Radiology - Image Guided Biopsy

This leaflet tells you about the procedure known as image guided biopsy. It explains what is involved and what the possible risks are. We hope you find this information helpful, but you should still discuss any concerns you may have with your doctor before you sign the consent form.

What is an image guided biopsy and why do I need one?

An image guided biopsy is a test during which a special needle is passed through the skin to take a tiny sample of bone or other tissue from an area inside the body. The doctor will use image guidance (CT, Ultrasound or fluoroscopy) to guide the needle to the abnormal tissue. The sample is then looked at under the microscope for a diagnosis. Other scans have shown an abnormal tissue inside your body; but it is not always possible to say exactly what the abnormality is. The biopsy will help assess the problem and guide treatment.

Who has made this decision?

The consultant in charge of your care feels that this is the best way of getting more information about your problem. We usually plan a biopsy in advance, so you have the opportunity to discuss your options with your consultant or their team. Your opinion will be taken into account. If you do not want this procedure, you can decide not to have it at any time, even after signing the consent form. We will notify your referring doctor of your decision so that they can discuss the options for further treatment with you.

What are the risks and complications?

An image guided biopsy is a safe procedure and serious complications are rare. Small risks vary depending on where we take the biopsy from. Despite these small risks your consultant has decided to refer you for this examination. This is because they feel that the benefits of having the biopsy outweigh the risks of having it done. Your consultant or one of their team will discuss your options with you in advance.

The risks include the following:

• Discomfort or mild pain in the area where the biopsy was taken is possible. This can usually be controlled with painkillers
• Bleeding is usually minimal and of short duration, but more serious bleeding can rarely occur. If the bleeding continues, then it is possible that you might need a blood transfusion. Very rarely, an operation or another procedure is required to stop the bleeding
• Infection of the skin or deeper tissue is rare
• Injury of surrounding structures

If the biopsy is from your spine there is a very small risk of damaging the adjacent nerve that comes from the spine close to the biopsy site. If you have any worries, please do not hesitate to discuss possible complications or risks with hospital staff before your biopsy. Unfortunately, some biopsies fail to give an answer. In this case, you may need the procedure to be repeated.

How do I prepare for the biopsy?

If you are not already an inpatient, you may be admitted to the hospital on the day of the procedure. You will have some blood tests performed beforehand to check that you do not have an increased risk of bleeding.

Can I eat and drink?

You must not eat anything for 6 hours before your biopsy. You can have a few sips of clear fluid (water, black tea or black coffee) up to 2 hours before the biopsy.

Can I still take my normal medications?

If you are taking warfarin, aspirin, clopidogrel or other blood thinning medications, please inform your hospital consultant at least one week before your procedure.

Your blood thinning medication will need stopping in advance.

If you are diabetic please contact the Diabetes Centre on 0161 206 2095 Monday to Friday between 8.30 am and 12 noon. Do this as soon as you receive this appointment to discuss your diabetes medicines with the Diabetes Specialist Nurses.

You can continue to take any other routine medicines.

Please bring a list of your medications with you to your appointment. Failure to follow this advice may result in your appointment being cancelled.

What actually happens during a biopsy?

You will be brought to the x-ray department to have your biopsy. The radiologist (the doctor who will do your biopsy) will speak to you beforehand and answer your questions. Please let them know if you are allergic to anything. The skin over the biopsy site will be cleaned with an antiseptic and covered with a sterile drape. The procedure will be performed under a local anaesthetic injection and in some cases sedative drugs through a drip.

The local anaesthetic will sting initially, before the skin goes numb. The sedation is designed to relax you and help manage any pain but is not an anaesthetic and you will be conscious throughout the procedure. The doctor will use imaging to guide the needle to the abnormal tissue or bone. You will need to stay still. You may feel some minor discomfort or pressure as the biopsy is taken. The procedure takes approximately 30 to 60 minutes from start to finish.

After the biopsy

You may be taken back to the ward where you need to rest in bed for a few hours. The nurses will check your blood pressure and pulse regularly to make sure that there are no problems. Some patients may experience pain following this procedure. Please let the nurses know if you have pain or if you need any painkillers. You can eat and drink normally unless instructed otherwise by the doctor.

Going home

If the procedure is being carried out as a day case and there are no complications, you will be allowed home a few hours after the biopsy. You must not drive or use public transport. You must have an adult to take you home (by car or taxi) and stay with you overnight. If you live a long distance from a hospital; or there is no one to take you home or stay with you overnight, you will have to stay in hospital.
 
If you feel unwell or continue to have severe pain, you should seek immediate medical advice (contact your GP or your consultant; or go to your nearest Accident and Emergency department).

When will I get the results?

It takes about two weeks for the results to come back. These will be sent to the consultant who asked for you to have the biopsy and they will contact you.

Could you be pregnant?

If there is any chance you could be pregnant, please call 0161 206 5091 if your appointment is at Salford Royal Hospital. Please call 0161 656 1178 if your appointment is at Royal Oldham Hospital.

Is x-ray guidance dangerous?

All x-ray machines use potentially harmful x-rays. Modern equipment is designed to keep the dose you receive as low as possible. If your doctor has asked for this test, they will have decided that the benefits from the procedure outweigh the risks from the very small dose of radiation that you receive.

What if I cannot attend my appointment?

If you have any queries about your appointment or cannot attend, then please telephone the booking office on:
0161 204 2044 or 2404 (Salford Royal Hospital)
0161 624 0420 (Royal Oldham Hospital)
Monday to Friday 8.30am to 4.00pm.
 
You can also email:

salford.radiology.booking@nca.nhs.uk (Salford Royal Hospital)
bookingandscheduling.outpatients@nca.nhs.uk (Royal Oldham Hospital)

Please include name, date of birth, address and hospital number (if known) in any correspondence.

I need an ambulance. How do I arrange one?

If you need an ambulance there are contact details on your appointment letter.

Please contact us if you are arriving by ambulance so we can time your appointment with your ambulance arrival. If we are not aware that you are coming by ambulance you may miss your appointment and it may have to be rebooked.

If you need an interpreter

If you need an interpreter for your examination, please call the department so that we can try and arrange this.

Contact Details

We hope your questions have been answered by this leaflet.

If you require help or any other information regarding your appointment you can contact:
The Angiography Department, Salford Royal Hospital Tel: 0161 206 2206/5091
Interventional Radiology, Royal Oldham Hospital. Tel: 0161 656 1178