Patients Undergoing Stereotactic Brain Biopsy at a Reference Neurosurgery Hospital: A Retrospective Cohort Study

Central nervous system tumors are not among the most common neoplasms. However, when present, they are associated with significant mortality and morbidity, which underscores the need for accurate diagnosis to determine the most appropriate oncological treatment. The present study aimed to analyze the clinical profile, the performance of the surgical technique, and the concordance rate between histopathological and neuroimaging diagnoses in patients undergoing stereotactic biopsy between 2010 and 2023 at a tertiary hospital in the city of Porto Alegre, Brazil. We conducted a retrospective cohort study using secondary data and a quantitative approach, analyzing 109 procedures. The study revealed a predominance of male patients (57.8%) and a mean age of 55.49 ± 15.74 years. The most frequent histopathological diagnosis was high-grade glioma (42.2%), and the region most commonly affected was the corpus callosum (23.9%). No clinical correlation was found between hematoma diameter and neurological alteration. The prevalence- bias-adjusted Kappa (PABAK) index indicated moderate agreement for gliomas and a high level of agreement with the Magnetic Resonance Imaging (MRI) scans for metastases (0.87). The procedures performed at the institution demonstrated a high diagnostic success rate, with the analyzed sample being similar to what was expected, despite minor differences from the literature. The replacement of invasive techniques with non-invasive methods is not yet a reality due to the necessity of tissue analysis to define oncological strategies and guide chemotherapy and/or radiotherapy. It is important to point out that the routine use of advanced technologies, such as spectroscopy, in the differential diagnosis of brain tumors, remains crucial.