Biopsy Overview and Lung Nodule Procedures

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Questions and Answers

What is the primary purpose of using MRI guidance in breast biopsies?

To visually assist during the excision

To enhance the imaging quality

To administer local anesthesia

To calculate the position of the abnormal tissue (correct)

Which of the following statements about breast biopsies is accurate?

They are only done on patients with breast cancer.

They can be performed on an outpatient basis. (correct)

They are always performed in a hospital setting.

They require general anesthesia.

During the procedure, how is the affected breast positioned?

It is elevated above the chest.

It is placed under direct sunlight for visibility.

It is rotated to 90 degrees.

It is compressed between compression plates. (correct)

What is injected into the breast to numb it before the biopsy?

A local anesthetic Signup and view all the answers

Which method does NOT involve the withdrawal of the needle during sample collection?

Vacuum-assisted device (VAD) Signup and view all the answers

How many tissue samples are typically collected using a vacuum-assisted device?

Eight to ten samples Signup and view all the answers

What is the role of gadolinium in the breast biopsy process?

It helps in visualizing the lesions during MRI. Signup and view all the answers

Which professional is primarily responsible for performing MR-guided breast biopsies?

Radiologist Signup and view all the answers

What is the primary characteristic of a traditional MRI unit?

It is a large cylinder-shaped tube surrounded by a circular magnet. Signup and view all the answers

Which type of MRI system is specifically designed for patients who are fearful of enclosed spaces?

Open MRI system Signup and view all the answers

How does MRI differ from traditional x-ray examinations?

MRI relies on radio waves and a strong magnetic field. Signup and view all the answers

What is a potential disadvantage of older open MRI units?

They may produce lower quality images. Signup and view all the answers

What is the role of the computer workstation in an MRI procedure?

To process the imaging information and create images. Signup and view all the answers

Why is MRI often preferred for differentiating abnormal tissues compared to other modalities?

MRI does not use any form of radiation. Signup and view all the answers

What technology in MRI units helps to send and receive radio waves?

Wire coils Signup and view all the answers

In a majority of MRI-guided breast biopsies, which type of MRI system is typically used?

Closed MRI system Signup and view all the answers

What is the primary purpose of a breast biopsy?

To determine whether a growth is benign or cancerous Signup and view all the answers

Which type of biopsy is employed when the abnormal area in the breast cannot be felt?

Image-guided needle biopsy Signup and view all the answers

What imaging technique is used to assist in MRI-guided breast biopsies?

Magnetic resonance imaging (MRI) Signup and view all the answers

Which type of biopsy uses a small needle to extract fluid or cells from the abnormal area?

Fine needle aspiration (FNA) Signup and view all the answers

What should you inform your doctor about prior to a needle biopsy?

All medications and allergies, especially to anesthesia Signup and view all the answers

Which of these biopsy procedures allows for the collection of multiple tissue samples during one insertion?

Vacuum-assisted device (VAD) Signup and view all the answers

Which piece of equipment is commonly involved in needle biopsies to assist with tissue collection?

Guide wire Signup and view all the answers

What is a precaution recommended for patients before undergoing a biopsy procedure?

Stop taking blood thinners or aspirin three days prior Signup and view all the answers

What characterizes a lung nodule?

Round lesions detected on a chest x-ray Signup and view all the answers

Which imaging technique is commonly used to guide needle biopsies?

Fluoroscopy, CT, or ultrasound Signup and view all the answers

What type of needle biopsy involves using a fine gauge needle and a syringe?

Fine needle aspiration Signup and view all the answers

What is an advantage of needle biopsies compared to open surgery?

They minimize pain and scarring Signup and view all the answers

What is the typical complication rate for needle biopsies?

Less than 1 percent Signup and view all the answers

When performing a needle biopsy, how should the patient be positioned?

Prone or supine depending on entry site Signup and view all the answers

What kind of equipment aids in performing needle biopsies more accurately?

Stereotactic imaging equipment Signup and view all the answers

What is the primary purpose of inserting a wire during a surgical biopsy?

To guide the surgeon to the suspicious area Signup and view all the answers

What sensation is typically reported by women during the biopsy procedure?

A slight pin prick from the local anesthetic Signup and view all the answers

What should be done if a patient experiences swelling and bruising after a biopsy?

Use a cold pack and an over-the-counter pain reliever Signup and view all the answers

What should patients avoid for 24 hours following their biopsy procedure?

Strenuous activity Signup and view all the answers

What is the expected duration of the biopsy procedure?

45 minutes Signup and view all the answers

Why is there usually no need for sutures after the biopsy?

Pressure is applied to stop bleeding Signup and view all the answers

What should patients do if they experience excessive swelling or bleeding post-biopsy?

Seek medical advice from their physician Signup and view all the answers

Which organization suggests that it is safe to continue breastfeeding after receiving intravenous contrast?

American College of Radiology (ACR) Signup and view all the answers

What option can a mother choose if she is concerned about the effects of gadolinium contrast medium on breast-feeding?

Temporarily abstain from breast-feeding for 24 hours and express milk. Signup and view all the answers

What is one of the advantages of MRI-guided breast biopsy compared to surgical biopsy?

It is less invasive and can be performed quickly. Signup and view all the answers

What is the likelihood of experiencing a significant discomfort during an MRI-guided breast biopsy?

It is rare and manageable with over-the-counter medication. Signup and view all the answers

What is a potential risk associated with the vacuum-assisted device used in MRI-guided breast biopsy?

Bleeding and hematoma formation. Signup and view all the answers

Which of the following is a limitation of MRI-guided breast biopsy?

