Objective: We aimed to evaluate the concordance between the image-based and the tissue-based diagnosis using frame-based stereotactic biopsy. Materials and methods: Medical records of biopsy procedures from 2000 to 2017 were reviewed. The radiologists' preoperative reports, biopsy procedures and postoperative histopathological diagnoses were retrieved. We compared the preoperative image-based diagnosis with the final histopathological diagnosis. Results: We identified 125 biopsy procedures performed in 123 patients. The concordance between image-based and histopathological diagnoses varied between 53.3 and 87.5. The concordance of diagnosis concerning both tumor entity (i.e. cell type) and WHO grade was 54.6. The diagnostic yield was 95.2. There was overall morbidity of 10.4, and a mortality rate of 0.8. Minor complications occurred in 4.0 of the cases, while clinically significant complications occurred in 6.4 of the cases. Conclusions: There was suboptimal concordance between radiological and histopathological diagnosis. Also, there was a tendency of histopathological undergrading. We confirm that frame-based stereotactic biopsies have a high diagnostic yield and a low rate of clinically significant complications and mortality.
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