A needle biopsy is a medical procedure that uses CT (computerized tomography) or ultrasound guidance in order to obtain biological samples such as cells, tissue or fluid from all areas of the body, such as bones, muscles, and organs, such as the liver or lungs.
Needle biopsies help doctors to determine what is causing such symptoms as infections, inflammation, lumps or masses.
Areas of the body that may be biopsied include:
The two most common forms of biopsy are:
- fine needle aspiration (FNA), which uses a very small needle to extract fluid or cells from the abnormal area.
- core needle (CN) which uses a hollow needle to remove one sample of tissue per insertion.
How do I prepare for a biopsy?
Needle biopsy procedures need little to no preparation. In some cases, sedatives may be administered, such as intravenous (IV) or conscious sedation.
You may be asked not to eat or drink before the procedure, depending on where the biopsy is being performed. Please advise your referring physician if you are taking any medications that are used for blood thinning (such as Cournadin, Warfarin, or even aspirin) as you may have to abstain from use before the procedure.
This procedure is usually completed within one hour.
What should I expect before the procedure begins?
You will be asked to change into a gown before the procedure, and will then lie on a table in a position that makes it easy and accessible for the physician to access the area for needle insertion.
When you are ready for the procedure to begin, the health care team will clean the area where the needle is to be inserted, and apply a local anesthetic to numb the skin. Intravenous sedatives may be introduced via the arm to help you relax during the procedure.
The site being biopsied may require more than one tissue collection. Your radiologist will walk you though the procedure before anything happens, and answer any questions you have before beginning.
How does the procedure work?
Using imaging guidance, the interventional radiologist inserts the needle through the skin, and advances it into the lesion.
Tissue samples will be removed using either fine needle aspiration or a core needle biopsy.
What should I expect during the procedure?
When you receive the local anesthetic to numb the skin, you will feel a slight pin prick from the needle. You may feel some pressure when the biopsy needle is inserted. The area will become numb within a short time.
You will be asked to remain still and not to cough during the procedure. You also will be asked to hold your breath multiple times during the biopsy. It is important that you try to maintain the same breath-hold each time to insure proper needle placement.
What happens after the procedure is done?
Once the biopsy is complete, pressure will be applied to stop any bleeding and the opening in the skin is covered with a dressing. No sutures are needed.
You will be taken to an observation area for at least one hour. It is recommended that you relax for the rest of the day of the procedure, and keep the bandage in place until otherwise instructed. Residual pain or discomfort from the procedure may only last a day or two.
What is done with the tissue that is collected?
When the radiologist has collected a sufficient number of cells and/or tissues for analysis, the needle biopsy procedure is concluded, and the sample is sent to a laboratory for analysis. Depending on the technical scope of the tests, results may be back within a few days.
Once sent to a laboratory, a pathologist (a specialist that studies cells and tissue samples for signs of disease) will examine the sample and make a diagnosis based on the findings. The diagnosis will be written into a pathology report and sent to the patient’s physician, who will contact with the results, and discuss what additional options, if any, are needed. While patients can request a copy of the pathology report, the reports are often filled with technical terms that would need the expertise of a physician to decipher.
Pathology reports often contain the following:
- Description of the biopsy sample – General description covering color and consistency of collected fluids and tissues.
- Description of the cells – Description of how the cells look under a microscope, types and number of cells that were seen during the testing procedure.
- Pathologist diagnosis – Lists the pathologists diagnosis and case related commentary, as well as other recommended tests for the patient.