It may carry a risk of the needle passing through the chest wall. Signup and view all the answers

What advantage does MRI-guided vacuum-assisted breast biopsy have over stereotactic biopsy?

Avoids ionizing radiation exposure. Signup and view all the answers

Which statement about MRI is accurate?

MRI is a noninvasive imaging technique. Signup and view all the answers

What is the risk of infection after an MRI-guided breast biopsy?

Less than one in 1,000. Signup and view all the answers

Study Notes

Biopsy Overview

Biopsy procedures aim to gather tissue samples for analysis.
Different types of biopsies exist, each with distinct purposes.
Needle biopsies are often image-guided using techniques like fluoroscopy, CT, ultrasound, or MRI, which help physicians pinpoint the exact location of the abnormal tissue.
These biopsies are usually performed as outpatient procedures with relatively low rates of complications.

Needle Biopsy of Lung Nodules

Lungs are conical-shaped organs for respiration.
They extend from the first rib to the diaphragm.
Lung nodules are round or abnormal tissue areas in the lung.
These are often detected via chest X-rays without causing pain or other symptoms.

Indications for Lung Biopsies

Lesions on chest radiographs are a key indicator.
Multiple nodules in patients without known malignancy, or those in prolonged remission.
Persistent focal infiltrates of lung tissue where no diagnosis can be arrived at via other methods.
A hilar mass is another indication to conduct a lung biopsy

Contraindications for Lung Biopsies

Abnormalities in lung function (e.g., respiratory failure), including mechanical ventilation.
Arterial and venous pulmonary hypertension.
Coagulation abnormalities are contraindications.

Types of Needle Biopsies

Fine needle aspiration uses a small needle and syringe to draw out fluid or cell clusters from the tissue.
Core needle biopsy involves an automated mechanism to insert the needle, filling receptacles with tissue cores. A sheath then cuts the tissue and keeps samples.

Advantages of Needle Biopsies

Image guidance allows for avoiding crucial nearby organs and blood vessels.
Minimizes pain, scarring, and the complications of open surgery.
Recovery times are often quicker than for open surgery.

Patient Positioning and Instructions

Patient positioning typically depends on the skin entry point.

Breast Needle Biopsy

Breast tissue samples are removed using a needle.
The extracted sample is looked at in a lab for diagnosis.
Various techniques exist for breast needle biopsies, including fine needle aspiration, ultrasound-directed needle biopsy, stereotactic core needle biopsy, MRI-guided breast biopsy, and vacuum-assisted device biopsy.

Procedure: Fine Needle Aspiration

The skin around the area is cleaned.
A small needle is inserted into the breast tissue to remove fluid or tissue.
The process might be repeated for a better sample.
Blood pressure is applied around the area before covering it with a bandage aftercare.

Procedure: Ultrasound-Directed Needle Biopsy

Ultrasound helps locate the area for biopsy.
Fluid or tissue samples are collected using a small needle.
Bandaging concludes the process.

Procedure: Stereotactic Core Needle Biopsy

The patient is positioned lying down on their stomach or by sitting.
Mammogram or ultrasound images help to locate suspicious areas.
A small cut is made, and a special probe is inserted to extract multiple core tissue samples.
A bandage is applied to complete the procedure.

Procedure: MRI-Guided Breast Biopsy

Patients lie face down on a moveable examination table.
Contrast medium (gadolinium) is injected intravenously.
The breast is gently compressed, and the radiologist uses computer software to identify the lesion and needle placement.
A local anesthetic is injected.
Tissue samples are collected using a needle.
A bandage is applied once the samples have been collected

Procedure: Vacuum-Assisted Device Biopsy

A needle is inserted, and pressure from a vacuum is used to pull tissue from the mass.
Tissue is placed in a sampling chamber.
Multiple samples can be collected without needle removal.

Biopsy Tools

Biopsy needle for soft tissues.
Local anesthetic.
Sheet
Apron
Ultrasound machine
Semi-automatic disposable devices, such as the MULTI RAM and SPEEDY RAM.

Benefits of MR Guided Breast Biopsy

Accurate, quick, minimal scarring, and avoids ionizing radiation.
Rapid, safe, accurate, and cost-effective compared with other methods.
Minimally invasive procedure.
Faster recovery compared to surgical procedures.

Risks of MR Guided Breast Biopsy

Bleeding and the formation of hematoma (collection of blood) at the biopsy site (low risk).
Infection (low risk).
Discomfort (can be relieved).
Slight risk of the needle passing through the chest wall, potentially collapsing the lung.

Limitations of MR Guided Breast Biopsy

Image guidance may not be sufficient to achieve accurate sampling for deep or poorly positioned lesions.
Can miss or underestimate lesions, potentially requiring additional procedures like surgical biopsy.
High cost and limited availability.

Post-Procedure Expectations

Minor swelling or bruising is normal.
Excessive swelling, bleeding, or heat in the breast warrants physician contact.
Avoiding strenuous activity for 24 hours is generally recommended after the procedure.

Important Considerations Before Biopsy

Inform the doctor about all medications (prescription/herbal) and allergies, especially to anesthesia.
Discontinue taking aspirin or blood thinners for a specified duration.
Report recent illnesses or medical conditions.
Consider having a companion for transport home, especially if sedated.

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Description

This quiz covers key concepts related to biopsy procedures, particularly focusing on the needle biopsy of lung nodules. It explores the types of biopsies, their indications, and the anatomical context of the lungs. Understanding these aspects is crucial for recognizing when and how lung biopsies are performed.