Background Information:

What are the other Names for the Procedure?

• Lung Mass Needle Biopsy
• Needle Biopsy of Chest Mass
• Needle Lung Biopsy

What is Needle Biopsy of Lung Mass radiology procedure? (General Explanation)

• A lung or chest mass is abnormal tissue or lesion within the lung. The mass can be detected through an X-ray examination
• The Needle Biopsy of Lung Mass procedure is used to determine, if the mass is cancerous or not
• A CT scan or fluoroscopy can also be used during the biopsy, to guide the needle to the abnormal tissues

What part of the Body does the Procedure involve?

A Lung Mass Needle Biopsy procedure involves the lungs of the chest.

Why is the Procedure Performed?

• The Needle Biopsy of Lung Mass procedure is done to classify lung masses, as either cancerous or benign
• A lung mass usually does not cause any symptoms or pain
• Typically, half of such lung masses are benign, but can be potentially malignant (cancerous)

What is the Equipment used? (Description of Equipment)

The following equipment may be used for Lung Mass Needle Biopsy

Ultrasound scan:

• The equipment consists of a transducer, computer monitor and other electronics
• A transducer is used to send high frequency sound waves in the body and the computer creates the image based on the echoes of that sound returning from the patient’s body.
• A computer monitor
• A central processing unit
• A printer

CT scan:

• The CT scanner looks like a big box with a hole inside.
• The examination table on which the patient is lying down slides the CT scanner.
• X-ray tube and electronic X-ray detectors rotates around the patient.

MRI scan:

• An MRI is a large cylinder-shaped tube that is surrounded by a circular magnet
• The patient lies on the table, which slides back and forth into the cylindrical tube
• In some MRI equipment, called short-bore systems, the magnet does not completely surround the patient. This is particularly helpful for patients who are obese, or for those who are afraid of being inside a closed tube

There are several types of needles that may be used. The common ones include:

• A fine needle attached to a syringe that is smaller than needles, normally used to draw blood
• A core needle, or an automatic spring-loaded needle, which consists of an inner needle connected to a channel, or shallow receptacle, with a covering and attached to a spring-loaded mechanism
• A vacuum-assisted device (VAD), which uses a vacuum to aid in obtaining larger sections of tissue

Needle biopsies are often performed with the guidance of a imaging tool, such as a computed tomography (CT), fluoroscopy, ultrasound, or MRI. Different instruments, such as ultrasound, CT, fluoroscopy, or MRI scanners may be used to guide the needle during a needle biopsy.

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the Lung Mass Needle Biopsy procedure. 

What is the Cost of performing the Needle Biopsy of Lung Mass radiology procedure?

The cost of the Lung Mass Needle Biopsy procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary. 

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding the Needle Biopsy of Lung Mass procedure and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.radiologyinfo.org/en/info.cfm?pg=nlungbiop (accessed on 08/03/2014)

Prior to Needle Biopsy of Lung Mass radiology procedure:

How does the Needle Biopsy of Lung Mass radiology procedure work?

The Needle Biopsy of Lung Mass works in the following manner: Using one of the imaging techniques, the physician inserts one of the following needles through the skin and guides it to the suspicious abnormal part of the organ, to remove the sample.

• Core needle biopsy:
  • In this procedure, a needle moves forward; as it moves forward, it gets filled with the tissue sample
• Fine needle aspiration:
  • A needle with syringe, pulls the tissue samples or fluids necessary for further examination

How is the Needle Biopsy of Lung Mass radiology procedure Performed?

The Needle Biopsy of Lung Mass procedure is performed in the following manner:

• An intravenous (IV) line is inserted into the patient’s arm
• General anesthesia is injected to numb the area
• A CT or MRI scan is used to find the location of the mass
• The needle insertion site is shaved and sterilized, before the needle is inserted through the skin
• It is then guided to the mass using CT or MRI scan
• A tissue sample is removed and the opening of the skin is covered
• The patient may return to home right after the procedure, in the case of most biopsies

Where is the Procedure Performed?

A Lung Mass Needle Biopsy procedure is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

The Lung Mass Needle Biopsy procedure is usually done by a radiology technologist.

How long will the Procedure take?

The Needle Biopsy of Lung Mass procedure takes about an hour to perform.

Who interprets the Result?

