CT (Computed Tomography) guided abdominal/pelvic biopsy

Why do I need a biopsy?

Previous imaging you have had has shown an abnormal area in your abdomen/pelvis. It is not possible to say exactly what the abnormality is but the best way to find out is to take a small piece of tissue (biopsy) and examine it under a microscope.

Where will the biopsy be carried out?

The biopsy will be done in a CT scanner in the Radiology Department.

A radiologist (a doctor who specialises in reading diagnostic images such as X-rays and CT scans) will carry out the biopsy. They will be assisted by a radiology nurse and a radiographer who will take the images.

How do I prepare for the biopsy?

Before your biopsy a pre-assessment conversation is required for you to discuss the procedure and any preparation that may be needed. This may take place over the telephone or you may be sent an appointment to attend a clinic in the hospital. Please have a list of all your medications available for this conversation. During this appointment the date and time of your biopsy will also be arranged.

You may also need a blood test before your biopsy to check that you do not have an increased risk of bleeding following the biopsy.

On the day of your procedure, you may have a light, early breakfast at home. You may continue to drink as normal.

Blood-thinning medications will need to be stopped before the biopsy (we will let you know how many days before) so that we can carry out your procedure safely but please continue to take any pain or blood pressure medication as normal. It is especially important to ensure that you do not stop your blood pressure medication as we may not be able to proceed with your biopsy if your blood pressure is too high on the day.

Report to the area stated on your appointment letter (this may be the Radiology/Imaging department or a Ward), where you will be asked to change into a hospital gown.

Although most people go home on the same day there is a possibility that you may need to stay in hospital overnight, so please bring an overnight bag with you.

You will not be able to drive after the procedure and will need to arrange transport home.

Can I bring a relative/friend?

Yes, but for reasons of safety they cannot join you in the CT scanning room except in special circumstances.

Giving your consent (permission)

We want to involve you in the decision about your care and treatment. The radiologist will explain the procedure and risks to you and give you the opportunity to ask questions. If you decide to go ahead you will be asked to sign a consent form. This states that you agree to the procedure and understand what it involves. You may withdraw your consent at any time, even after you have signed the consent form.

The Radiology Department plays an important role in the training of future healthcare professionals. The part patients play in this is vital in ensuring we produce the right quality of healthcare professionals for the future. If at any time you would prefer not to have students present, please inform the team looking after you. This will not impact on your care in any way.

What happens during the procedure?

You will be taken into the scanning room and made comfortable on the bed. You may be asked to lie on your back, side or front. This is dependent on where the biopsy is to be taken from, so it is important for you make sure you are comfortable before the radiologist starts. You will need to lie as still as possible during the procedure.

A scan will be taken of the relevant area to locate the exact position for the insertion of the biopsy needle. The skin over the area will be cleaned with antiseptic and then numbed using a local anaesthetic before the biopsy needle is inserted and the tissue sample taken. You may be asked to hold your breath during the procedure so it is important that you take the same ‘depth’ of breath each time.

After the biopsy, the area will be cleaned and a dressing put over the wound site.

Will the procedure be uncomfortable?

The biopsy is performed under local anaesthetic which will sting when given and you may feel some pressure as the doctor pushes on the needle. Most people do not feel much pain during the biopsy.

What are the risks involved?

A biopsy is a safe procedure but complications can sometimes happen.

• You may notice a small amount of bruising around the wound site due to bleeding into the skin.
• There is a small risk of damage to structures such as organs, blood vessels or nerves near to the biopsy location. If this happens you may be admitted to hospital for further care.
• In very rare cases there is a risk of severe bleeding and infection. If this happens you will be admitted to the hospital for further care.
• If the sample taken does not provide a diagnosis the procedure may need to be repeated at a later date.

CT scanning does involve X-rays and has the usual risks associated with ionising radiation. The amount of radiation is equal to the natural radiation we all receive from the atmosphere over a period of about 3 years.

How long will the procedure take?

The procedure usually takes about 30 minutes but varies from individual to individual. However, following the biopsy you will need to remain in the hospital for 4 hours – this may be in the Radiology Department or on a ward.

You may have to wait longer if you feel unwell or if you develop a complication.

What happens after the procedure?

After the biopsy you will be looked after by a radiology or ward nurse who will monitor your blood pressure, pulse, temperature and oxygen levels at regular intervals. They will advise you when you are able to get up and move around.

You must have an adult to take you home and stay with you for 24 hours following the biopsy.

You should avoid heavy lifting, exercise or straining for 24 hours. If you have any pain, you may take a mild pain relief such as paracetamol.

You should not drive for 24 hours following the procedure.

Are there any side effects?

Not usually. You should spend the remainder of the day resting. If you notice any bleeding from the wound site or feel unwell, please contact your GP immediately.

If you experience severe abdominal pain, or sudden bleeding, you should go to the Accident and Emergency Department immediately.

Frequently asked questions

Should I still take my regular medication?

Yes, but you will need to stop any blood thinning tablets. These include, aspirin, clopidogrel, warfarin, apixaban, rivaroxaban, dabigatran and fondaparinux. If you take any of the medications listed, please contact our radiology nurses for advice.

When will I get the results?

On the day of the procedure, the biopsy sample will be sent to the laboratory. The results of these tests usually take 1 to 2 weeks and will be sent to your referring doctor.

Interpreters

If you need an interpreter for your procedure, please contact the department so we can try to arrange this.

Cancelling your appointment

If you are unable to attend your appointment, we would be grateful if you could contact us as soon as possible. We can then offer your appointment to another patient and arrange another date and time for you.

If you have had diarrhoea and/or vomiting, please cancel your appointment unless you have been free of symptoms for 48 hours.

Please ring the CT Appointments Officer on the number shown on your appointment letter, between 9:00am and 4:30pm, Monday to Friday.

Additional information

We have produced a series of patient information videos to help you understand more.

You can type the address below into your browser’s search bar: https://youtu.be/h18zjzvwXkk

Alternatively, you can find the Gloucestershire Hospitals Youtube page and enter “biopsy” into the search bar to find all the videos in the series.

https://www.youtube.com/@GlosHospitalsNHS

Hopefully the information on this page has answered any questions you may have but remember this is only the starting point for discussion about your treatment. Make sure you are satisfied that you have received enough information about the procedure in advance. Please feel free to contact your consultant or the Radiology Department to discuss any queries you have before the procedure.

Contact information

Interventional Radiology Bookings

Cheltenham General Hospital

Tel: 0300 422 3104

Tel: 0300 422 5559

For Cancer Nurse Specialists, please either call the number you have been given by your specialist team or call Gloucestershire Hospitals Switchboard on 0300 422 2222 and ask for the operator when prompted.

When the operator responds, ask them to bleep the Cancer Nurse Specialist for the specialty you require for example Urology, Haematology, Gynaecology etc. or your consultant’s secretary.

For patient information videos about the procedure itself see the ‘Additional information’ section.

We are pleased that we can offer state of the art technology for diagnosis. However, radiology equipment needs constant updating and there is a charitable fund for this. If you would like to make a donation, please send a cheque to the appropriate address below. Cheques are payable to GHNHSFT.

Please send your donation to:

Business Manager, Department of Radiology (Imaging 1), Gloucestershire Royal Hospital,, London Road, Gloucester GL1 1NN