Image-Guided Biopsy

An image-guided biopsy consists of the placement of a biopsy needle through the patients skin into an organ of interest using imaging for guidance. The most commonly used imaging modality are ultrasonography, and computer thermography (CT). Such a procedure is a minimally invasive method of obtaining tissue from the patient without the need of the patient to resort to surgery.

What are the indications?

Perhaps the most common type of biopsy in patients with GI tract disorders is in those who require a liver biopsy. Such a biopsy is performed in one of two situations - either there is the suspicion generalized liver disease and a biopsy is needed to confirm that suspicion and make the diagnosis, and the other where there are one or more focal masses within the liver and a biopsy is necessary to confirm the nature of these lesions. As imaging has become more refined so the variety of abdominal structures has increased and apart from the liver other possibilities include the pancreas, lymph nodes and other masses within the abdominal cavity.

What is the preparation for the biopsies?

Preparation for an image-guided biopsy is minimal and varies from institution to institution. Depending upon the sight to be biopsied, an IV line may or may not be placed in the patients hand or arm. It is usually the case when the liver, a very vascular organ, is to be biopsied the patient does indeed have intravenous access. The patient will be asked prior to the procedure whether they suffer from any allergies or whether they are on any medications as this may interfere with the procedure. In particular, patients who are taking blood thinning agents, e.g. cumadin, may be at increased risk of bleeding from the procedure and this information is essential to the radiologist. In such a situation it is usually the case that a blood test will be obtained beforehand in order to establish the coagulation (clotablity) of the patients blood. As CT involves radiation, it is also necessary to determine whether or not the patient is pregnant or may be so. Once it is established that the procedure is safe and should proceed details will be explained to the patient and written and informed consent will be obtained her.