Many diseases, including cancer, can be detected with blood tests or seen with X-rays, computed tomography (CT) scans, magnetic resonance (MR) and other imaging techniques. When cancer is suspected, it is necessary to obtain a sample of the abnormal tissue to confirm or rule out a diagnosis of cancer. The removal of sample tissue is called a biopsy. By examining the biopsy sample, pathologists and other experts also can determine what kind of cancer is present and whether it is likely to be fast or slow growing. This information is important in deciding the best type of treatment. Traditionally, biopsy has required open surgery. With interventional radiology techniques, however, tissue samples usually can be obtained without the need for open surgery.
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Needle biopsy, also called image-guided biopsy, is usually performed using a moving X-ray technique (fluoroscopy), CT, ultrasound or MR to guide the procedure. In many cases, needle biopsies are performed with the aid of equipment that creates a computer-generated image and allows radiologists to see an area inside the body from various angles. This stereotactic equipment helps them pinpoint the exact location of the abnormal tissue.
Advantages of needle biopsy include:
- With image guidance, the abnormality can be biopsied while important nearby structures such as blood vessels and vital organs can be seen and avoided.
- The patient is spared the pain, scarring and complications associated with open surgery.
- Recovery times are usually shorter and patients can more quickly resume normal activities.
A breast biopsy using stereotactic equipment helps doctors pinpoint the exact location of abnormal tissue.
Large core needle biopsy.
In this technique, a special needle is used that enables the radiologist to obtain a larger biopsy sample. This technique is often used to obtain tissue samples from lumps or other abnormalities in the breast that are detected by physical examination or on mammograms or other imaging scans. Because approximately 80 percent of all breast abnormalities turn out not to be cancer, this technique is often preferred by women and their physicians because it:
- is less painful and requires less recovery time than open surgical biopsy
- avoids the scarring and disfigurement of the breast that may result from open surgery
A similar technique called fine needle aspiration can be used to withdraw cells from a suspected cancer. It also can diagnose fluids that have collected in the body. Sometimes, these fluid collections also may be drained through a catheter, such as when pockets of infection are diagnosed.
Reprinted with permission of the Society of Interventional Radiology © 2004, www.SIRweb.org. All rights reserved.