Fluoroscopic guided biopsy / aspiration Patient information leaflet (182kB pdf)
Introduction
We hope this guide will answer your questions about your fluoroscopic guided biopsy / aspiration procedure. Please contact the team if you require further information via the details at the end of this leaflet.
What is a fluoroscopic guided biopsy / aspiration procedure?
Fluoroscopic guided biopsy / aspiration is a procedure that uses radiation to produce an image to guide a needle into the exact area where the biopsy / aspiration is needed. A contrast medium (an iodine based solution often known as x-ray dye) is used to demonstrate the area on the x-ray.
Who will be doing the fluoroscopic guided biopsy / aspiration procedure?
The examination is carried out by a Consultant Radiologist (special interventional x-ray doctor), a radiographer (person who takes the x-ray images) and the radiology nursing team.
What are the associated risks?
X-Ray radiation: All x-ray procedures involve exposure to radiation in varying amounts. The dose you get from a medical x-ray is very low and your doctor along with the radiologists have determined that the benefits of having the examination outweigh potential risks. The radiographer is present throughout your test making sure that the radiation dose is kept as low as reasonably possible and the duration and level of x-rays are kept to a minimum.
Contrast medium: A very small number of patients have an allergic reaction to the contrast medium (x-ray dye). This can be minor, severe, or even life threatening but the chances of this occurring are very rare. If you get an itchy rash or difficulty breathing during the procedure tell a member of staff, the team will provide appropriate treatment. Before your examination begins the radiographer will ask you a series of questions about your medical history, including any allergies you may have. This will help us assess if you are at risk of an allergic reaction to the x-ray dye.
Procedure: Small risk of infection, against which we will take all precautions. If a biopsy is being performed there is a small risk of bleeding around surrounding tissues, however this will be identified using ultrasound and x-rays.
Patients aged 12 to 55, could you be pregnant? X-rays can be harmful to an unborn
baby and should be avoided by patients who are or may be pregnant. It is recommended that the examination is performed within 10 days of the first day of your menstrual period. If your appointment is not within this time or if you think you may be pregnant, please contact the X-ray department before your appointment. When you arrive for your Angioplasty, you will be asked when your last period started. If it is more than 10 days earlier, your appointment may be postponed.
Preparing for your procedure
The biopsy will take place in the Interventional Radiology room (part of the radiology department). Your biopsy can either be undertaken as an inpatient or outpatient. You may have some blood tests prior to the biopsy to check you do not have an increased risk of bleeding. If you are taking any blood thinning medications, like warfarin, Aspirin, Rivaroxaban, Dabigatran, Apixaban, Edoxaban or Clopidogrel , Ticagrelor you should inform your doctor before the procedure. You may be asked not to eat for four hours before the procedure, although you may still drink clear fluids such as water. Please leave any jewellery or valuables at home. Please contact the booking team before your appointment if:
- you are or think you may be pregnant
- you have had a previous allergic reaction to contrast medium (X-ray dye) or are allergic to iodine.
- you weigh over 30 stone/190 kilograms
- you plan on using hospital transport or need a hoist to transfer
- you require an interpreter – please inform us as soon as you receive your appointment letter, and we will arrange an interpreter for you
If you are unsure or have questions about your preparation, contact your doctor or the X-ray department for advice.
Allergies
If you have any allergies you must inform your doctor. If you have previously reacted to contrast medium (the dye used for CT imaging) you must tell your doctor about this.
Medication
Please contact the radiology department if you are taking blood thinning medication (anti coagulants) such as Warfarin, Aspirin, Rivaroxaban, Dabigatran, Apixaban, Edoxaban or Clopidogrel, Ticagrelor. You may be asked to stop or be given alternative medication.
Getting to us
Once you have arrived at The Princess Alexandra Hospital (Hamstel Road, Harlow, Essex,
CM20 1QX), follow the signage to the radiology reception, which is located on the ground floor, green zone. Please let the radiology receptionist know that you have arrived for your appointment.
