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High quality diagnostic imaging is sought after by physicians, insurance payers and patients alike. Consequently, the case study portion of the accreditation application provides laboratories with an opportunity to demonstrate the quality of work performed in the laboratory and are considered the most important aspect of the application submission, weighing heavily in the final accreditation decision.

As part of the case study evaluation, both the reports and the image quality are examined. The final reports are reviewed for accuracy, format and content. The images are evaluated in terms of overall image quality, accurate acquisition, processing and display, and the presence or absence of artifacts.

General Requirements for Submission

The cases must be performed by current personnel on equipment presently used in the laboratory. Case study selection is not camera dependent and cases may be selected from any camera in the department.

If more than one person is performing or interpreting procedures, the selected cases should represent as many different staff members as possible.

Applicant laboratories are asked to submit images (either electronic or hard copy), final reports, EKG tracings (if applicable), and any clinical worksheets for studies performed in the laboratory. In order to ensure accurate representation of a complete examination, it is important that all images utilized in the interpretation of a study by a physician are included with the cases.

For all areas of ICANL accreditation (i.e., Nuclear Cardiology, General Nuclear Medicine, or PET), not more than one case study per body system or area may be normal. An abnormal study is one that has true positive findings or true abnormalities demonstrating clinical pathology. Images with artifact or attenuation would not qualify as abnormal studies. For example, a myocardial perfusion study with breast attenuation or subdiaphragmatic attenuation would not be considered an abnormal study. However, any type of fixed or reversible defect would be considered abnormal.

All cases must be labeled, including any disks and hard copy, with the following information:

• laboratory name with site location
• patient name
• case number or ID identifying the case study
• date/day the study was performed
• type of study
• imaging camera manufacturer and model number
• computer or software used in processing

All case study documentation, whether on CD, DVD or paper, must be submitted in duplicate. Please note that all materials submitted to the ICANL will be handled with strict confidentiality in accordance with HIPAA regulations.

Required Case Studies by Area of Accreditation

NUCLEAR CARDIOLOGY (ONLY)

In an effort to better assess the overall quality of a nuclear cardiology laboratory, the ICANL Board of Directors recently voted to change the case study selection criteria. This change will allow for a better evaluation of all physicians, technologists and equipment in the laboratory.

Effective with the January 1, 2009 application deadline, those laboratories applying for accreditation solely in Nuclear Cardiology (i.e., radionuclide myocardial perfusion [RMPI], equilibrium radionuclide angiography [ERNA], or cardiac PET) will no longer be required to follow the random selection criteria when submitting the RMPI case studies. Laboratories will be required to submit five (5) complete RMPI studies following the guidelines discussed below and in the box to the right. In addition to the five cases, laboratories will be required to submit two abnormal reports (without any images or clinical data) from each interpreting physician listed in the application. All studies and reports should reflect the high quality of studies performed in the laboratory.

All cases must be selected from studies performed two months prior to the expected submission of the application. For example, if a laboratory intends to submit the application on January 1, the cases can be chosen from the beginning of November through December 31.

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