We have received a request from your referring doctor for you to have a CT Guided Biopsy.  This web page is designed to give you some information about the CT scanner, to help you prepare for your scan and to give you some idea of what to expect when you attend.

A biopsy is a test performed in the hospital to investigate the cause of a lump or other abnormal area within a patient.  A doctor takes a small piece of the tissue from the lump using a special type of needle.

A CT guided biopsy is a biopsy test performed in the x-ray department.  A CT scanner is used to check the position of the biopsy needle, making sure that the correct piece of tissue is taken. 

If your appointment time is not convenient it is essential you contact the hospital department that you are attending immediately (see above for relevant helpline telephone numbers), so that a more appropriate time can be arranged.  This will enable us to reallocate valuable scanning time to someone else.

Very little.  Almost all CT guided biopsies are performed while the patient is awake, with local anaesthetic (see below) used to numb the area.  Sometimes a sedative may be given and very occasionally, a general anaesthetic may be used.  If this is the case, you will be given specific instructions about eating and drinking before the test.  Otherwise you should eat and drink normally and continue to take any medication prescribed by your doctor.  You will be admitted to a hospital ward before your biopsy is performed and will usually be asked to change into a hospital gown before you are taken to the x-ray department.

Local Anaesthetic

• Your radiologist will ask you to keep quite still while the injection is given.
•  You may notice a warm tingling feeling as the anaesthetic begins to take effect.
•  Your procedure will only go ahead when you and your radiologist are sure that the area is numb.
•  If you are not having sedation, you will remain alert and aware of your surroundings.
•  Your radiologist is always near to you and you can speak to him/her whenever you want to.

Yes, you should inform the hospital consultant looking after you, or the x-ray department as soon as possible if you are taking any tablets to thin the blood (Warfarin) or if you have a medical condition which makes it hard for your blood to clot.  In the event of either of these, we may need to check your blood before the biopsy to ensure you are not at risk of bleeding too much after the test.  You should also let your hospital consultant know if you are diabetic.

Yes.  The preparation procedure may change. If you are diabetic and take insulin, you may need a drip to keep your blood sugars controlled.  This will be discussed with you on the ward prior to the procedure. Please ring the hospital department that you are attending, as above (see contact details) and speak to a member of staff, who will be able to advise you. (see next question also). 

Yes - Metformin (Glucophage, Avandamet) is most commonly taken by diabetic patients to control blood sugar, but occasionally is taken for other conditions.

If you are taking Metformin, your preparation for the procedure may change.   Please ring the appropriate helpline telephone number, as above, and speak to a member of staff, who will be able to advise you.

You will come to the x-ray department on a wheelchair, trolley or in your bed.  The staff will check your details and you will be taken into the CT scan room.  The doctor who will be performing the biopsy will talk to you about why it is being done, what will happen and what problems can occur following a biopsy.  You will be given the chance to ask any questions you may have.   You will be asked to sign a consent form to confirm you understand before the test begins. 

You will be asked to lie on a couch which enters a fairly wide, short tunnel, the C.T. scanner, and a wire strip will be placed over the area where the biopsy will be taken.  You will move through the tunnel as the first scans are taken.  The radiographer operating the scanner will explain if you need to do anything.  Once the doctor has decided where to put the needle, a mark will be made on your skin and it will be cleaned with a sterilising solution to kill any bacteria on the skin surface.  Local anaesthetic will be injected into the skin and muscle underneath by the doctor.  This causes a brief stinging sensation and then makes the area numb.  The doctor will then position the needle.  This may involve briefly moving the couch in and out of the tunnel to check the position of the needle.  Once the doctor is happy that the needle is in the right place, the biopsy will be taken.  You may hear or be aware of the clicking sound at this stage.  The doctor will remove the needle and check the sample.  Sometimes more than one piece of tissue will be taken and if so, the biopsy needle will be put back into position for the next sample.  Once the doctor has taken sufficient samples, a dressing will be placed over the area and you will be transferred back your bed or chair.  A nurse will come down from the ward and you will be taken back there.  Once on the ward, the staff will check your pulse and blood pressure for several hours. 

Provided your pulse and blood pressure are normal, you will be allowed to go home later the same day.  The biopsy samples are sent to the laboratory where they are assessed by a pathologist.  The pathologist will send a report to your hospital doctor saying what has been found.  The results will then be discussed with you in clinic.

We advise that you do not drive home immediately after an injection.  You should arrange alternative transport.

CT scanning of pregnant women should be avoided whenever possible.

If you think you may be pregnant it is very important that you tell the nurse or radiographer before your scan.  To avoid accidental irradiation, all females between the ages of 11 and 55 years are asked the date of their last menstrual period (LMP).  From this information X-ray staff will decide if there is cause for the CT examination to be postponed or if it is safe to continue.

Like all X-ray machines, a CT scanner produces potentially harmful X-rays.  Modern equipment is designed to keep the dose to patients as low as possible.  If your doctor has asked for a scan, then he or she will have decided that the benefit of having the information that the scan gives, is greater than the risk of the small dose of radiation.  Since X-rays can harm unborn babies, if you are, or could be pregnant, please tell the radiographer or nurse before you have the scan.  This is very important.

If you need an ambulance, you must ask at your General Practitioner’s surgery to arrange one, giving them three working days notice.  Please inform the department if you are arriving by ambulance as we will arrange your appointment time to fit with ambulance arrivals.

Should you have any suggestions or concerns, please make these known to the person conducting your examination, or by letter addressed to the hospital you are attending your appointment:

Mrs J Chambers
Superintendent Radiographer (RVI/NGH)
Leazes Wing X-ray Department
Royal Victoria Infirmary
Newcastle upon Tyne
NE1 4LP
 

Tel: 0191 2825624

Mr G Hughes
Superintendent Radiographer (FH)
Main Xray Department
Freeman Hospital
High Heaton
Newcastle upon Tyne
NE7 7DN
 

Tel: 0191 2231012

Should you have any questions regarding this examination, please ring the appropriate helpline number, as above (Monday – Friday 9.00 – 5.00)

All Newcastle Hospitals: Switchboard Tel: (0191) 233 6161

 If you need to turn to someone for on-the-spot help, advice and support, please contact the Patient Advice and Liaison Service (PALS) on:

Freephone 0800-032-02-02