A needle biopsy involves placing a needle into a tumor, organ or other tissue to obtain a sample of cells or a piece of tissue to be evaluated by a pathologist. In an imaging-guided biopsy, a radiologist uses some form of medical imaging, usually ultrasound or CT scanning, to help guide a needle to a particular target site. Use of imaging guidance allows the most accurate needle placement, maximizing the chance that the biopsy will be successful and minimizing the risk of complications. Not long ago, many biopsies were performed surgically, requiring hospitalization, general anesthesia, and an incision, along with the associated risks. Today we can perform needle biopsies of most sites safely and easily, usually on an outpatient basis, with a high rate of success and a very low complication rate. Several members of Clinical Radiologists perform biopsies; they are experienced and highly skilled at these procedures. We perform biopsies of virtually any organ or body part. Last year Clinical Radiologists performed more than 1000 imaging-guided biopsies.

What preparation is needed prior to a biopsy?

The morning of the biopsy you will report to the hospital registration desk. You will usually be asked to report two hours prior to the scheduled procedure. Have someone with you who will be able to drive you home. Bring any relevant x-rays, CT scans or ultrasounds with you when you come for the procedure.

If your procedure is in the morning, you should not eat or drink after midnight the night before the biopsy. If your biopsy is in the afternoon, you may have a small liquid breakfast (juice, coffee, etc.). Take your usual medicines with a small amount of water unless otherwise directed. If you are diabetic and take insulin, check with the Radiology Department or your personal physician for additional instructions about diet and medications. If you are on blood thinners such as Coumadin, Plavix, or Lovenox, check with your personal physician for instructions.

What happens the day of the procedure?

For some biopsies, you will go directly to the Radiology Department, have the procedure and be discharged from the Radiology Department. For most biopsies, you will be admitted to a same day care nursing unit. The nurses will take your history, start an IV line and arrange to have blood drawn if needed. After the procedure, you will return to the same unit where the nurses will observe you and monitor your vital signs.

What happens during the procedure?

The radiologist will discuss the procedure, its purposes and risks prior to beginning the biopsy. If you have any questions about the biopsy, be sure to ask. Let the technologist or radiologist know if you have family members you want to be present while the radiologist explains the procedure and answers questions. Family members will not be able to watch the procedure being performed.

The radiologist may use ultrasound, CT or both to look at the spot to be biopsied and make sure the biopsy can be performed safely. The radiologist will clean your skin and numb the skin and area to be biopsied. In some cases a sedative and/or pain medicine will be given through the IV line. The radiologist will then use either ultrasound or CT scanning to help direct the needle to the appropriate spot and obtain a sample. Often a pathologist will be present to briefly review the specimen to help decide whether the sample is adequate. Once an adequate sample has been obtained, the procedure is over.

You may be observed for three to four hours after the procedure. Discharge times may vary based on individual recovery.

What about after the procedure?

For most biopsies you should not do any heavy lifting, exertion or driving the day of the biopsy. The area of the biopsy may be sore for one or two days after the procedure. Call the Radiology Department and ask to speak to a nurse or radiologist if you have any questions about the biopsy. Notify us if the following occur:

• Redness, swelling or bleeding at the site where the needle was placed
• Excessive pain
• New onset of chest pain or shortness of breath
• New onset of coughing up blood
• New onset of blood in the urine or stool

You may be given additional discharge instructions by the radiologist or nurse.

What about the results?

A pathologist will interpret the specimen obtained from the biopsy and will send a report to your physician. Call your doctor’s office in two to three days for biopsy results unless other arrangements have already been made.

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