CT GUIDED FNAC

A CT Guided Fine Needle Aspiration Cytology, commonly known as a CT Guided FNAC, is a highly precise and minimally invasive diagnostic procedure. It is performed by an interventional radiologist to obtain a sample of cells from a specific, often deep-seated, lesion or mass within the body. By combining the detailed imaging of a CT scan with the accuracy of a fine needle, doctors can investigate abnormalities without the need for open surgery. This test is crucial for providing a definitive diagnosis that guides subsequent medical treatment.

At Cadabams Diagnostics, we utilize advanced imaging technology and expert care to ensure your CT Guided FNAC is performed safely, accurately, and with minimal discomfort.

What is a CT Guided FNAC?

To understand a CT Guided FNAC, it's helpful to break down the term. A CT (Computed Tomography) scanner uses X-rays and a computer to create detailed, cross-sectional images of the inside of your body, like virtual slices. These images allow the radiologist to see the exact size, shape, and location of the target area.

During the procedure, this real-time imaging "guides" a very thin, hollow needle through the skin to the precise location of the lesion (e.g., a nodule in the lung, a mass in the liver, or an enlarged lymph node). Once the needle is correctly positioned, a syringe is used to "aspirate," or gently suction out, a small sample of cells and fluid. This sample is then sent to a pathologist for microscopic analysis. It is important to remember that a CT guided FNAC is purely a diagnostic test designed to provide information; it is not a form of treatment.

Types of CT Guided Biopsies

The primary focus of this page is the CT Guided FNAC, which involves collecting a sample of individual cells for cytological analysis.

However, it's useful to know about a related procedure:

• CT Guided Core Needle Biopsy: This procedure uses a slightly larger needle to remove a small, solid cylinder of tissue instead of just cells. A core biopsy provides more architectural detail of the tissue and is often performed if an FNAC result is inconclusive or if a specific type of diagnosis requires a larger tissue sample.

The procedure is also often named based on the organ being targeted, such as a CT Guided Lung FNAC, CT Guided Liver FNAC, or CT Guided Pancreatic FNAC.

The success of a CT Guided FNAC relies on careful consideration of multiple parameters by both the radiologist performing the test and the pathologist analyzing the sample.

During the Procedure (Radiologist's Focus)

• Lesion Characteristics: The precise location, size, and depth of the target mass or nodule.
• Needle Pathway: Determining the safest and shortest path for the needle to travel from the skin to the lesion, carefully avoiding major blood vessels, other organs, and vital structures.
• Needle Tip Confirmation: Using the CT scanner to confirm in real-time that the tip of the needle is accurately placed within the target lesion before aspirating the sample.

After the Procedure (Pathologist's Focus)

• Cellularity and Sample Adequacy: Assessing if enough cells were collected for a reliable diagnosis.
• Cell Type: Identifying the origin of the cells (e.g., epithelial, lymphoid, mesenchymal).
• Cellular Morphology: Examining the size, shape, and appearance of the cell nuclei and cytoplasm for any abnormalities.
• Diagnostic Findings: Looking for the definitive presence of malignant (cancerous) cells, atypical cells, benign cells, or evidence of specific infections or inflammation.

There are several compelling reasons why your doctor would order this test:

• To Achieve a Definitive Diagnosis: The primary goal is to determine if a tumor or mass is benign (non-cancerous) or malignant (cancerous).
• To Guide Treatment: If cancer is found, the results can help identify the specific type, which is crucial for planning the most effective treatment (e.g., chemotherapy, radiation, surgery).
• To Diagnose Infections: The test can identify infectious organisms causing abscesses or conditions like tuberculosis.
• To Avoid Major Surgery: It provides a diagnosis in a minimally invasive way, often preventing the need for a more complex and higher-risk surgical biopsy.

When and Who Needs to Take a CT Guided FNAC?

Your doctor may recommend a CT Guided FNAC if a previous imaging test—such as an X-ray, ultrasound, or a standard CT scan—has revealed a suspicious or unexplained finding. It is the definitive next step to understand the nature of an abnormality.

Common indications include:

• Investigating suspicious nodules or masses found in organs like the lungs, liver, pancreas, adrenal glands, kidneys, or retroperitoneum.
• Diagnosing abnormalities in deep-seated lymph nodes that are not accessible by other means.
• Evaluating lesions in bones.
• Determining the cause of symptoms when a deep, internal lesion is suspected but cannot be easily seen or felt from the outside.

Benefits of Taking the Test

Opting for a CT Guided FNAC offers significant advantages for patients:

• High Accuracy: It has a very high diagnostic accuracy rate for many types of cancers and other conditions.
• Minimally Invasive: It involves only a small needle puncture, resulting in less pain, a smaller scar, and a quicker recovery compared to open surgery.
• Safety: The risks of major complications are very low when performed by an experienced team.
• Outpatient Procedure: In most cases, it is performed as an outpatient procedure, meaning you can go home the same day.

