Image Guided Biopsy (Ultrasound or CT)

General Information | Scheduling, Insurance and Preparation | What to Expect


General information General Information

About Image Guided Biopsies

Needle localization using imaging guidance may be done before a surgical biopsy to help the surgeon more accurately identify the abnormal tissue.

An image guided biopsy is generally performed when an abnormal mass or lump has been found in an organ (thyroid, liver, kidney, lung, etc.) or body part (bone, abdomen, pelvis, lymph nodes, etc.). A biopsy is the most definitive way to determine if the abnormal tissue is cancerous. Imaging studies alone usually cannot provide a certain diagnosis on which to decide treatment options.

During a biopsy, a small amount of tissue is removed from the abnormal area with a needle so a pathologist can examine the material for cancerous (malignant) cells. Radiologists use image guidance (ultrasound or CT) in performing biopsies to obtain tissue from the right spot and to avoid injuring important nearby body parts.

There are several image guided biopsy procedures available. Most of them can be performed on an outpatient basis using local anesthetic. Conscious sedation can also be used when necessary. These biopsies allow a radiologist to access hard to reach areas of the body without surgery, but with the same or even better accuracy than a surgical biopsy. Radiology Imaging Associates' radiologists have great success in precisely sampling any mass in the body that can be seen with imaging technology. The specific type of biopsy chosen by your doctor will depend on the location of the lump and other circumstances.

Image Guided vs. Surgical Biopsies

Reasons for choosing an image guided biopsy rather than a surgical biopsy include:

  • Smaller incision
  • No stitches
  • No scar
  • Shorter procedure
  • Minimal bruising
  • No or minimal cosmetic disfigurement
  • Less expensive
  • Faster results

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Types of Image Guided Biopsies

Following is information on two types of image guided biopsies performed by Radiology Imaging Associates' radiologists.

Biopsy Type Description
Fine Needle Aspiration Biopsy
  • Ultrasound guided for accurate placement of the needle.
  • Uses a tiny needle, smaller than the needle used to draw blood.
  • Commonly used on the thyroid gland, salivary glands, breasts, and lymph nodes.
Needle Core Biopsy
  • Ultrasound or CT guided for accurate placement of the needle.
  • Uses a larger needle than a fine needle aspiration biopsy.
  • Used to remove tissue from many organs and body structures.

Risks Involved in an Image Guided Biopsy

The risks involved in an image guided biopsy include the following:

  • Bleeding and infection at the puncture site
  • Rarely, the pathologist may request that an area be re-biopsied with a needle technique or through surgical excision
  • A hematoma or collection of blood may form at the biopsy site
  • Infection or abscess

Chest Biopsy

Sometimes a lung will collapse following a needle biopsy of the chest. You should immediately go to the nearest emergency room if you experience any of the following signs of a collapsed lung:

  • Shortness of breath
  • Difficulty catching your breath
  • Rapid heart rate
  • Sharp chest or shoulder pain when breathing
  • Blueness of the skin

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Scheduling, Insurance and Preparation Scheduling, Insurance and Preparation

Procedure Locations

The procedure is performed at the following Radiology Imaging Associates partner hospitals in the Denver, Colorado area:

Call the hospital to schedule.

Scheduling

To schedule an image guided biopsy, please call the hospital where the procedure will be performed.

  • Medical Center of Aurora
  • Littleton Adventist Hospital.
  • Porter Adventist Hospital
  • Sky Ridge Hospital
  • Swedish Medical Center

Insurance Coverage

Image guided biopsies are usually covered by insurance when ordered by a physician. Check with your insurance company to be sure. Please bring your insurance card with you to your procedure.

Conditions to Let Us Know About

In advance of your procedure, let your scheduler, technologist, or radiologist know if any of the following circumstances apply to you:

  • Currently taking blood thinning medication
  • Currently pregnant
  • Allergic to any medications or anesthetics
  • Heart valve replacement
  • Mitral valve prolapse
  • Joint replacement
  • Taking medications regularly
  • Taking aspirin or medications that contain aspirin
  • Been told that you have a bleeding problem

Preparation Guidelines

Following are the general preparation guidelines for image guided biopsies. You may receive additional or differing guidelines based on your specific situation. Please contact us at 720-493-3700 if you have any questions.

  • Wear comfortable clothes with a separate top and bottom.
  • Do not wear talcum powder, deodorant, lotion, or perfume at the location of the biopsy.
  • Remove all jewelry.
  • Do not take blood thinning medications, including aspirin, for 4 days prior to the procedure. (Check with your doctor to ensure it’s safe.)
  • Bring any images and reports you have that were not done by Invision Sally Jobe.

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What to Expect What to Expect

Before the Procedure

Before your image guided biopsy, you may need to have additional pre-procedure exams, such as blood tests, ultrasound, CT scan, or MRI.

During the Procedure

Image guided biopsies vary depending on the type. However, here is generally what will happen:

  1. You will fill out paperwork and consent forms so the radiologist will know your medical history.
  2. A nurse or technologist will answer any questions you have.
  3. You may need to change into a gown depending on the area to be biopsied.
  4. You will meet the radiologist that will perform your procedure and he or she will further explain the procedure.
  5. The technologist will position you on a padded biopsy table.
  6. The radiologist will use ultrasound to locate the abnormal tissue.
  7. The area will be cleansed and anesthetized.

See the specific biopsy types below for additional exam details.

Fine Needle Aspiration (FNA) Biopsy

Steps for this biopsy type also include:

  1. While watching the ultrasound monitor, the radiologist will carefully insert very small biopsy needles into the abnormal tissue.
  2. The needle will be moved backward and forward several times to obtain a good sample of tissue. Usually, several samples are taken.
  3. The incision will be cleaned and closed with tape and a pressure dressing applied.
  4. You will change back into your usual clothes if necessary.

This procedure takes about 30 minutes.

Needle Core Biopsy

Steps for this biopsy type also include:

  1. The radiologist will make a small incision, about 1/8 of an inch long, in the skin above the area to be biopsied.
  2. While watching the ultrasound monitor, the radiologist will carefully insert the spring loaded biopsy needle into the area of the abnormal tissue. You should not feel any pain; just pressure.
  3. The needle will be activated, making a clicking noise, and a small sample of tissue will be removed. This will be repeated 3-7 times through the same incision but at different angles. No further anesthetization will be necessary.
  4. The incision will be cleaned and closed with tape and a pressure dressing applied.
  5. You will change back into your usual clothes if necessary.

This procedure takes about 30 minutes.

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After the Procedure

Recovery

You may experience soreness at the site of the biopsy, but it should quickly improve. Follow these instructions to help with your recovery:

  • Leave the bandage over the biopsy site in place and keep it dry for 24 hours. After that you can bathe or shower as usual.
  • No heavy lifting or strenuous activities for 24 hours.
  • A a lung biopsy, you may cough up a little blood or experience temporary shortness of breath.
  • Use ice packs or over the counter pain relievers to minimize discomfort.

Exam Results

Your tissue sample will be sent to a laboratory so a pathologist can examine it. The results are usually available the next business day and will be reported to your physician. You can get your results from your physician or from the Invision Sally Jobe facility where the biopsy was performed.

During the biopsy, our radiologists and technologists will be happy to answer questions about the procedure itself; however, they will not be able to give you the results until the pathologist provides them.

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