• The tissue removed from the Lung Mass Needle Biopsy procedure is sent to the pathologist
• The pathologist examines the tissue under a microscope and gives the result, to the interventional radiologist

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a Needle Biopsy of Lung Mass procedure:

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
• Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
• The patient may continue their medications, but if they are taking beta-blocker medications, they should ask the physician about temporarily discontinuing the same
• Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
• The individual should not take caffeine and avoid smoking for 48 hours before the procedure
• It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the procedure
• It is highly recommended to inform your healthcare professional, if you are pregnant or breastfeeding
• The patient must avoid eating or drinking at least 8 hours prior to the procedure, depending on when the procedure is arranged
• The patient may be asked to stop taking certain medications, such as aspirin or other blood thinner medicines, before biopsies.
• The patient may be required to be driven home, after the procedure; especially, if they were sedated during the procedure

What is the Consent Process before the Procedure?

A physician will request your consent for a Needle Biopsy of Lung Mass procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the Needle Biopsy of Lung Mass procedure:

• A biopsy is not painful after anesthesia is administered
• The recovery time is relatively fast
• A needle biopsy is less invasive than a surgical biopsy
• A biopsy is a very helpful tool in determining, whether or not the tissue is cancerous

Following are the risks of the Needle Biopsy of Lung Mass procedure:

• There is a high chance that the patient will cough blood, during or after the procedure
• The lungs may collapse during the procedure; but, this can be cured, by placing a tube in the chest cavity to drain away the air
• Any procedure, where the skin is penetrated carries a risk of infection. Although, the probability of an infection requiring antibiotic treatment, is less than 1 per 1,000 procedures

What are the Limitations of the Needle Biopsy of Lung Mass radiology procedure?

Following are the limitations of the Needle Biopsy of Lung Mass procedure:

• It is very difficult to make a diagnosis using this procedure, when the masses are small. A small mass is difficult to obtain with a needle; it may also not provide enough sampling, to make a diagnosis
• Sometimes, the samples obtained through this procedure may not be enough to make an accurate diagnosis
• The procedure is not recommended, if the patient has the following conditions:
  • Inadequate oxygen in blood
  • Lung cysts
  • Emphysema
  • Blood coagulation abnormalities
  • Pulmonary hypertension

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is the Lung Mass Needle Biopsy procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the biopsy procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place, during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the Needle Biopsy of Lung Mass radiology procedure:

What is to be expected during the Needle Biopsy of Lung Mass radiology procedure?

The following may be expected during the Needle Biopsy of Lung Mass procedure:

• The patient may feel some pain, due to the needle insertion into the skin
• Once local anesthesia is administered, the rest of the procedure is relatively painless
• The patient may be asked to hold the breath and remain still, during the procedure
• During biopsy requiring surgery, the patient is given anesthesia

What kind of Anesthesia is given, during the Procedure?

A local anesthesia will be administered to numb the path of the needle, during the Needle Biopsy of Lung Mass procedure. A general anesthesia may be needed for children.

How much Blood will you lose, during the Procedure?

There is only a minimal blood loss involved, during the Needle Biopsy of Lung Mass procedure.

What are the possible Risks and Complications during the Needle Biopsy of Lung Mass radiology procedure?

• During the Needle Biopsy of Lung Mass, there is a slight risk of infection, since the skin is penetrated by a needle. However, this risk is very low; it is less than 1 in 1000 procedures
• If the biopsy needle punctures the chest wall, the lung may collapse and the patient may experience shortness of breath, rapid heart rate, shoulder pain, and the skin may turn blue, or they may experience a sharp chest pain

What Post-Operative Care is needed at the Healthcare Facility after the Needle Biopsy of Lung Mass radiology procedure?

There is no postoperative care necessary after the Needle Biopsy of Lung Mass procedure, at the healthcare facility.

After the Needle Biopsy of Lung Mass radiology procedure:

What is to be expected after the Needle Biopsy of Lung Mass radiology procedure?

The following may be expected after the Needle Biopsy of Lung Mass procedure:

• The patient may feel sore in the area of biopsy for a few days, after the procedure
• The patient may cough a little blood, but it should stop within 12-48 hours
• The patient should not engage in any strenuous activities for the next 24 hours, following the procedure

When do you need to call your Physician?

If the patient is experiencing any infection at the needle site or some unusual signs and symptoms, then do contact the physician.

What Post-Operative Care is needed at Home after the Needle Biopsy of Lung Mass radiology procedure?

There is no postoperative care required after the Needle Biopsy of Lung Mass procedure.

How long does it normally take to fully recover, from the Procedure?

In most cases, the patient needs no recovery time after the Needle Biopsy of Lung Mass procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The tissue is taken for further examination and later disposed as per the standard medical procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

• The tissue removed is processed in the laboratory under a pathologist's supervision
• Slide(s) are prepared once the tissue is processed and is examined by a pathologist and a pathology report issued
• Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time

Who will you receive a Bill from, after the Needle Biopsy of Lung Mass radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• A radiologist, performing the procedure
• A pathologist
• Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Needle Biopsy of Lung Mass procedure is performed.