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Beginning January 1, 2010, the ICAVL will no longer accept case studies recorded on videotape and encourages non-digital laboratories to look toward more contemporary methods of recording and storing ultrasound images.

Since the inception of the ICAVL in 1990, commonly accepted hardcopy representation has included not only videotape but also thermal prints, color copies, and radiographic film, encompassing the main mediums used to record ultrasound images at that time. Around 2001, some applicant laboratories began to inquire about their ability to submit case studies digitally on compact disc (CD). At that time, guidelines for submitting cases on CD were published. Since then, a steady increase in the number of laboratories submitting digitally recorded images has been seen, though in comparison to other imaging specialties such as echocardiography, the trend in vascular laboratories has been somewhat gradual.

In keeping with the "inclusive versus exclusive" philosophy that is a cornerstone of the ICAVL's philosophy, the Board of Directors exercises great consideration in balancing the technologies needed to provide optimal quality with the broad demographics of those laboratories seeking accreditation. Statistics from the past two quarters indicate that approximately 15% of the applications submitted for accreditation included case studies recorded on videotape. Considering this relatively low segment of the applicant laboratories, the Board, at its February 2008 meeting, made the decision to implement a requirement that will emphasize the importance of quality image recording, thus eliminating videotape as an acceptable method of submitting case studies for accreditation. The decision is a statement implying that, at this time, the overall quality of cases being interpreted from videotape is limited and the ability to share data impractical.

Prefacing the need for this change, Thom Rooke, MD, RVT, President of the ICAVL Board of Directors, stated, "Labs that deal with imaging face a common problem -- how to record these images. Patients often undergo testing in one setting and receive treatment in another; when this occurs, it's essential that the images obtained during a study are available for review by everyone who needs access to them. Unfortunately, if a laboratory records their images in a format that cannot be readily accessed by others, the study becomes unusable. Based on current ICAVL statistics, it's clear that most laboratories and clinicians no longer record on videotape, nor have the required equipment available to play (i.e. review) a study when the images are provided on tape. In response to this trend, the ICAVL must adjust their standards to ensure that imaging studies are provided in widely available formats that can be reviewed in most laboratory or clinical settings.

As noted by Dr. Rooke, it is not uncommon for patients being seen in accredited laboratories to undergo examinations in one location, yet receive treatment by physicians located in another facility. This point is further validated through the 52% of currently accredited laboratories that are located in physician's offices (of varied specialties) and other freestanding facilities. With over half of the laboratories operating in these settings, the impact of sharing quality data with referring physicians and surgeons in the management of patient care is paramount.

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