{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T03:29:27Z","timestamp":1786418967442,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82171968"],"award-info":[{"award-number":["82171968"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The objective of this study is to investigate the value of conventional ultrasound, contrast\u2010enhanced ultrasound (CEUS) and percutaneous ultrasound\u2010guided biopsy in the diagnosis of pancreatic metastases from clear cell renal cell carcinoma (ccRCC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective database search was conducted to identify all pancreatic lesions performed CEUS and final diagnosed as metastasis from ccRCC at our institution from September 2017 to June 2024. All enrolled patients were considered unsuitable for endoscopic ultrasound (EUS)\u2010guided tissue acquisition, had failed EUS\u2010guided biopsy, or required an alternative diagnostic approach. A total of 23 patients were enrolled in this study. Demographics, clinical features, ultrasound and CEUS findings, biopsy procedures, and results were collected and reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the enrolled patients, metachronous metastasis was 100%. The median interval time from tumor\u2010nephrectomy to the emergence of the pancreatic metastasis was 121.0\u2009months (range: 46.0\u2013276.0\u2009months). Ultrasonography revealed rounded, well\u2010defined, homogeneous hypoechogenic lesions in all the patients. Color Doppler flow image findings displayed plenty of blood flow signals around and inside the pancreatic lesions in 87.0% of patients. 22 patients (95.7%) exhibited rapid hyper\u2010enhancement in the arterial phase of CEUS and 1 patient (4.3%) showed iso\u2010enhancement. In the venous phase, 15 cases showed sustained hyper\u2010enhancement and 8 cases showed iso\u2010enhancement. In the biopsy procedure, ultrasound\u2010guided core needle biopsy demonstrated higher diagnostic yield than fine needle aspiration (75.0% vs. 46.7%). The biopsy diagnosis was positive in 13 patients (65.0%) in general.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Metastatic tumors of the pancreas can occur after a prolonged period from ccRCC diagnoses, thus long\u2010term follow\u2010up is necessary. The features of the lesion by conventional ultrasound and CEUS were specific, which are valuable for diagnosis. In patients who are unsuitable for EUS\u2010guided tissue acquisition or have experienced unsuccessful EUS\u2010guided sampling, CEUS combined with percutaneous ultrasound\u2010guided biopsy may serve as a valuable complementary second\u2010line diagnostic approach and facilitate accurate diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72123","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T04:27:37Z","timestamp":1784089657000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pancreatic Metastasis of Clear Cell Renal Cell Carcinoma: Challenges in Percutaneous Biopsy and Contrast\u2010Enhanced Ultrasound Imaging Features"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4671-1417","authenticated-orcid":false,"given":"Yang","family":"Gui","sequence":"first","affiliation":[{"name":"Department of Ultrasound Peking Union 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