There are few regulations regarding facility accreditation and individual credentialing in diagnostic medical sonography (DMS), although it is known that the quality of examinations in the field can vary based by the operator. This literature review summarizes the findings from 19 research studies on accreditation, credentialing, and quality improvement and includes illustrative quotes from 23 position papers and 42 editorials. The review uncovered large differences in facility accreditation status based on sonography specialty and geographical area. The findings included many examples of positive correlations between accreditation and improved quality and also a positive correlation between credentialing and improved image quality. The survey studies revealed overwhelming support for accreditation and credentialing. Many articles raised concerns about the unknown quality of sonograms performed in nonaccredited facilities or by uncredentialed sonographers. If facility accreditation and/or individual credentialing could be implemented nationwide in DMS, it may lead to increased quality within the field.

Objective: Continuous improvement is vital to ensuring quality in sonography education. The aim of this literature review was to compile and summarize the current literature on accreditation, credentialing, and quality improvement initiatives in sonography education. Materials & Methods: Four sonography-specific journals and six health science/academic databases were searched using the terms education, sonography, ultrasound, accreditation, credential, and quality. The search was limited to findings in the English language, from 2000 to 2020. Results: The search uncovered only 19 articles on this topic in sonography education. The vast majority of papers focused on quality improvement initiatives, while just a few concentrated on accreditation or credentialing. Conclusion: Much of the contemporary sonography educational literature focuses on clinical, lab, or didactic quality improvement initiatives. Overall, it is clear that more research is needed in the field of sonography education. This review provides examples of quality initiative research in other allied health fields that can be useful guides for future sonography educational research.

Surveillance following abdominal aortic endovascular aneurysm repair (EVAR) is imperative to confirm graft patency, analyze residual sac size (RSS), and evaluate for complications. This retrospective study evaluated ultrasonographic (US) surveillance after EVAR compared to computed tomography (CT). US was done by 1 of 11 experienced registered technologists. US was ordered for surveillance more frequently than CT, with a ratio of 4:1. Compared to CT, US endoleak evaluations were 74% sensitive and 76% specific with a 63% positive predictive value and 84% negative predictive value. However, 11 CT scans were likely false negatives, and 1 CT was a false positive. For true positives that stated endoleak type, there was a 93% agreement between the type on US and CT. US had a 75% accuracy for RSS (95% CI,-1.02 to 1.16). These data support the use of US along with clinical symptoms as a first-line surveillance program after EVAR and are widely applicable to the majority of vascular laboratories that employ multiple registered vascular technologists. The adaptation of increased US surveillance would decrease the number of CT scans, thereby significantly reducing cost and radiation/contrast exposure to patients.