US GUIDED BIOPSY

An Ultrasound-Guided Biopsy is a type of minimally invasive procedure which targets a specimen of tissue from a distinct body region using ultrasound imaging for guidance. This procedure helps determine if the specimen is benign (non-cancerous) or malignant (cancerous). 

It assists in making informed treatment decisions when lesions are found in the breast, thyroid, lymph nodes, liver, kidney, prostate, soft tissues, and even more. 

What Is an Ultrasound-Guided Biopsy? 

Ultrasound-guided biopsy locates the abnormal area and guides a needle into the exact location with the help of real-time ultrasound imaging. Thus, improving accuracy and minimizing damage done to surrounding tissues. 

Two dominant techniques are: 

• Fine Needle Aspiration (FNA): Involves using a thin needle to obtain cells or fluid. 
• Core Needle Biopsy (CNB): Accomplished using a hollow larger needle to extract the core of tissue. 

Depends on the location, size, and nature of the lesion. 

Types of Ultrasound Guided Biopsy Techniques

Fine needle aspiration (FNA) 

Remove cells by means of a thin needle 

Thyroid, lymph nodes and cystic lesions 

| Core Needle Biopsy (CNB) | Utilizes a larger needle to extract a core of tissue | Breast, liver, kidney, solid tumours | 

| Vacuum-Assisted Biopsy | Employs suction to remove a larger volume of tissue | Breast or deeper soft tissue lesions | 

| Prostate Biopsy | Performed via transrectal or trans perineal approach with ultrasound guidance | Assessment of prostate cancer | 

The following parameters are assessed during a biopsy: 

• Lesion size and shape 
• Vascularity (blood supply) 
• Depth and location 
• Surrounding structures 
• Accessibility under ultrasound 

The sample’s quality and adequacy are also monitored in real-time. 

• To verify or dismiss a diagnosis of cancer 
• To analyse a concerning mass observed during an imaging study 
• To initiates a treatment plan based on a conclusive diagnosis 
• For surveillance of recurrence or spread of the disease 
• For assessing inflammatory or infectious processes 
• As part of known cancer staging 

Who Needs an Ultrasound Guided Biopsy and When? 

Common Indicators: 

• Breast masses or other findings noticed on mammography or ultrasound imaging 
• Thyroid nodules. 
• Liver or renal tumours. 
• Palpable lymphadenopathy. 
• Prostatic nodules (transrectal ultrasound guidance) 
• Soft tissue tumours 
• Finding of concern from imaging 

Ideal Candidates: 

• Patients with focal suspicious lesions. 
• Patients with abnormal imaging. 
• Patents with histological diagnosis for verification of the disease or staging. 
• Patients for infection, inflammation or cancer assessment. 

Benefits of Choosing an Ultrasound Guided Biopsy

• Non-invasive nature of the biopsy 
• No radiation exposure 
• Short recovery 
• Extremely accurate due to real-time imaging 
• Less expensive than surgical biopsies 
• May reduce the incidence of unnecessary surgeries for non-cancerous lesions 

Conditions Diagnosed Through Ultrasound Guided Biopsy

Conditions diagnosed with the help of ultrasound-guided biopsy are: 

• Tumours (benign and malignant) 
• Inflammatory conditions 
• Abscesses or infections 
• Lymphosarcoma or secondary tumours 
• Autoimmune diseases 
• Focal liver lesions (Fibrosis or cirrhosis) 

Regulations: 

• No prior fasting unless stated on the request form. 
• Appropriate attire is comfortable clothes. 
• Stop taking anticoagulant drugs like Aspirin (consult your physician) 
• Fill the team in on. 
• Dragged Issues 
• Allergy Symptoms 
• Current Pregnancy 
• Previously performed Biopsies or Imaging's 

Pre-requisites for an Ultrasound Guided Biopsy 

• Recent diagnostic images Ultrasound, CT and MRI showing the lesion 
• Laboratory results for clotting assessment (INR, PT, aPTT) 
• Consent documents completed prior to the intervention 
• Clinical notes along with current medications 

Ideal Timing for an Ultrasound Guided Biopsy 

Breast biopsy procedures are performed based on imaging results, the patient's condition, and other more urgent factors. There is no prescribed hour for conducting the procedure. For menstruating women, breast biopsies are sometimes performed in the latter half of the cycle for ease. 

Eligibility and Exclusion Criteria for Ultrasound Guided Biopsy 

Adequate Considering: 

• Any patient with a targetable lesion 
• Patients who are immunocompetent or immunocompromised 
• Patients who are medically stable 

Contraindicative Factors 

• Patients who suffer with unsupervised bleeding disorders 
• Individuals who are unable to remain motionless 
• Lesions not efficiently viewed at/or through ultrasound 

In these alternative instances, a surgical or CT-guided biopsy can be done.  

Ultrasound Guided Biopsy Procedure Step-by-Step 

Detailed Phased Outline: 

1. Positioning: You will be asked to lie back comfortably. 
2. Surgical site antisepsis: Cleaning the surgical site with antiseptic 
3. Initial anaesthesia application: Placed over the identified region of interest 
4. Lesion Localization through Ultrasound Scan: Ultrasound for lesion localization. 
5. Needle Insertion: Under ultrasound guidance, the needle is carefully advanced to the lesion. 
6. Tissue harvesting: Cells or tissue slicing can be done. 
7. Post-procedure Compression: To reduce the amount of bleeding or bruising noted. 
8. Dressing: Applies a sterile covering on the wound site. 

Duration: 

• Generally, the operation lasts between 15 to 30 minutes. 
• Post procedure, the observation period is for 30-60 minutes. 

Precautions Before and After an Ultrasound Guided Biopsy 

Preface: 

• Disclose to your physician all medications and allergies that may affect the procedures so that the treatment plan may be adjusted accordingly. 
• Do not use antithrombotic or NSAIDs, as ordered. 
• Confirm that a designated person is radially ready. You cannot be put under anaesthesia by yourself. 

From: 

• Bruising is usually correlated with pain and slight discoloration. 
• For safety reasons, it is advised that you exercise common sense restraint and refrain from physically demanding movements for a day. 
• Visually examine the biopsy cutoff for any discoloration, inflammation, or secretion. 
• So, you do not end up in a situation of great discomfort, consult a medical practitioner if you sustain fever, intense discomfort, injury.