Illnesses Diagnosed with CT Guided FNAC

This powerful diagnostic tool can help identify a wide range of medical conditions, including:

• Cancers:
  • Lung Cancer
  • Liver Cancer (Hepatocellular Carcinoma)
  • Pancreatic Cancer
  • Kidney Cancer (Renal Cell Carcinoma)
  • Lymphomas and Sarcomas
• Metastatic Disease: It can confirm if cancer has spread to other organs (e.g., from the colon to the liver).
• Infections: It can diagnose deep-seated abscesses or specific infections like tuberculosis.
• Benign Conditions: It helps confirm that a mass is non-cancerous, such as a benign tumor or an inflammatory pseudotumor, providing peace of mind.

Proper CT guided biopsy preparation is essential for the safety and success of the procedure. The team at Cadabams Diagnostics will provide you with detailed instructions, but here are the general guidelines.

Specific Instructions

• Fasting: You will likely be asked not to eat or drink anything for 4 to 6 hours before your scheduled appointment.
• Medication Review: It is crucial to inform your doctor and our staff about all medications you take, especially blood thinners like Aspirin, Warfarin (Coumadin), Clopidogrel (Plavix), Rivaroxaban (Xarelto), or other anticoagulants. You will be given specific instructions on when to stop taking these medications before the procedure.
• Transportation: You will not be allowed to drive yourself home after the procedure due to the effects of sedation or discomfort. Please arrange for a friend or family member to drive you.
• Clothing: Wear comfortable, loose-fitting clothing to your appointment.

Pre-requisites

• A valid referral from your doctor is required to schedule the procedure.
• You may need to have recent blood tests done, particularly a Prothrombin Time (PT/INR) and Partial Thromboplastin Time (PTT), to check how well your blood clots.
• Please bring all your previous imaging reports and CDs (X-ray, CT, MRI, Ultrasound) with you so the radiologist can review them.

Best Time to Take the CT Guided FNAC

A CT Guided FNAC is not an emergency test. It is a scheduled procedure that can be performed on any working day based on an appointment with our interventional radiology department. You can book a time that is convenient for you by contacting us at [Link to: Schedule an Appointment].

Eligibility

Most patients who have a suspicious, deep-seated lesion that requires diagnosis are eligible for a CT Guided FNAC.

However, there are some contraindications:

• A severe, uncorrectable bleeding disorder.
• Inability to lie still for the duration of the procedure (approximately 30-60 minutes).
• If there is no safe path for the needle to reach the lesion without passing through a vital organ or major blood vessel.

Procedure for Taking a CT Guided FNAC

Understanding the step-by-step process can help alleviate any anxiety. Here is what you can expect during your CT guided fine needle aspiration procedure at Cadabams Diagnostics.

1. Arrival and Prep: You will be asked to change into a hospital gown. A nurse may place a small intravenous (IV) line in your arm.
2. Positioning: You will be helped onto the CT scanner table. Depending on the location of the lesion, you may be asked to lie on your back, stomach, or side.
3. Initial Scan: A preliminary CT scan is performed to precisely locate the lesion and plan the safest needle path.
4. Numbing the Area: The radiologist will clean the skin over the target area with an antiseptic solution. Then, a local anesthetic will be injected with a tiny needle to numb the skin and deeper tissues. This may sting for a moment.
5. Needle Insertion: Using the CT images as a live guide, the radiologist will carefully insert the fine aspiration needle through the numbed skin and advance it toward the lesion. You may feel a sensation of pressure.
6. Collecting the Sample: Once the needle tip is confirmed to be in the correct position, a syringe is attached, and a small sample of cells is gently aspirated. During this part, which only takes a few seconds, you may be asked to hold your breath to keep the area perfectly still.
7. Completion: The needle is quickly removed, and firm pressure is applied to the site to prevent bleeding. A small bandage is placed over the puncture site.
8. Duration: The entire CT guided FNAC procedure typically takes between 30 and 60 minutes.
9. Post-Procedure Monitoring: After the procedure, you will be moved to a recovery area and monitored for a few hours to ensure there are no immediate complications before you are discharged.

Caution Before Taking the Test

For your safety, it is absolutely essential that you share the following information with our staff at Cadabams Diagnostics before your procedure:

• Allergies: Any known allergies, especially to local anesthetics, iodine, or contrast dye (though contrast is not typically used for a standard FNAC).
• Pregnancy: Inform the doctor and technologist if you are or think you might be pregnant.
• Medications: Provide a complete list of all medications, including over-the-counter drugs, vitamins, supplements, and herbal remedies. Pay special attention to blood thinners.
• Medical History: Mention if you have a history of bleeding disorders or problems with your kidneys.