We provide a variety of imaging services for the doctors in the Newcastle Hospitals NHS Trust and GP’s. This leaflet is one in a series, which we hope will help to answer some of the questions you may have about the examinations that we do.

Q1. What is an Ultrasound Guided Biopsy?

A1 This test is routinely performed in the X-ray department and involves taking a small piece of tissue from the part of your body that your doctors wish to investigate. The procedure is carried out using an Ultrasound scanner to guide the Radiologist to the exact area of the body under investigation. This allows the best sample possible to be obtained.

Q2. How do I prepare for an Ultrasound Guided Biopsy?

A2. Depending on which part of the body is being examined, preparation instructions will be given out with your appointment letter.

Q3. What does the biopsy involve?

A3. You will come to the x-ray department on a wheelchair or in your bed. The staff will check your details and you will be taken into the Ultrasound 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 down on your bed or on a couch and the doctor will put some gel on your skin over the area where the biopsy will be taken. The doctor will use the ultrasound machine to decide where to put the needle. A mark will then be made on your skin and the gel will be cleared away. A sterilising solution will be used to clean your skin and local anaesthetic (see below) will be injected. This causes a brief stinging sensation and then makes the area numb. The doctor will then position the needle using the ultrasound machine to guide it into the right place. Once the doctor is happy that the needle is correctly position, the biopsy will be taken. You may hear or be aware of a 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. A nurse will come down from the ward and take you back there on your bed or chair. Once on the ward, the staff will check your pulse and blood pressure for several hours.

· Local Anaesthetic

Your radiologist will ask you to keep quite still while the injections are 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.

Q4. Will anything prevent me from having the biopsy?

A4. 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. Please see the top of this page for telephone numbers.

Q5. Where is the Ultrasound Guided Biopsy carried out?

A5. The procedure is carried out in all three Newcastle Hospital X-ray departments. Directions are as follows:

RVI - Ultrasound Room, Leazes Wing X-ray Department, 1st Floor

Access via Richardson Road entrance: Walk straight ahead, turn right at the X-ray sign then left, to report to the reception desk.
Access via Peacock Hall entrance: Walk down central corridor and turn left at the Medical School sign, follow corridor all the way round until you get to the main lifts on the right, take the lift to the 1st Floor; turn right and right again, then left, to report to the reception desk. Alternatively, if you need assistance, please ask at the Peacock Hall Reception desk for a car, which will take you there.

FRH – Ultrasound Room, Main X-ray Department

Access via main entrance – Walk straight ahead, passing all of the shops on your left, turn right then first left at the X-ray sign to report to the reception desk.

NGH – Ultrasound Room, Main X-ray Department

Access via main entrance – Walk down main corridor and turn right at the X-ray sign to report to the reception desk.

Q6. How long will it take?

A6. Depending on which part of the body is being examined, it could take between 10 – 30 minutes.

Q7 Will the biopsy hurt?

A7 The biopsy is carried out under local anaesthetic, which is administered by an injection (i.e. the area from which the sample is taken is ‘frozen’). This means it is unlikely that you will feel the sample being taken.

If you are anxious it is usually possible for you to have some sedation before the examination to help you to relax. Please ask the doctor on the ward.

Q8. Why is this necessary?

A8. By taking a small sample of tissue it is possible to obtain important information regarding your condition and also the treatment you might require. The sample obtained at the biopsy will be examined in detail under a microscope to find out what is wrong with you.

Q9. Will I suffer any side effects?

A9. Most people undergoing this test have no side effects and are able to go back to their usual activities within 12-24 hours.

Q10. What about after the biopsy?

A10. If you are an outpatient and your pulse and blood pressure are normal, you will be allowed to go home later the same day. You may be required to stay in hospital overnight for observation. This will be arranged with you beforehand. It is likely that you will be required to rest in bed for four to six hours.

The nurses on the ward will check your pulse and blood pressure regularly to make sure you are well and comfortable after the procedure.

Q11 When will I get the results?

A11. Because the sample needs to be examined in detail, the results can take up to a week. 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.

Q12. What if I have any other questions?

A12 If you require any more information regarding this procedure or have any questions, doubts or worries, please ask a member of staff. This is a teaching hospital and we sometimes have junior medical staff and trainees in our department, who may be present at the time of your examination. If you are uncomfortable with this arrangement, please inform the Ultrasound staff at the time of your appointment – this will not affect your care or treatment in any way.

Q13 What if I have any comments, suggestions or complaints?

A13 We try very hard to offer the best service we can, with the resources we have, but we appreciate constructive criticism. If you feel that the service could be improved, please contact: (Monday – Friday, between 9.00 – 5.00)

The Departmental Manager

Leazes Wing Xray Department

Royal Victoria Infirmary

Queen Victoria Road

Newcastle upon Tyne

NE1 4LP

Tel: (0191) 2825624 [RVI]

The Departmental Manager

Main Xray Department

Freeman Hospital

High Heaton

Newcastle upon Tyne

NE7 7DN

Tel: (0191) 2231012 [FRH]

All Newcastle Hospitals: Swithcboard 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

Map details: Due to the transformations of the Newcastle Hospitals, please go to the Trust web site to check for progress updates. Alternatively, please see local map details and directions on how to get to the new
Victoria Wing, RVI.

This patient information is available in large print size for people with visual impairments or partial vision. Please click on the link above to print or view the document. Alternatively, please ring the X-ray department you are attending your appointment and ask the receptionist to send you a large print-size leaflet.

Information prodcued by: Clinical Directorate of Radiology, The Newcastle Hospitals NHS Foundation Trust Reviewed: November 2009
Next Review: November 2012