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Patient motion is inevitable in SPECT and PET due to the lengthy period of time patients are imaged and patient motion can degrade diagnostic accuracy. The goal of our studies is to perfect a methodology for tracking and correcting patient motion when it occurs. In this paper we report on enhancements to the calibration, camera stability, accuracy of motion tracking, and temporal synchronization of the visual tracking system (VTS) we are developing. The purpose of the VTS is to track the motion of retro-reflective markers on stretchy bands wrapped about the chest and abdomen of patients. We have improved the accuracy of 3D spatial calibration by using a MATLAB optical camera calibration package with a planar calibration pattern. This allowed us to determine the intrinsic and extrinsic parameters for stereo imaging with our CCD cameras. Locations in the VTS coordinate system are transformed to the SPECT coordinate system by a VTS/SPECT mapping using a phantom of 7 retro-reflective spheres each filled with a drop of Tc99m. We switched from pan, tilt and zoom (PTZ) network cameras to fixed network cameras to reduce the amount of camera drift. The improved stability was verified by tracking the positions of fixed retro-reflective markers on a wall. The ability of our VTS to track movement with sub-millimeter accuracy was established with the 7-sphere phantom for 1 cm vertical and axial steps as well as for an arbitrary rotation and translation. The difference in the time of optical image acquisition as decoded from the image headers relative to synchronization signals sent to the SPECT system was used to establish temporal synchrony between optical and list-mode SPECT acquisition. Two experiments showed better than 100 ms agreement between VTS and SPECT observed motion for three axial translations. We were able to track 3 reflective markers on an anthropomorphic phantom with a precision that allowed us to correct motion such that no loss in visual quality was- noted in motion corrected slices relative to motion free slices.