Sometimes, the only way to be sure we correctly diagnose an abnormality is to take a small sample of the suspicious tissue and have a pathologist look at it under a microscope. This is called a biopsy. Biopsies can help determine if something we see on a CT scan or other imaging test is cancerous or benign. A special kind of biopsy is a bone marrow biopsy, where a sample of bone and marrow is taken for evaluation by the pathologist. Image-guided biopsies are common in diagnosing cancer.
We use several techniques to obtain a biopsy, but they all involve using imaging, such as a CT scan or ultrasound, to guide a needle to the suspicious area and to collect a tissue sample. The two most common biopsy techniques are fine needle aspiration, which uses a tiny, hollow needle to remove fluid or cells, and core needle biopsy, which uses a larger needle to remove a sample of tissue—sometimes more than once. An image-guided biopsy is less invasive than surgically removing a tissue sample.
What to expect during a biopsy…
You will have already discussed the treatment options with the physician doing the procedure. Prior to your procedure, we’ll take you to a preparation area where our nurses will start an IV in your arm and give you any medication that may be required prior to your procedure.
When it’s time to begin, we’ll take you either to the CT scanner area or to a special room that is similar to an operating room. We often use conscious sedation, or moderate anesthesia, during biopsy procedures, so you’ll remain slightly awake throughout the procedure.
During the procedure, you’ll lie on your back, stomach, or turned slightly to one side on a table (or the CT table). Your interventionalist will inject a local anesthetic into your skin so you don’t feel pain. We’ll use either a handheld ultrasound transducer, or images taken by the CT machine, to locate the lesion. Then we’ll insert the needle into the mass/lesion and withdraw it with the tissue sample.
After the procedure, we’ll apply pressure to stop bleeding and put a bandage over the spot where we inserted the needle. Image-guided biopsies can be performed within nearly all organs, such as kidneys, liver, lungs or other abdominal organs, except for the brain (neurosurgeons perform brain biopsies).
After your procedure, your interventionalist will review the results of your biopsy with your physician so he or she can discuss the next steps with you. After the pathologist examines the sample, we may ask you to come back for further evaluation.