Prof. Dr. Rahmi Çubuk

Biopsies

Biopsies

What is biopsy with interventional radiology, and how is it performed ?


Biopsy in interventional radiology is also known as percutaneous biopsy, meaning a biopsy performed through the skin.

In a percutaneous biopsy, the procedure is done by inserting special needles through the skin. Unlike surgery, there is no incision on the skin, and the abdomen or chest cavity is not opened with a scalpel.

To ensure the patient does not feel pain, local anesthesia is applied to the skin and underlying tissue where the procedure will take place.

Radiological devices like ultrasonography and computed tomography are used during the procedure to visualize the diseased tissue. These devices help guide the process to take a sample precisely from the diseased area (not blindly ! ).

Thanks to this visualization, diagnosis can be made accurately and quickly without cutting or excessive intervention, saving valuable time for treatment.

A percutaneous biopsy involves taking a sample through the skin, followed by diagnosis.
There is no need for surgery to make the diagnosis.

What is the purpose of a biopsy?

A biopsy is performed to sample abnormal tissues observed as swelling or seen in various imaging tests in the body.

The biopsy determines whether the lesion is benign or malignant.

If the lesion turns out to be malignant, the sample is used to determine the cancer’s subtype. This classification allows for the most accurate and up-to-date treatment for the patient.

You performed a biopsy and took a sample. What happens to these samples afterward ?

The collected biopsy samples are placed in appropriate containers and sent to a pathology laboratory for examination.

It is worth emphasizing the importance of a quality pathology laboratory. The process does not end with sample collection. These samples are examined under a microscope by a pathologist to provide a definitive diagnosis.

Based on this diagnosis, the disease is treated either with medication or surgery. It’s like buttoning up the first button correctly—hence, the pathology center is of critical importance.

The pathology laboratory must be well-known, reputable, and experienced in oncology. Additionally, it should have the necessary equipment to store the samples for many years.

Therefore, I ensure that the samples I take are evaluated in the best and most reliable pathology centers in the country. I also advise patients to pay close attention to this aspect.

Is preparation needed for a biopsy procedure?

In most cases, very little preparation is required for a percutaneous biopsy.

The procedure is performed in a hospital or clinical outpatient setting.

You may be asked not to eat or drink anything for 6–8 hours before the procedure.

Your current medications will be reviewed before the procedure.
The dosage of certain medications may need to be adjusted, or blood-thinning drugs may need to be temporarily discontinued.

Blood tests may be conducted if necessary. It is also advisable to have someone accompany you and take you home after the procedure.

Is a biopsy performed in an operating room?

A biopsy is typically conducted in an ultrasonography, computed tomography, or fluoroscopy suite with the help of these devices. An operating room is usually not required.

Before the procedure, previously taken imaging tests such as US, CT, MRI, or PET-CT scans are reviewed to determine the exact location of the lesion and the safest biopsy route.

The patient is positioned appropriately on the procedure table.
The skin is sterilized, and local anesthesia is applied to the skin and subcutaneous tissue.
In some cases, sedative and/or pain-relieving medications may be administered intravenously.

The biopsy needle is inserted, and a small tissue sample is collected.
Post-procedure bleeding is usually brief and can be controlled with pressure applied with a fingertip.
The entry site is covered with a small bandage.
In some cases, imaging may be necessary after the procedure.

The patient is observed in the hospital for a certain period after the biopsy. If the patient’s overall condition is stable, they will be discharged.

What are the risks of a biopsy?
A percutaneous biopsy is a safe procedure with a low complication rate. Possible complications include localized bruising, bleeding (usually brief), infection, perforation, unintended damage to neighboring organs, tumor seeding, or procedural failure.

Every patient and case is unique. Your doctor can provide you with more detailed information about your biopsy and answer your questions.

 

Is biopsy with interventional radiology risky?

Since very thin needles (similar to needles used in intramuscular injections) are generally used, the risks of bleeding and infection are minimal.

The use of advanced devices like ultrasonography and computed tomography ensures that any potential complications are immediately detected and addressed, enabling patients to recover and be discharged in good health.

 

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

You may be required to stay in the hospital and be monitored for 1 to 6 hours. To prevent complications, you may need to remain in a specific position for a few hours.

In some cases (e.g., patients with a high risk of bleeding), you may be hospitalized for one night following the procedure for observation.

How long does it take to get biopsy results?  What should I do with the results?

Biopsy results are typically available within 5–7 days. For some complex diseases, this duration may be longer.

The pathology results from interventional radiology biopsies should be taken to the doctor who requested the biopsy. If this is not possible, the interventional radiologist will inform you about which doctor to consult next.