When should I arrive?
Please arrive in the radiology department at your given appointment time. A notification
through text or letter should have been sent to you to confirm this appointment.
Can someone stay with me in hospital?
You may have a friend or relative attend with you, but they will be asked to stay in
the waiting area while you have your procedure.
Children are not allowed in the waiting area unattended. Our staff are not permitted to
supervise children, so please ensure child care arrangements are in place to avoid your
tests being rescheduled.
The day of the procedure
You will be shown to a cubicle and asked to undress and put on a gown; please bring a dressing gown if you have one. You may also be asked to remove jewellery, dentures, glasses, or other metal objects, which may show up on the X-rays.
The procedure
Your identification will be checked by a nurse and radiographer, a brief history will be taken; please tell the radiologist what medication, severe allergies, choking episodes or other medical conditions, such as thyroid disease and diabetes you may have. Before the procedure, the interventional radiologist will explain the procedure and ask you to sign a consent form. Please feel free to ask any questions that you may have and, remember that even at this stage, you can decide against going ahead with the procedure if you so wish. You will lie on the scanning table, either on your back or on your stomach. You may need to have a needle (cannula) put into a vein in your arm so that we can give any necessary medication such as sedation or pain-killers during the procedure. The procedure is performed under sterile conditions and the radiologist performing the procedure will wear sterile gloves and, in some cases, an operating gown. X-ray images will be performed to determine the best site to perform the aspiration / biopsy; it is likely that ultrasound will also be used to identify areas of interest. The skin of the appropriate area will then be cleaned with cold antiseptic skin preparation, and the surrounding area covered with sterile towels. Your skin will then be anaesthetised with local anaesthetic before a fine needle is passed through the skin into the abnormal area of tissue or fluid collection. Samples will then be taken and sent for analysis. If a large fluid collection is identified it may be necessary to insert a small tube attached to a bag in order to drain the fluid. Your nurse, radiographer and radiologist will be with you the whole time during the procedure and will explain what is happening or what you need to do on the day. If you have any questions or concerns, it is OK to ask.
How long will this take?
This will depend on the situation and type of biopsy. The procedure may take over 30 minutes, although you will be in the department for a longer period to ensure no there have been no complications.
Is it uncomfortable?
This procedure is not painful but, it can be uncomfortable and unpleasant.
After the procedure
Depending on the type of biopsy you may be asked to stay in bed for a few hours until you have recovered. A nurse will carry out routine observations, such as taking your pulse and blood pressure, to make sure there are no problems. If you have any pain following the procedure, we may give you some pain-relief medication. Depending on the biopsy you may have to stay in hospital overnight. This can be discussed with the doctors looking after you. Do not expect to get the result of the biopsy before you leave, as it will always take a few days for the pathologist to do all the necessary tests on the biopsy specimen.
Can I drive after my procedure?
We recommend that you do not drive for twenty-four hours and you ask a friend or relative to drive you home following your procedure
How soon can I return to work?
We recommend you do not undertake strenuous activity and rest for the remainder of the
day.
What do I do if I feel unwell after I have gone home?
If you feel unwell after your procedure, you should seek medical advice from your GP/ hospital doctor or through the emergency department and inform them that you have had a procedure.
Follow up
You will have a follow-up appointment with your doctor to discuss the results of your biopsy / aspiration. Sometimes the biopsy is not successful in obtaining the required tissue, or there was not enough normal tissue for the pathologist to make the diagnosis. In this case you may be recalled to have another biopsy.
Contacting the team
- If you have any further questions about your procedure or an existing appointment, please contact the radiology department (Monday to Friday, 9am to 4pm) at 01279 82 2527 or 3405
- If you have any queries outside of working hours (after 4pm and on weekends), you will be redirected to the main radiology reception. Please note appointment bookings cannot be made during this time.
Your feedback matters
- If you would like to give feedback on your care, please contact our patient experience team at [email protected] or01279 827211.
- Please contact the communications team at [email protected] if you would like this leaflet in another language or format.