Table 4. Summary of the key points regarding the challenges and limitations of MRI in the assessment of supratentorial neoplasms.

MRI: magnetic resonance imaging

Challenge/limitation	Details
Need for sedation in pediatric patients	Young children often require sedation to remain still during MRI scans, which poses risks such as respiratory complications and prolonged recovery times. Sedation may also affect the imaging quality due to potential motion artifacts.
Developmental differences in pediatric brain	The pediatric brain undergoes significant developmental changes, affecting the appearance of normal anatomical structures on MRI. This complicates the interpretation of MRI findings, as radiologists must differentiate between normal variations and pathological changes.
Differentiation of tumor types	MRI findings can overlap among different tumor types, making it difficult to distinguish between them based solely on imaging characteristics. For example, gliomas and metastatic lesions may appear similar, necessitating the integration of clinical information and advanced imaging techniques.
Interpreting MRI in the context of treatment effects	Differentiating between tumor recurrence and treatment-related changes (e.g., radiation necrosis and pseudoprogression) is challenging. Advanced MRI techniques help, but sometimes, histopathological confirmation is required for accurate diagnosis.
Technical limitations	MRI machines have limitations in terms of resolution and signal-to-noise ratio, which can affect the quality of the images. In some cases, artifacts or technical limitations may obscure critical details, impacting diagnostic accuracy.
Age-specific imaging protocols	The need for age-specific imaging protocols can lead to inconsistencies in imaging quality and interpretation. Pediatric-specific protocols may be limited, leading to challenges in obtaining optimal images without compromising patient safety.
Availability and accessibility	Advanced MRI techniques and pediatric-specific protocols may not be readily available in all healthcare settings, leading to disparities in diagnostic and treatment planning capabilities, especially in underserved regions.
Cost- and resource-intensive	MRI, particularly advanced techniques, can be expensive and resource-intensive, limiting their accessibility and use in routine clinical practice. This is especially challenging in resource-limited settings where cost-effective alternatives may be necessary.