Prof. Dr. Rahmi Çubuk

Biopsies

Biopsies

What is a percutaneous biopsy, and how is it performed?


A percutaneous (through the skin) biopsy involves inserting a needle through the skin to collect a small tissue sample from a specific part of the body. During the procedure, radiological tools such as ultrasonography or computed tomography are used to assist the process. This allows the interventional radiologist to visualize the lesion and collect tissue directly from it with precision.

Most of the time, a biopsy is sufficient for diagnosis, eliminating the need for open surgery.

 

What is the purpose of a percutaneous biopsy?


A biopsy is performed to determine whether a lesion is benign or malignant.
If the lesion is malignant, the collected tissue is analyzed to identify subtypes that guide treatment decisions.

Additionally, a biopsy can be used to:

  • Identify tumor markers and cell types.
  • Analyze tumor mutation status.
  • Evaluate patients with suspected or known infections.
  • Determine the nature and extent of diffuse or systemic diseases.

 

How does a biopsy benefit me ?

A percutaneous biopsy allows for safe and accurate sampling from even very small tissues. It spares patients from more invasive surgical biopsies that often require longer hospital stays and recovery times.
The results of a biopsy help your doctor diagnose the disease, determine its severity, and create a tailored treatment plan.

 

How should I prepare for a biopsy ?

Most percutaneous biopsies require minimal preparation and are performed in an outpatient setting.

  • You may be asked to refrain from eating or drinking for 6–8 hours before the procedure.
  • Inform your doctor about any medications you are taking, as some (especially blood thinners) may need to be adjusted or temporarily stopped.
  • Blood tests may be conducted prior to the procedure.
  • It is advisable to have someone accompany you to take you home afterward. If sedation is used, having a companion is mandatory.

The biopsy procedure

The biopsy is usually performed under imaging guidance, using ultrasonography, computed tomography (CT), or fluoroscopy (real-time X-rays). The interventional radiologist reviews prior imaging studies (e.g., CT, MRI, or PET-CT scans) to locate the lesion and determine the safest and shortest path for the biopsy.

In some cases, a small catheter may be placed in a vein in your arm or hand for administering medications.

The area is positioned appropriately, and the skin is sterilized. Local anesthesia is injected into the skin and underlying tissue. Sometimes, sedative or pain-relieving medications are administered intravenously.

A biopsy needle is inserted, and a small tissue sample is collected. Your doctor will give you instructions during the procedure (e.g., holding your breath) that you need to follow. In most cases, multiple tissue samples are taken.

In some situations, the interventional radiologist may use a guide needle to inject medications and reduce the risk of bleeding at the end of the procedure. Bleeding is usually short-lived and can be controlled with gentle pressure. The entry site is covered with a small bandage.

In some cases, imaging may be required after the procedure. Tissue samples are then prepared and sent to a laboratory for analysis.

After the biopsy, patients are observed in the hospital for a specific period. If the patient’s overall condition is stable, they will be discharged.

What are the risks of a biopsy ?

Percutaneous biopsy is a safe procedure with a low complication rate. Potential risks include:

  • Localized bruising.
  • Bleeding (usually short-term).
  • Infection.
  • Perforation.
  • Unintended damage to neighboring organs.
  • Tumor seeding.
  • Procedural failure.

Every patient and case is unique. Your doctor will provide detailed information specific to your biopsy and answer your questions.

What happens after the procedure ?  What is the follow-up plan ?

You will quickly regain your physical and cognitive abilities after sedation.

  • You may be required to stay in the hospital for 1–6 hours and remain under observation.
  • To prevent complications, you might need to stay in a specific position for several hours.
  • For procedures with a higher risk of bleeding (e.g., kidney biopsies), blood tests may be needed.
  • If your doctor has any concerns, you may be asked to stay in the hospital overnight.

You will need a follow-up appointment with your doctor to review your biopsy results and determine whether further treatment is necessary.