Letter to the editor, "Superb microvascular ultrasound is a promising non-invasive diagnostic tool to assess a ventriculoperitoneal shunt system function: a feasibility study".

This letter discusses major aspects of the research "Superb Microvascular Ultrasound as a Promising Non-invasive Diagnostic Tool to Assess Ventriculoperitoneal Shunt System Function: A Feasibility Study." While the study shows great promise in adopting superb microvascular imaging (SMI) for non-invasive evaluation of ventriculoperitoneal shunt (VPS) systems, some limitations are noted. These include the small patient group, which focusses primarily on adult patients with programmable shunts, limiting the generalisability of the results. Furthermore, the paucity of long-term follow-up data raises questions about the accuracy of SMI in diagnosing shunt dysfunctions over time. Furthermore, the lack of comparative research with known diagnostic modalities such as CT and MRI, as well as the omission of operator-dependent variability in results, may impair the study's broader relevance. Future research should address these limitations by including varied patient populations, long-term investigations, and standardised techniques in order to improve the validity and clinical usefulness of SMI as a diagnostic tool for VPS systems.