CT Guided Biopsies
We have pioneered the use of routine core biopsies as against fine-needle aspirations in different parts of the body, especially the lungs.
CT Guided Biopsies
Instructions for CT Guided Biopsy
Pre-Biopsy Assessment
- First, it is necessary to do a pre-biopsy assessment of the recent scans that may include MRI, PET/CT or CT scan to plan the biopsy properly.
- For this, it is necessary to submit all recent scans in advance. The front desk will guide you. Please note that there is a charge of Rs. 4,500 for the pre-assessment, which will be absorbed in the total cost of the biopsy procedure. However, if the biopsy is not possible, not indicated or not to be done for any reason, then an opinion report will be given against the charge taken for the pre-assessment.
- The cost of the biopsy is Rs. 27,500. This does not include the histopathology and microbiology charges, which will be paid separately either by you directly or through us, depending on where the samples are sent. Please see the Reports Section at the end of this sheet for more information.
Blood Tests
- It is important to make sure that the body's ability to clot the blood is normal. Normal PT, PTT and INR test results, done within 1 week of the biopsy are needed.
- If the patient is on any blood-thinners (anti-coagulants), then these have to be stopped for between 3 to 5 days. The common blood thinners are aspirin and clopidogrel. Please give us a list of blood thinners you are or maybe on.
Instructions Prior to the Biopsy
- Minimum 4-hours fasting.
- Please wear comfortable loose clothing.
- The PT/INR report should be carried along, so that the values can be re-verified.
- If diabetic, then the appropriate medication / food should be carried along. Any other medications to be taken in the morning should be brought along.
- One relative / friend at least should accompany the patient. Preferably not more than 3 relatives should come along – there isn't enough space in the waiting room.
Pre-Procedure Steps on the Day of the Biopsy
- All biopsies are done in the morning between 8:00 am and 10:00 am.
- There will be a detailed explanation given by Dr. Bhavin Jankharia to the patient and the accompanying relatives and friends. Please note that the patient needs to and must understand the procedure in detail. Only if the patient is below 18 years of age and/or unable to understand or not in her/his senses, will the counselling be done only with the relatives.
- Following this or at the same time, the patient will change into appropriate clothing.
- An intravenous needle will also be placed as standard protocol.
Biopsy Procedure
- This is done inside the CT scanner using a CT fluoroscopy unit.
- In most instances, an anesthetist / intensivist will be present.
- The biopsy involves the following steps (usually 10-15 minutes)
- Cleaning and draping
- Injecting local anesthesia
- The actual biopsy
- Following the biopsy, the patient will be kept on table for 2-10 minutes to ensure everything is
- Once the patient is out of the CT scanner, he/she will either be lying in a bed or will be sitting outside in the waiting room for between 1-3 hours depending on the procedure and the sister/staff nurse will give further instructions.
Complications
There are two complications that can occur
- If the INR is normal, then this is not a problem. Sometimes, there may be a little discomfort for 1 day which will reduce on an hourly basis. With liver biopsies, the bleeding may not potentially stop, causing an emergency, but this hasn’t occurred with Dr. Bhavin Jankharia for over 25 years.
- Pneumothorax (air leak) (in case of a lung biopsy)
- Whenever a needle is passed through the lungs, there is a 20-100% chance of an air leak. Usually, if the air leak occurs, it stops in 1-2 minutes and the air (10-200cc) is absorbed in 2-3 days.
- Sometimes, if the air leak does not stop, which we would know right then or over 2-3 hours, we may put a tube inside the chest to remove the air. The patient has to bear the inconvenience of having a tube in the chest for 2-3 days, either at home or admitted for observation to a hospital, as the case may be.
Post-Biopsy Instructions
- It is a good idea not to work that day, irrespective of which biopsy it is.
- For lung, liver, spleen and kidney biopsies, the patient should take bed rest overnight.
- Once the patient leaves the premises, he/she can otherwise resume his/her normal daily routine related to food, water, medicines, etc.
If you have any more questions, feel free to ask the front desk or the staff nurse / sister.
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Time taken
15-45 Minutes
Primary Expert Radiologist
Dr. Bhavin Jankharia
Machine
Siemens Somatom 64 with CT Fluoroscopy
Reports
- Our preferred providers for histopathology are Dr. Anita Borges' team at Centre for Oncopathology and Dr. Jay Mehta at Neuberg Oncopath. Both of them collect the samples from our centre and we can collect the payment on your behalf. It is also fine if you would like to personally go and deliver the samples to them.
- If microbiology is needed, then all the tests will be sent to Hinduja Hospital or Unilab – they come and pick up the samples and we will collect the payment on your behalf. We will send the reports to you whenever they are ready.
Delivery of Report
For biopsies, the reports depend on the pathologist. For drainages, there are no reports.
Inner Spaces
- Biopsy Please! No FNAC
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- CT Guided Biopsy in TB Spine
- Trans-Retroperitoneal Approach for Difficult Pancreatic and Peri-Celiac Lesion Biopsies
- CT Guided Anterior and Lateral Approaches into the Vertebral Bodies for Biopsy
- What is the smallest lung nodule that can be biopsied
- Chronicling a single day of 6 lung biopsies