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What is image-guided biopsy?

A biopsy is a minimally invasive way to take a sample of tissue in order to determine whether it is benign (noncancerous), malignant (cancerous) or infectious. In image-guided biopsy, a doctor uses imaging technology, such as ultrasound CT (computed tomography) or MRI (magnetic resonance imaging), to provide guidance so that he or she can safely extract tissue from hard-to-reach areas of the body. Image-guided biopsies are performed by subspecialized radiologists in body imaging, breast imaging and interventional radiology.

Examples of biopsies utilizing image guidance include the biopsy of thyroid nodules, breast lesions, liver lesions and lymph nodes.

Real time imaging during the procedure allows the radiologist to harvest cells more precisely from the area being examined. This may be done through fine needle aspiration (FNA), in which a thin needle and syringe is used to remove very small pieces from a tumor; through a core needle biopsy, in which the doctor uses a large, hollow needle to extract a “core” of tissue; or in a vacuum-assisted device procedure, in which a vacuum-powered instrument collects multiple tissue samples during a single insertion.

Our approach

A biopsy is a critical tool in determining a diagnosis, and imaging can make that process easier, safer and more effective. When it comes to image-guided biopsies, the interventional radiologists at Northwell Health Imaging are the power behind the procedure. Every image-guided biopsy is performed by a fellowship-trained interventional radiologist whose skills have been honed by specialized training and thousands of hours of experience. If you need additional care, your interventional radiologist will work side by side with the rest of your care team, collaborating closely to answer your questions and help guide your care.

Northwell Health Imaging offers the largest group of fellowship-trained and subspecialized interventional radiologists on Long Island, as well as access to all the resources and clinical expertise of New York state’s largest health system. Whether you are here for screening, diagnostic or treatment imaging services, each of our practitioners is committed to providing a caring, comfortable environment and a positive, productive experience.

Risk factors

The risks of image-guided biopsy depend on the kind of biopsy being performed and the kind of imaging used to direct the doctor. Risks generally include bleeding (formation of a hematoma at the biopsy site) and infection. Also, with any biopsy, there is a chance that the procedure will not explain the abnormality under investigation.

If X-ray radiation is used, risks include the possibility of an increased chance of developing cancer. If there is a possibility that you might be pregnant, let your doctor know; exposure to radiation is potentially dangerous for a fetus, so the doctor might choose to delay the biopsy or recommend a different imaging technology.

How to prepare

Some medications (both prescription and over-the-counter) and supplements can raise the risk of bleeding during or after a biopsy. Tell your doctor and our scheduling team about all medications and supplements you take as you may be asked to stop taking certain medications several days prior to the procedure. These include Coumadin, aspirin, nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Anaprox, Naprosyn). Acetaminophen (Tylenol) does not promote bleeding and is safe to take.

Certain types of image-guided biopsy require you to not eat or drink for some time before the procedure. Our scheduling team will inform you if this is the case.

If you’ve previously had any diagnostic exams (CT scan, ultrasound, MRI) of the area of interest at an outside facility, please submit their results to the site of the procedure for review prior to the biopsy.

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