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, please do not eat anything for 6 hours before your appointment. You may drink clear fluids during this time but please stop these 2 hours before your appointment.

Some blood-thinning medications may need to be stopped before the biopsy (we will let you know if this is the case for you) but please continue to take any pain or blood pressure medication as normal.

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.

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 reasonably 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 may sting slightly 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 will 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 will 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?

Every patient is different so it is not possible to give a definite timeframe. The procedure will take about 30 minutes to carry out. 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.

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 chest pain, shortness of breath or cough up large volumes of blood you should go to the Accident and Emergency Department immediately.

Frequently asked questions

Should I still take my regular medication?

Yes, but you may 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?

Shortly after the procedure the biopsy sample will be sent for tests. The results of these tests 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 9:00 am and 4:30 pm, Monday to Friday.

Contact

If you do not believe you should have been referred for this procedure, please contact the CT department immediately. Alternatively, you can contact your consultant’s secretary or one of the Cancer Nurse Specialists.

Cancer Nurse Specialist

Cheltenham General Hospital

Tel: 0300 422 2379

Gloucestershire Hospitals Switchboard

Tel: 0300 422 2222 and ask for the operator when prompted. When the operator responds ask them to bleep the Cancer Nurse Specialist on 2649.

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 Gloucestershire Hospitals NHS Foundation Trust.

Please send your donation to:

Business Manager

Department of Radiology (Imaging 1)

Gloucestershire Royal Hospital,

London Road

Gloucester

GL1 1NN