Information for patients requiring a CT guided biopsy
This information leaflet has been produced to give you general information, and hopes to answer most of your questions when requiring a CT Guided Biopsy. It is not intended to replace the discussion between you and your healthcare team, but may act as a starting point for discussion. If after reading it you have concerns or require further explanation, please discuss this with a member of the healthcare team.
Please contact us prior to your scan if:
- You have diabetes and are taking Metformin
- You are, or might be, pregnant
- You weigh more than 200kg or 31 stone
What is a CT Guided Biopsy?
You may have had previous tests which have shown an abnormal area inside your body which needs further tests.
A biopsy is carried out by taking a small sample of this abnormal tissue using a special needle and then examining it closely under a microscope. The needle is carefully guided to the area in question using a CT scanner, which is a specialised x-ray machine that produces detailed pictures of the inside of your body. The CT scanner is an open ring-like structure which resembles a giant doughnut. It is not a tunnel as some people might expect.
How should I prepare for my CT Guided Biopsy?
Please do not eat for four hours before your procedure. You can drink water up to two hours prior to your appointment time, unless otherwise advised.
Can I take my prescribed medicines as usual?
If you are on blood thinning (anti-coagulant) tablets such as Warfarin and have not already been asked to stop taking this medication prior to your appointment, then please contact the Radiology Department for advice (details at the end of this leaflet).
If you take any other medication, continue to take as usual unless you have been specifically told otherwise by the CT Appointments Team or Radiology Nurses.
Can I bring a relative or friend?
Yes, but for safety reasons they will not be able to accompany you into the CT scan room except in very special circumstances.
What happens at the hospital before the biopsy?
Most biopsy procedures are performed as a day case so you will be admitted to a ward in the hospital. You will be told exactly where to go and at what time in your appointment letter.
You will have some assessments carried out by nurses on the ward, such as pulse and blood pressure checks. They may also insert a small cannula (needle) into a vein in your arm or back of your hand and take blood samples if this is necessary. (Sometimes your GP will have taken blood samples before you come into hospital, if they are required). You will be asked to change into a hospital gown. It is advisable to leave any valuables at home.
At your CT biopsy appointment time, a porter will take you to the Radiology Department where you will be greeted by the Reception Team, Radiology Assistants and Radiology Nurses.
A Radiologist (a doctor who specialises in reading x-ray images) will then explain the biopsy procedure in detail. They will also discuss any relevant risks and will ask you to sign a written consent form for the examination to go ahead. If you have any concerns or questions about the procedure please ask the radiologist at this time.
What happens during a CT Guided Biopsy?
Once in the scan room the radiographer (member of the Radiology Team trained to carry out scans) will ask you to either lie on your back or your front depending on where the radiologist is going to take the biopsy. You will need to lie very still in this position for up to one hour so it is important that you are comfortable.
The radiologist will use the CT scanner to decide on the best place to take the biopsy sample from and the radiographer will mark this point on your skin with a pen. To keep everything clean the radiologist will be wearing sterile gloves and a gown. The chosen area on your skin will be cleaned with antiseptic and the area will be covered with a sterile towel. Next the radiologist will anaesthetise the area with local anaesthetic. This may sting a little to start with but then the area should become numb.
The biopsy needle will then be inserted into your skin and you may feel pressure but you should not feel pain. To ensure the needle is in the right place, the scanning table will move your body through the ‘doughnut’ shaped hole (gantry) of the CT scanner so that the relevant area of your body can be scanned. You may be asked to hold your breath for a moment. We understand that some people have difficulty holding their breath – please tell us at the time if this is a problem for you.
Once the radiologist is happy with the position of the needle, biopsy samples will then be taken of the tissue. The radiologist will sometimes need to take several samples from the same area to make sure they have taken enough tissue for testing. When taking the biopsies the needle may sometimes make a sharp snapping sound, this is nothing to be alarmed about and the radiologist will tell you beforehand. There will be staff with you at all times to reassure you.
Finally another scan is taken to check for any possible complications.
How long will the biopsy take?
The whole procedure will take between 30 to 60 minutes, but the actual biopsy takes only a minute or two.
We will try to keep to your appointment time but occasionally we have to scan patients urgently at short notice. This means your appointment could be delayed. We will let you know if this is the case.
Are there any risks?
As with x-rays, CT scans use radiation. The level of radiation used is small and the benefits of the scan are thought to outweigh any risks.
CT guided biopsies are considered a very safe procedure but there are a few risks and complications that can arise as with any medical procedure. Small risks vary depending on where we take the biopsy from.
The main complications are bleeding or infection. These complications occur rarely, in less than one in 100 biopsies. The radiologist will explain the risks to you before the procedure.
If you are having a lung biopsy the main risk is of
- An air leak into the space between the lung and inner chest wall (pneumothorax). A small air leak after a lung biopsy is fairly common. Small air leaks do not cause any problems and will get better on their own. Sometimes though a large air leak occurs and then the air will need to be drained.
- Coughing up blood. This can happen because the needle caused some bleeding to occur in your lung. If you are coughing up a lot of blood you will need to stay in hospital for observation until it clears.
Despite these slight risks, your doctor believes it is advisable that you should have this procedure.
Do bear in mind that there may be greater risks from missing a serious condition by not having this procedure.
What happens after the procedure?
After the procedure you will go back to the ward you will have some assessments carried out by nurses on the ward such as your pulse and blood pressure to make sure that there are no problems. Usually you will need to stay on the ward for about five to six hours after the biopsy before you can go home.
If you have had a CT lung biopsy, you will have a chest x-ray to check for any air leaks before you go home.
You must not drive yourself home on the day of the procedure. A relative or friend should accompany you home and stay with you until the next day. You can eat and drink as normal.
How do I find out the results of my biopsy?
Your biopsy sample will be sent to the laboratory for testing. This can take up to one week. The doctor who asked us to perform your test will then arrange an appointment for you to discuss the results of the biopsy. If after three weeks they have not contacted you, please contact the hospital switchboard on (0191) 482 0000 and ask to speak to your consultant’s secretary.
Unfortunately not all biopsies are successful. This may be because despite taking every possible care the sample of tissue taken may be too small to make a diagnosis. Sometimes even with a good sample of tissue it is not possible to make a definite diagnosis. If this is the case your doctor will be able to discuss the next course of action with you.
Who do I contact if I have concerns?
Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Radiology/CT Department on (0191) 445 2094.
Any personal information is kept confidential. There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible.
In order to assist us to improve the services available, your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews and Statistics.
This leaflet can be made available in other languages and formats upon request