological-Anatomical-Pathophysiological and revised Venous Clinical Severity Score (VCSS)]. Primary outcomes included compliance with IAC standards, treatment results (eg, VCSS changes, complications, endothermal heat-induced thrombosis >2), and interventional practice patterns, such as intervention rate and Utilization Index. RESULTS:Of the 287 IAC-accredited vein centers who pursued reaccreditation, 59 were compliant initially and at reaccreditation. The remaining centers (n = 229) had multiple deficiencies, with safety issues persisting in some centers at reaccreditation. Before accreditation, group 2 centers treated younger, lower body mass index patients with less severe disease, and group 1 centers saw more advanced cases. Over time, group 2 centers began treating more severe cases. Group 1 had higher intervention rates and lower use indices before accreditation. Post-treatment complication and endothermal heat-induced thrombosis rates were low and similar across both groups. Group 1 showed a greater VCSS score change after treatment, partly owing to higher baseline scores. Over time, group 2 showed a decrease in Utilization Index, without a post-treatment decrease in the revised VCSS change aligning with group 1, indicating improved practice patterns after accreditation. CONCLUSIONS:IAC accreditation plays a meaningful role in standardizing and improving the quality of outpatient venous care. It promotes safer procedural environments, encourages more selective use of interventions, and is associated with improved clinical outcomes-particularly among initially noncompliant centers. These findings support the expansion of accreditation programs and underscore their importance in maintaining high standards of care in an increasingly heterogeneous field.

center dot Detection of pulmonary embolism and recurrent pulmonary embolism. center dot Documentation of pulmonary embolism resolution. center dot Evaluation of quantitative lung function (i.e., lung center dot Evaluation of lung transplants. center dot Evaluation of congenital heart defects or lung diseases such as the following: o Cardiac shunts. o Pulmonary arterial stenosis. o Arteriovenous fistula. center dot Confirmation of bronchopleural fistula. orders such as cystic fibrosis. center dot Evaluation of pulmonary hypertension.

Cardiac PET imaging is increasingly used for myocardial perfusion studies because of its high diagnostic accuracy and low radiation exposure to the patient. However, patient motion can be challenging, affecting a large number of studies. Motion artifacts can lead to inconclusive or false-positive results, complicating clinical interpretation. This article explores the causes of motion artifacts and their characteristic appearance in cardiac PET imaging, highlighting their distinction from true perfusion abnormalities. Strategies for minimizing motion through effective patient positioning and communication are discussed. Understanding and addressing motion artifacts are crucial for optimizing diagnostic accuracy and ensuring the full benefit of cardiac PET imaging.

Cortical renal imaging has a high diagnostic sensitivity (>90%) for detecting renal cortical defects. Blood is filtered within the kidney nephrons, specifically the glomerulus of the nephron, located within the renal cortex. Defects seen on renal cortical imaging indicate a loss of function, most

Several nuclear medicine technologist-specific groups exist on social media sites such as Facebook and LinkedIn. Although these sites provide a valuable resource and forum for technologists to interact and pose questions, any recommendations, especially those regarding patient care, should be carefully scrutinized and evaluated on the basis of scientific merit and not opinion. Recently, an assortment of unvalidated ingredients for solid-meal gastric emptying scintigraphy has been suggested on these social media sites. Often, these ingredients do not comply with the peer-reviewed guidelines and can potentially produce unreliable results and misdiagnosis. Thus, before implementing advice from an unvetted source, technologists must distinguish between low- and high-quality information. Currency, reliability, authority, and purpose-a test of the trustworthiness of an information source-can help technologists evaluate recommendations and avoid the use of unsupported solid-meal gastric emptying scintigraphy ingredients.

Many variables can influence the results of gastric emptying scintigraphy (GES). A lack of standardization causes variability, limits comparisons, and decreases the credibility of the study. To increase standardization, in 2009 the Society of Nuclear Medicine and Molecular Imaging (SNMMI) published a guideline for a standardized, validated GES protocol for adults based on a 2008 consensus document. Laboratories must closely follow the consensus guideline to provide valid and standardized results as an incentive to achieve consistency in patient care. As part of the accreditation process, the Intersocietal Accreditation Commission (IAC) evaluates compliance with such guidelines. The rate of compliance with the SNMMI guideline was assessed in 2016 and showed a substantial degree of noncompliance. The aim of this study was to reassess compliance with the standardized protocol across the same cohort of laboratories, looking for changes and trends. Methods: The IAC nuclear/PET database was used to extract GES protocols from all laboratories applying for accreditation from 2018 to 2021, 5 y after the initial assessment. The number of labs was 118 (vs. 127 in the initial assessment). Each protocol was again evaluated for compliance with the methods described in the SNMMI guideline. The same 14 variables were assessed in a binary fashion: patient preparation (4 variables-types of medications withheld, withholding of these medication for 48 h, blood glucose ≤ 200 mg/dL, blood glucose recorded), meal (5 variables-use of consensus meal, nothing by mouth for 4 h or more, meal consumed within 10 min, documentation of percentage of meal consumed, meal labeled with 18.5-37 MBq [0.5-1.0 mCi]), acquisition (2 variables-anterior and posterior projections obtained, imaging each hour out to 4 h), and processing (3 variables-use of the geometric mean, decay correction of data, and measurement of percentage retention). Results: Protocols from the 118 labs demonstrated that compliance is improving in some key areas but remains suboptimal in others. Overall, labs were compliant with an average of 8 of the 14 variables, with a low of 1-variable compliance at 1 site, and only 4 sites compliant with all 14 variables. Nineteen sites met an 80% threshold for compliance (11+ variables). The variable with the highest compliance was the patient's taking nothing by mouth for 4 h or more before the exam (97%). The variable with the lowest compliance was the recording of blood glucose values (3%). Notable areas of improvement include the use of the consensus meal, now 62% versus previously only 30% of labs. Greater compliance was also noted with measurement of retention percentages (instead of emptying percentages or half-times), with compliance by 65% of sites versus only 35% 5 y prior. Conclusion: Almost 13 y after the publication of the SNMMI GES guidelines, there is improving but still suboptimal protocol adherence among laboratories applying for IAC accreditation. Persistent variation in the performance of GES protocols may significantly affect patient management, as results may be unreliable. Using the standardized GES protocol permits interpretation of results in a consistent manner that allows interlaboratory comparisons and fosters acceptance of the test validity by referring clinicians.