Background Information:

What are the other Names for the Procedure?

• Biopsy using Imaging Tools
• Biopsy using Radiology Techniques
• Tissue Biopsy using Imaging Tools

What is Tissue Biopsy using Radiology Techniques radiology procedures? (General Explanation)

• A biopsy is the removal of tissue from an abnormal part of the body for examination. This may be done either by removing small tissue samples via needle insertion, or by removing the entire abnormal part
• Tissue Biopsy using Radiology Techniques: An X-ray, CT scan, MRI scan, or ultrasound scan, may be appropriately used during biopsies, to remove the suspicious/abnormal part, or in order to obtain a tissue sample

What part of the Body does the Procedure involve?

A tissue biopsy may involve any area of the body; it depends on the target area needing examination.

Why is Tissue Biopsy using Radiology Techniques radiology procedures Performed?

A Tissue Biopsy using Radiology Techniques may be performed for a variety of reasons:

• To diagnose cancer and various infections
• To match organs for transplantation
• To check, if a nodule is cancerous (malignant) or non-cancerous (benign)

Some of the common biopsy procedures are listed below:

• Endometrial biopsy - to detect cancers in the lining of the uterus, or for other uterine conditions
• Kidney biopsy - to detect any inflammation and check functionality of the kidney
• Breast biopsy - to identify if a lump in the breast is benign or malignant
• Bone biopsy - to detect bone cancer or infection in the bones
• Bone marrow biopsy - to diagnose leukemia (blood cancer) and other conditions
• Liver biopsy - to diagnose disease related to liver, or for liver transplantation
• Lymph node biopsy - to examine abnormal lymph nodes for cancer
• Lung biopsy - to identify lung nodule as benign or cancerous
• Testicular biopsy - to diagnose cancer of testicles or other benign conditions

What is the Equipment used? (Description of Equipment)

The equipment used for a Biopsy using Radiology Techniques may include the following:

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 Tissue Biopsies using Imaging Tools.

What is the Cost of performing the Tissue Biopsy using Radiology Techniques radiology procedures?

The cost of a Tissue Biopsy using Radiology Techniques 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 Tissue Biopsy using Imaging Tools 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.cancer.org/acs/groups/cid/documents/webcontent/003185-pdf.pdf (accessed on 08/02/2014)

http://www.radiologyinfo.org/en/info.cfm?pg=biopgen (accessed on 08/02/2014)

Prior to Tissue Biopsy using Radiology Techniques radiology procedures:

How does the Tissue Biopsy using Radiology Techniques radiology procedures work?

Using one of the imaging techniques, the physician inserts the needle through the skin and guides it to the suspicious abnormal part of the organ to remove the sample:

• Vacuum-assisted biopsy:
  • After placing the needle on the target site/part, vacuum is used to pull the tissue sample
• Core needle biopsy:
  • In this procedure, the needle moves forward; as it moves forward, it gets filled with the tissue sample
• Fine needle aspiration:
  • A needle with syringe, pulls the tissue sample or fluids necessary for further examination

How is the Tissue Biopsy using Radiology Techniques radiology procedures Performed?

Tissue Biopsies using Radiology Techniques are performed in the following manner:

• An intravenous (IV) line is inserted into the patient’s arm
• Local anesthesia is then injected to numb the location. In some situations, a general anesthesia may be given
• An ultrasound, CT, or MRI scan, is used to find the location of the nodule (or target organ/site/part)
• The needle insertion site is shaved and sterilized, before the needle is inserted through the skin
• It is then guided to the nodule/site using an ultrasound, CT, or MRI scan
• The tissue sample is removed and the opening of the skin is covered
• The patient may return home right after the procedure, in the case of most biopsies
• A marker may be placed to locate the site in the future

Where is the Procedure Performed?

Normally, Tissue Biopsies using Radiology Techniques are performed as outpatient procedures, at a hospital. 

Who Performs the Procedure?

The Tissue Biopsy Using Radiology Techniques is usually done by a radiology technologist.

How long will the Procedure take?

Tissue Biopsies using Radiology Techniques are usually completed within 1 hour. The patient may be required to stay for a while (several hours) for further observation after the biopsy, depending on the type of biopsy performed.

Who interprets the Result?

• The tissue removed from the procedure is sent to the pathologist
• The pathologist will examine the tissue under a microscope, and give the results to the interventional radiologist

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a Tissue Biopsy using Imaging Tools:

• 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
• Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
• It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the x-ray
• 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
• Depending on the procedure adopted, the patient may be asked for certain bowel or bladder preparations, before the preparation sessions
• The patients may be required to be driven home, after the procedure, in some cases

What is the Consent Process before the Procedure?

A physician will request your consent for the Tissue Biopsy using Radiology Techniques 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 performing a Tissue Biopsy using Radiology Techniques:

• A biopsy is usually not painful
• The recovery time is relatively fast
• A needle biopsy is less invasive than a surgical biopsy, such as an open surgical biopsy
• A biopsy is a very helpful tool in determining, whether or not the tissue is cancerous

Following are the risks of performing a Tissue Biopsy using Radiology Techniques:

• 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 Tissue Biopsy using Radiology Techniques radiology procedures?

Following are the limitations of a Tissue Biopsy using Radiology Techniques:

• Some biopsies may have to be repeated, in order to obtain sufficient amounts of tissue samples for diagnosis
  • Some breast biopsies are not useful in detecting the extent of the disease; thus, a biopsy surgery may be necessary
  • A biopsy is not a definitive procedure for malignant tumors; futher surgical procedures may be needed

What are some Questions for your Physician?

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

• What is Tissue Biopsy using Radiology Techniques?
• 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 Tissue Biopsy using Radiology Techniques radiology procedures:

What is to be expected during the Tissue Biopsy using Radiology Techniques radiology procedures?

The following may be expected during the Tissue Biopsy using Radiology Techniques:

• The patient may feel some pain, due to needle insertion into the skin
• During biopsy requiring surgery, the patient is given anesthesia. This may either be local or general anesthesia, depending on the location of the biopsy

What kind of Anesthesia is given, during the Procedure?

Local anesthesia is generally injected to numb the path of the needle, during the procedure. In some cases, general anesthesia may be given.

How much Blood will you lose, during the Procedure?

There is only a minimal blood loss involved during the Tissue Biopsy using Radiology Techniques procedure; in a majority of the cases, no blood loss occurs.

What are the possible Risks and Complications during the Tissue Biopsy using Radiology Techniques radiology procedures?

During the Tissue Biopsy using Radiology Techniques, 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.

What Post-Operative Care is needed at the Healthcare Facility after the Tissue Biopsy using Radiology Techniques radiology procedures?

There is no postoperative care necessary after the tissue biopsy procedure, at the healthcare facility.

After the Tissue Biopsy using Radiology Techniques radiology procedures:

What is to be expected after the Tissue Biopsy using Radiology Techniques radiology procedures?

The patient may feel sore in the area of the biopsy for a few days, after 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 Tissue Biopsy using Radiology Techniques radiology procedures?

There is no postoperative care necessary after the Tissue Biopsy using Radiology Techniques.

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

In most cases, the patient needs no recovery time after the Tissue Biopsy using Radiology Techniques.

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 Tissue Biopsy using Radiology Techniques radiology procedures?

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

The patient is advised to inquire and confirm the type of billing, before Tissue Biopsies using Radiology Techniques are performed.