Thyroid Biopsy & Other Image Guided Biopsies

A biopsy is generally performed when an abnormal mass or lump has been found in an organ or body part, such as the thyroid or lungs. A biopsy is the most definitive way to determine if the lump is cancerous, as imaging studies alone cannot provide a specific diagnosis on which to decide treatment options.

During a biopsy, a small amount of tissue is removed from the abnormal area with a needle or similar instrument so a pathologist can examine the material for malignant cells. Radiologists use image guidance (ultrasound, CT, MRI, or mammography) in performing biopsies to obtain tissue from the right spot and to avoid injuring important nearby body parts.

There are several imaging guided biopsy procedures available, most of which can be performed on an outpatient basis using local anesthetic. Conscious sedation can also be used when necessary. These biopsies allow a radiologist to access hard to reach areas of the body without surgery, but with the same or even better accuracy than a surgical biopsy. INVISION radiologists have great success in precisely sampling any mass in the body that can be visualized with imaging technology. The specific type of biopsy chosen by your doctor will depend on the location of the lump and other circumstances.

This page contains the following information about biopsies:

Reasons for Having an Image Guided Biopsy

A biopsy is used to definitively determine if a growth or lump is cancer or not. Biopsies are performed on various organs and body parts, including the thyroid, kidneys, liver, lungs, pancreas, adrenal glands, bones, lymph nodes, and soft tissue masses throughout the neck and body.

Reasons for choosing an imaging guided biopsy rather than a surgical biopsy include:

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Types of Image Guided Biopsies

Following are the biopsies performed by INVISION radiologists:

Biopsy Type Description
Fine Needle Aspiration Biopsy
  • Commonly used on the thyroid gland
  • Ultrasound guided for accurate placement of the needle
  • Uses a tiny needle, smaller than the needle used to draw blood
Needle Core Biopsy
  • Used to remove tissue from many organs and body structures
  • Ultrasound or CT guided for accurate placement of the needle
  • Uses a larger needle than a fine needle aspiration biopsy

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Risks Involved in This Procedure

Since the skin is penetrated during a biopsy, there is a slight risk of bleeding and infection.

A potential risk of all biopsies is that the tissue sample may not be adequate for a diagnosis, requiring additional measures to be taken (i.e. additional sampling or surgical excision).

Sometimes a lung will collapse following a needle biopsy of the chest. You should immediately go to the nearest emergency room if you experience any of the following signs of a collapsed lung: shortness of breath, difficulty catching your breath, rapid heart rate, sharp chest or shoulder pain when breathing, or blueness of the skin.

Conditions to Let Our Doctor Know About

In advance of your exam, let your INVISION radiologist or technologist know if any of the following circumstances apply to you:

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Insurance Coverage

Biopsies are usually covered by insurance. Check with your insurance carrier to be sure. Please bring your insurance card with you to your procedure.

Procedure Locations

Biopsies are performed at the following INVISION location in the Denver, Colorado area. They may also be performed at INVISION partner hospitals.

Scheduling This Procedure

To schedule an image guided biopsy (other than breast biopsies), please call 720-493-3305.

Some biopsies may have to be arranged through the INVISION partner hospital where the biopsy will be performed.

Preparation Guidelines

Following are the preparation guidelines for biopsies. If you have any questions, please contact us at the same telephone number used to schedule your appointment.

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What to Expect During Your Procedure

Prior to the date of the procedure, you may have to receive pre-procedure exams, such as a blood test, ultrasound, MRI or CT scan.

When you come in for the procedure, a nurse or technologist will answer any questions you have. You will fill out paperwork and consent forms so the radiologist will know your medical history. You may need to change into a gown, depending on the area to be biopsied. The radiologist who will perform the biopsy will then meet you to further discuss the procedure and answer your questions. A technologist will then position you on a table in a manner that’s appropriate for the location and type of biopsy being performed.

Following is additional information for specific biopsy types.

Fine Needle Aspiration (FNA) Biopsy

The site of the biopsy will be cleansed and anesthetized. The radiologist will apply gel to the area and use ultrasound to locate the abnormal tissue. While watching the ultrasound monitor, the radiologist will carefully insert a very small biopsy needle into the abnormal tissue. A vacuum will be created within the needle and it will be moved backward and forward several times to obtain a good sample of tissue. Usually, several samples are taken.

The incision will be cleaned and taped and you will be allowed to change back into your clothes.

Needle Core Biopsy

The radiologist will use ultrasound to locate the abnormal tissue. The site of the biopsy will be cleansed and anesthetized to minimize pain. A small incision, about 1/8 of an inch long, will be made in the skin above the area to be biopsied. While watching the ultrasound monitor, the radiologist will carefully insert a small biopsy needle into the abnormal tissue. A spring-loaded device within the needle will remove a small sample of tissue. The needle will be removed and reinserted from different angles. Altogether, 3-7 samples will be taken, all through the same incision.

The device will make a clicking sound when the sample is taken. You should not feel any pain; just pressure.

The incision will be cleaned and taped and a pressure dressing applied. You will then change back into your clothes, if necessary.

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Recovering from Your Procedure

The bandage over the biopsy site should remain in place and dry for 24 hours. After that you can bathe or shower as usual. Avoid heavy lifting and other strenuous activities for 24 hours. You may then resume your normal activities.

You may experience soreness at the site of the biopsy, but it should quickly improve. You can take over the counter pain relievers or use ice packs to minimize any discomfort. With a lung biopsy, you may cough up a little blood or experience temporary shortness of breath.

Getting Your Procedure Results

Your tissue sample will be sent to a laboratory so a pathologist can examine it. The results will be available the next business day and will be reported to your physician. You can get your results from your physician or from the Sally Jobe or INVISION facility where the biopsy was performed. During the biopsy, our radiologists and technologists will be happy to answer questions about the procedure; however, they will not be able to give you the results until the following business day.

Additional Information

The information on this page was taken in part from the following sources. Review these web sites or articles for additional information on imaging guided biopsies.

Sources

During a biopsy, a small amount of tissue is removed from the abnormal area with a needle so a pathologist can examine the tissue for malignant cells. Needle localization using imaging guidance may be done before a surgical biopsy to help the surgeon more accurately identify the abnormal tissue.