Radiology
What is a biopsy?
A biopsy is a sample of tissue, taken out of the body, to examine it further in the laboratory. Most Computerised Tomography (CT) guided biopsies are performed for abnormalities in the lung, which have been seen on chest x-rays and CT scans.
How is it organised?
We carry out most of these biopsies via the radiology day unit, as day case procedures.
Occasionally we organise for a ward bed, particularly if the appointment is later in the day, or if the patient has no one at home with them (we require another adult to stay with the patient for the first night).
Prior to coming in for the procedure, blood tests will be carried out and checked to confirm your blood clotting is satisfactory. You will be contacted by one of the nurses to check up on your general health and fitness. This will be a few days prior to your admission.
Before this conversation, please make sure you have a list of your drugs and medications available. Please tell the nurse if you are taking anticoagulants, as some have to be stopped for a few days before the procedure.
Please bring an overnight bag with you when you come for the biopsy, as there is a small chance you may have to stay in the hospital after the biopsy.
After arriving in the radiology day unit you will be admitted by the nurses and your personal details confirmed. The radiologist (doctor) performing the procedure will also talk to you to discuss your risks and benefits of the procedure.
How is it done?
CT scanner is used to guide the procedure. Before we start, we will have reviewed your images and decided if it is easier to have you lying on your back or your front. You will have to lie still for about 20 minutes, please try to breath gently and not to cough.
We will start by doing a limited scan to allow us to perform some measurements. The radiologist (doctor) will then join you in the scan room and draw the measurements on your skin. We then clean the skin and cover you with sterile drapes (covers).
Local anaesthetic (numbing solution) is injected through a very fine needle to numb the skin and chest wall. This will take two to three minutes to take effect. Once the area is fully numb, we will take the biopsy samples using a needle which makes a loud clicking noise.
The images from the CT scanner are used to guide the needle insertion and position. We will often take four to six samples. Once we have finished, we will again check your ID to confirm the samples taken are labelled correctly.
After the biopsy?
Following the procedure, you will then go back to the radiology day unit, or the ward, for a period of observation. If all is well, after a few hours, you will be allowed to go home. You will need an adult to accompany you home and to stay with you overnight. You can travel home by private car or taxi, but you should not drive yourself or use public transport. You can usually return to work and driving the day after the biopsy.
What are the benefits?
CT guided biopsy is a very good, but not perfect, test. It tells us what the abnormality is in about 90% of patients. Unfortunately, in about 5 to 10% of the patients the results are inconclusive. This will be discussed with you by the medical team who referred you for the biopsy.
What are the risks?
There is a risk of bruising and bleeding for all procedures involving needles. Serious or life threatening bleeding is very rare. There can be some discomfort after the procedure, but this can usually be successfully managed with simple pain relief medication such as paracetamol.
If we are performing a biopsy of the lung there are two specific risks.
- Coughing up blood
This happens quite commonly and can be frightening if you are not expecting it. It will settle without any specific treatment within 30 to 40 minutes. - Collapsed lung (pneumothorax)
When we put the needle between the ribs and into the lung, a little air can escape from the lung and collect in the space between the lung and the ribs (pleural space). This is called a collapsed lung or pneumothorax.
We see a tiny amount of escaped air fairly commonly, but in about 2.5% of patients (1 in 40) enough air escapes that we need to treat it. We treat this either by withdrawing the air with a needle or by placing a chest drain (small tube in the pleural space) to allow this air to come out. You may need to stay in hospital for a few days if this happens. This will be discussed with you at the time if this is required.
Results
The results are usually available in seven to ten days. You will be informed of the results by the doctor or team that sent you for the biopsy.
For chest or lung patients you will be contacted by the chest clinic (Marton day unit), the specialist nurses, or the secretaries in seven to ten days and invited to attend to discuss the results with the chest physician.
Contact us
If you have any concerns or questions, please contact the radiology day unit:-
Telephone: 01642 854332
Monday to Friday, 08:00 until 17:00 hours
Email: [email protected]
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
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