CT Guided Biopsies

A biopsy involves removing a small piece of tissue for examination by a physician. A needle biopsy, sometimes called a needle aspiration is the easiest way that tissue can be safely removed from the body. The procedure, which is most often performed by a radiologist or interventional radiologist involves a needle that is inserted through the skin. The needle biopsy may use a syringe or an automated needle to obtain the tissue sample.

CT can be used to direct biopsies in many parts of the body including lung nodules, masses in the neck or lesions in the abdomen including the liver and lymph nodes. A nodule is defined as a relatively round lesion that is less than three centimeters in diameter. A lung nodule is located within the lung itself, not in the airways. A patient with a lung nodule usually experiences no symptoms; the nodule is most often detected on a chest x-ray.

More than half of solitary or single nodules within the chest are benign, or non-cancerous, usually due to a previous infection. However, all solitary chest nodules are considered potentially malignant until proven otherwise, and for this a needle biopsy may be required.

What to expect with your procedure

In general, you should have nothing to eat or drink for eight hours prior to your biopsy. However, you may take your routine medications with sips of water. If you are diabetic and take insulin, you should talk to your doctor; who will probably have you adjust your usual insulin dose. Prior to a needle biopsy, you should report to your physician all medications that you are taking, including herbal supplements. It is especially important to let your physician know if you are taking medications that may cause you to bleed, such as aspirin or other blood thinners. You may need to stop using these medications for several days prior to your biopsy. You should have a friend, spouse and/or relative accompany you to the hospital and provide transportation home following the procedure.

The tissue specimen will be sent to a laboratory, where a pathologist will examine it. Results should be available within a few days. Your primary care physician should receive the biopsy results and discuss them with you. In a small number of cases, the tissue obtained may not be adequate for diagnosis. In that case, your doctor will discuss the next steps.

Preparing for your procedure

Local anesthesia or numbing medication will be given at the skin site to minimize pain. You may feel a stinging sensation as the local anesthetic is injected. The area will become numb within a short time. You may be given a mild sedative prior to the biopsy, and in addition, sedation or relaxation medication may be given intravenously during the procedure, if needed.

Your bandage may be removed one day following the procedure, and you may bathe or shower as normal. No stitches will need to be removed. You should not exert yourself physically (such as heavy lifting, extensive stair climbing, sports, etc.) or travel by airplane the night of and for one full day following your biopsy. On the second day, if you feel up to it, you may return to your normal activities. You may experience some soreness at the biopsy site as the local anesthesia fades, but this should improve. You may also cough up a little blood if you had a lung biopsy, but this should be minimal. These symptoms will gradually fade over the 12 to 48 hours following the procedure.

Signs of a collapsed lung, which sometimes occurs following a needle biopsy of the chest, include shortness of breath, difficulty in catching your breath, rapid pulse (heart rate), sharp chest or shoulder pain with breathing, and/or blueness of the skin. If you experience any of these symptoms, go to the nearest Emergency Room, and contact your physician as soon as possible.