What is Needle Biopsy of Abdominal Mass?

An intra-abdominal mass is a solid lesion, an area of abnormal tissue located within a solid organ of the abdomen such as liver, pancreas, kidney, or a pathological lymph node located within the peritoneal cavity. These masses are most often detected by ultrasound or computed tomography (CT) examinations. However, it is not always possible to tell from these imaging tests whether a mass is benign or cancerous.

A needle biopsy involves removing some cells from a suspicious area within the body and examining them under a microscope to determine a diagnosis.

In a needle biopsy of abdominal masses, ultrasound or CT is often used to help guide the interventional radiologist’s instruments to the site of the abnormal growth.

How should I prepare?

You may be instructed not eat or drink for eight hours before your biopsy. However, you may take your routine medications with sips of water.

Prior to a needle biopsy, you should report to your doctor all medications that you are taking, and if you have any allergies, especially to anaesthesia. Your doctor will advise you to stop taking aspirin or a blood thinner three days before your procedure.

Also, inform your doctor about recent illnesses or other medical conditions.

You will be asked to fill out a Questionnaire and a Consent form prior to the exam.

You may be asked to remove some or all of your clothes and to wear a gown during the exam.

In case of CT-guided needle biopsy, you may also be asked to remove jewellery and any metal objects or clothing that might interfere with the x-ray transmission. Women should always inform their doctor if there is any possibility that they are pregnant. Some procedures using image-guidance are typically not performed during pregnancy because radiation can be harmful to the foetus. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby.

It is recommended to have a relative or friend accompany you and drive you home after discharging from wards.

How is the procedure performed?

Imaging-guided, minimally invasive procedures such needle biopsy of abdominal masses are most often performed by a specially trained interventional radiologist.

Needle Biopsy of Abdominal Mass under Image-guidance is usually done on an inpatient basis.

According to the location of the mass previously detected by imaging techniques, the patient will be positioned lying on the examination table with face up or face down or turned to the side.

Under US or CT guidance, the radiologist confirms the location of the mass, chooses the safest approach and the entry site is marked on the skin. The skin around the insertion site will be scrubbed and disinfected, and a sterile surgical drape will be applied.

A local anaesthesia will be injected to numb the insertion site of the needle.

CT-guided needle biopsies require patient’s cooperation (as being still on the CT Table) and patient to be able to hold breath exactly at the same position, repeatedly.

A very small nick is made in the skin at the site where the biopsy needle is to be inserted.

Under image-guidance, the radiologist will insert the needle at the site already marked and advance it directly into the mass. As tissue samples are taken, you may hear clicks from the sampling instrument. After this sampling, the needle will be removed. Tissue samples will then be collected.

This process may be repeated one or two times.

Once the biopsy is complete, pressure will be applied to stop any bleeding and the opening in the skin is covered with a dressing. You will be taken to an observation area or returned to your room in your ward. If necessary, an imaging control will be performed later to exclude minor complications.

This procedure is usually completed within one hour.

What will I experience during and after the procedure?

When you receive the local anaesthetic to numb the skin, you will feel a slight pin prick from the needle. You may feel some pressure when the biopsy needle is inserted. The area will become numb within a short time.

You will be asked to remain still during the procedure. You also will be asked to hold your breath multiple times during the biopsy. It is important that you try to maintain the same breath-hold each time to insure proper needle placement.

Generally your bandage may be removed one day following the procedure and you may bathe or shower as normal.

You should not exert yourself physically (such as heavy lifting, extensive stair climbing, sports, etc.) for some days following your biopsy. You will return to your normal activities soon.

You may experience some soreness at the biopsy site as the local anaesthesia fades, but this should improve.

In some cases, bleeding may occur within the abdomen, originating from the solid organ harbouring the mass or from the concerned lymph node itself. This situation is called internal abdominal haemorrhage and sometimes requiring a surgical intervention for haemostasis. You will be charged for all extra treatments.

Who interprets the results and how do I get them?

A pathologist will examine the removed specimen and make a final diagnosis so that treatment planning can begin. Your doctor will disclose the results to you.

What are the benefits versus risks?

Benefits

Needle biopsy is a reliable method of obtaining tissue samples that can help diagnose whether a mass is benign or malignant.

A needle biopsy is less invasive than open and closed surgical biopsies, both of which involve a larger incision in the skin and local or general anaesthesia.

Generally, the procedure is not painful and the results are as accurate as when a tissue sample is removed surgically.

Recovery time is brief and patients can soon resume their usual activities.

Risks

Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.

Intra-abdominal bleeding can occur bust remain rare

What are the limitations of Needle Biopsy of Abdominal mass?

For masses partially necrotized, the tissue obtained during a needle biopsy may not be adequate for diagnosis.

For further information and for taking an appointment, kindly contact our imaging department at (08) 54 11 34 00