Image-guided Biopsy

What is an Image-guided Biopsy?

A biopsy is the removal of very small pieces of tissue from a body organ or mass, so that a pathologist may examine it under the microscope to identify various types of disease. The information gained is then used to name the disease (diagnosis) and determine appropriate treatment.

How should I prepare?

You may be instructed not to eat or drink for several hours before the procedure. You will be instructed not to take blood thinners or aspirin for a specific number of days before a biopsy. However you may take your usual medications with sips of water. If you are diabetic and take insulin, discuss with your doctor whether to adjust your insulin dose.

Inform your doctor of all medications you are taking, and any allergies to medications or to latex. Women should always inform their physician if there is a possibility they may be pregnant.

You may want to have a responsible friend or relative to accompany you and drive you home afterward. This will be required if sedation is to be given.

How is the procedure performed?

Image-guided biopsy is done using ultrasound or CT to guide the placement of the local anesthesia and the biopsy needle. The patient is usually lying flat. A safe path is found, the skin is cleansed with antiseptic, and local anesthetic is infiltrated along the path of the biopsy needle. A single needle is placed into the liver, and then samples are removed through that needle to get tissue for the pathologist to analyze. The needle is then removed. The patient is monitored while lying flat after the procedure for 1one to three hours depending on what part of the body was biopsied.

What will I experience during and after the procedure and how will I get my results?

You will be asked to remove your clothing and wear a gown. You will be positioned on a stretcher, or on a CT table, and a scan is done. The skin is cleansed and a local anesthetic given, which may sting briefly. Placement of the biopsy needle should then be painless. You will have to be motionless for up to 30 minutes, breathing normally. You will be asked to avoid coughing. After the needle is removed and a sterile dressing applied, you will be monitored by our nursing staff. If the path of the biopsy is close to your ribs, you may feel an aching pain in your right shoulder. Inform the nurse if you develop any pain in your abdomen after the biopsy.

Avoid strenuous exertion or distant travel for 24 hours. Signs of internal bleeding from a biopsy include new abdominal pain after the biopsy, feeling faint, or rapid pulse rate. If you develop these symptoms, go to the nearest emergency room and inform the emergency physician of your recent procedure.

The pathology results will be available in about three to four business days after the procedure. They will be available to your physician. Please contact your referring physician if you have not received these results after one week.

What are the benefits and risks?

Needle biopsy is a reliable and accurate way to determine the nature of many diseases, or whether a particular mass is benign or malignant, and to decide what course of treatment is necessary. Needle biopsy is safer and easier to tolerate than surgical biopsy, and the recovery time is brief.

There are some risks: Less than 1 percent (one out of a hundred) of patients who undergo a soft tissue biopsy will have significant internal bleeding that requires a transfusion. Rarely another treatment or procedure is required if bleeding continues.

In a very small percentage of biopsies, the tissue obtained may not be sufficient to give a diagnosis. In that case a biopsy may be repeated.