Saline versus contrast-enhanced ultrasound for confirmation of intranodal needle position: reply to Fung et al.

This document is a reply to an article on the feasibility of using contrast-enhanced ultrasound (CEUS) to confirm intranodal needle position for dynamic contrast-enhanced magnetic resonance lymphangiography (DCMRL) in children. The authors discuss the importance of stable nodal needle position for successful DCMRL examinations and the need for confirmation of adequate needle position prior to the actual MR examination. They mention previous techniques for needle position validation, such as injection of water-soluble radiographic contrast-agent under fluoroscopy, and the use of CEUS in adults. The authors argue that while CEUS may be helpful in some cases, needle position verification by saline solution alone yields a high success rate without the need for additional off-label ultrasound contrast-agent administration in children. They emphasize the need for further studies with larger patient cohorts to reach more meaningful conclusions. [Extracted from the article]