CT guided needle biopsy (lung)

Who is this leaflet for? What is its aim?

This leaflet is to provide clarity for those patients undergoing a CT guided needle biopsy.

What is a CT guided lung needle biopsy?

A guided needle biopsy is a procedure that takes a small sample of cells (biopsy) from the lung tissue for further analysis. The CT scanner allows the radiologist (x-ray doctor) to accurately locate the best place to access the sample required. The sample is obtained by inserting a needle into the lung, using local anaesthetic and extracting a small sample of cells.

Why do I need a biopsy?

Previous investigations, such as a chest x-ray, have suggested an area within the lung needs further examination. A lung biopsy can help diagnose the problem which will help the doctor to discuss with you whether you need further treatment.

Preparing for the procedure

In the morning you can have a light breakfast and tea / coffee before 07:00. Please take your usual medication. Those taking warfarin, aspirin or diabetic medication should have received specific instructions, if you are unsure please phone either your nurse specialist or the radiology department.

The procedure is planned to be undertaken as a day case, with approximately a four hour recovery, you will not be able to drive home and will require someone to stay with you overnight that night. Occasionally however, you may be asked to stay in hospital that night so please bring an overnight bag in with you.

What will happen?

You will be advised where to report to prior to the day of the biopsy (usually beds are allocated via G2 or on the radiology day unit), from here you will be taken to the radiology department. Just before the biopsy is taken a CT scan of your chest will be performed. Once the exact location of the sample site has been identified your skin will be cleaned and a local anaesthetic injected to numb the area. The local anaesthetic may sting a little for a short period of time. Following this the biopsy itself should not be painful, but may be uncomfortable. Often the radiologist will take three or four biopsies from the same area.

Once the procedure has finished you will go back to the ward, where you will recover and lie on your side for an hour. Shortly after this you will be able to eat and drink. A chest x-ray will be performed approximately four hours after the biopsy prior to you going home.

The results will be discussed with you once they are ready, five to seven days after the procedure.

Are there any risks or complications?

A needle biopsy is considered a safe procedure, although a common complication is a pneumothorax. This is where air can enter the chest cavity during the procedure causing part of the lung to collapse. A small pneumothorax, which can occur in up to 25% of cases does not require any intervention and repairs independently. However, a larger leak may require a drain to be inserted and occurs in approximately 5% of patients. This drain withdraws the trapped air allowing the lung to re expand. Insertion of a chest drain would require an overnight hospital stay. You may require admission for a few days, until it is safe to remove the chest drain, but this is rare.

After the procedure some people cough up a small amount of blood. This should not be a cause for concern and should settle within a day or so. However, if it persists and you feel unwell or are unsure then please contact your GP.

The biopsy site itself may feel a little sore which is to be expected and should settle after a few days. Occasionally there may also be bleeding from this area, if this doesn’t resolve after a period of ten minutes of applied pressure or you feel unwell or faint, please seek urgent medical attention.

Alternatives?

It is possible to take a biopsy using a bronchoscope (a long narrow flexible tube) which is passed through the nose or mouth to reach the lungs. A biopsy can also be taken using a surgical procedure to reach the lung tissue. Your doctor will explain to you the reasons a needle biopsy has been chosen as opposed to the alternative options and will happily discuss these with you.

Contacts / further information

For further information please feel free to contact your nurse specialist or the CT department.

References / sources of evidence

BTS Guidelines for radiologically guided lung biopsy. Thorax (2003) 58: 920-936.

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.