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To view this FREE CME activity, please register on this page.

You must achieve a score of 75% or above to receive credit.
You may take the test up to 3 times.

Thank you for your participation.

Expiration Date: May 31, 2019


Course Director:
Mark Tulchinsky, MD, FACNP
Professor of Radiology and Medicine
Penn State University College of Medicine
Hershey, Pennsylvania

Dr. Tulchinsky is a Professor of Medicine and Radiology at the Pennsylvania State University, practicing Nuclear Medicine at the Penn State University, Milton S. Hershey Medical Center, for the past 24 years. He is board certified in Nuclear Medicine and Internal Medicine. His academic work has resulted in more than 50 original publications, several in the area of hepatobiliary scintigraphy, including the current Society of Nuclear Medicine and Molecular Imaging (SNMMI) practice guideline. He serves as the Hepatobiliary Chair of the General Clinical Nuclear Medicine Council of the SNMMI.

Kelly Holes-Lewis, MD
Assistant Professor of Psychiatry and Behavioral Sciences
Department of Psychiatry and Behavioral Sciences
Medical University of South Carolina
Charleston, South Carolina

Dr. Holes-Lewis received her BS (Biology) and MD degrees from Niagara University and the State University of New York at Buffalo now the University at Buffalo, respectively. Upon graduation from medical school, Dr. Holes-Lewis was awarded the humanitarian award from the UB School of Medicine and Biomedical Sciences. She completed her Nuclear medicine residency and PET/CT fellowship at through the UB Graduate Medical Education program, where she also served as Chief Resident. In addition, she completed a Psychiatry residency at Penn State, being awarded Teacher of the Year, followed by a research fellowship at the Medical University of South Carolina (MUSC). She is currently an assistant professor in the Division of Brain Research and Integrative Neuropsychopharmacology (BRAIN) at MUSC. Focusing on the utilization of nuclear medicine and molecular imaging to investigate the brain-gut axis and mechanisms of dysfunction. She served as an intern for the General Nuclear Medicine Council for the board of directors of the Society of Nuclear Medicine and Molecular Imaging.


This CME activity is intended for nuclear medicine physicians, pharmacists, and radiologic technologists.


Cholecystokinin-cholescintigraphy (CCK-CS) is considered a common clinical examination, yet the methodology of stimulating the gallbladder varies greatly among clinical practices, and evidence-based guidelines are often not followed. Recent research suggests that simple refinements in the methodology may reduce nonessential imaging to free up time for optimal gallbladder stimulation during this procedure. This program reviews the use of CCK-CS in the diagnosis of chronic abdominal pain and gallbladder dysfunction, including refinements to the methodology of gallbladder stimulation and imaging and the clinical implications of abnormal findings.


At the conclusion of this activity, participants should be able to:
• Identify reasons for diagnostic challenges in chronic abdominal pain
• Explain gallbladder dynamics as it relates to CCK-CS
• Name the radiopharmaceutical options for CCK-CS
• Discuss consensus recommendations for the methodology of GBEF testing
• Identify hepatobiliary pathology based on patterns observed during CCK-CS
• Explain new refinements in the protocol for CCK-CS
• Assess clinical implications of abnormal GBEF findings


Physicians: This program has been reviewed and is acceptable for up to 1.25 Prescribed credit hours by the American Academy of Family Physicians. AAFP Prescribed credit is accepted by the AMA as equivalent to AMA PRA Category 1 CreditTM for the AMA Physician’s Recognition Award. When applying for the AMA PRA, Prescribed hours earned must be reported as Prescribed hours, not as Category 1 Credit. (This statement applies to all Physicians, not just Family Physicians.) Educational Review Systems is also approved for physician continuing education by the state of Florida.

Pharmacists: Educational Review Systems is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmaceutical education. This program is approved for 1.25 hours (0.125 CEUs). ACPE # 0761-9999-14-005-H01-P. Educational Review Systems is also approved for pharmacy continuing education by the state of Florida.

Technologists: Approved by the ASRT for Category A+ continuing education credit. ASRT Reference # FLZ0054024R.


Dr. Tulchinsky - Bracco Diagnostics, Inc. (research grant, consultant).
Dr. Holes-Lewis - No relevant relationships to disclose.
Julie Linick (copy editor) - No relevant relationships to disclose.

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