Needle Biopsy

A needle biopsy is a procedure that takes tissue samples from an area needed to make a diagnosis.

The tissues are taken under image guidance, which means that images or pictures taken through CT, ultrasound, or x-ray are used to guide the placement of the needle into the abnormal tissue with minimal risk of damage to adjacent organs. The imaging technique used depends upon the area of the body being examined.

The needle will take out a tiny piece of tissue, which will be tested by the appropriate laboratory.

When might a needle biopsy be needed?

• A biopsy may be necessary to learn the nature of a newly diagnosed mass lesion. The most common causes of mass lesions include tumors and infections.
• Biopsy is often performed to determine the type and severity of kidney and liver disease.

How should I prepare my child for a needle biopsy?

Some children may need to have an appointment in the pre-op clinic:

• You will meet with the pre-op nurse, anesthesiologist, and interventional radiology nurse practitioner.
• Laboratory testing will be completed.
• Additional testing may be needed depending on your child's history.
• Please plan on at least two to four hours for the pre-op visit.

Your child may receive sedation or general anesthesia to help him stay still during the procedure. The interventional radiology nurse or anesthesiologist will discuss this with you and obtain consent, either on the day of the procedure or at a scheduled pre-operative visit.

Explain in simple terms why the procedure is needed and what will happen.

• Assure your child that you will be close by during the procedure.
• Your child may bring a favorite toy or blanket into the room.

What should I expect when I bring my child to the hospital for a needle biopsy?

• A staff person from Admitting, Day Surgery, or our Preoperative Clinic will call you a few days before the procedure to tell you where to go when you come to the hospital.
• When you arrive, the interventional radiologist will talk with you about the procedure and ask you to sign a consent form. You must be your child's legal guardian to sign this form. If you are a legal guardian and not a parent, you must bring legal paperwork with you showing proof of legal guardianship.
• Your child will change into a hospital gown.
• A nurse or anesthesiologist may start an intravenous (IV).
• You and your child will be brought into the room where the procedure is done. The nurse or the anesthesiologist will give some medicine through the IV to help your child relax. You may stay until your child falls asleep.
• If your child is young, he may go to sleep with medicine and a mask.
• You will be waiting in a special area until your child's procedure is done and he is settled in the post-anesthesia care unit (PACU).

What happens during a percutaneous needle biopsy?

• The interventional radiologist will explain the procedure to you and your child.
• You and your child will be brought into the room where the procedure is done. You may be able to stay until the sedation medication is given.
• At the beginning of the procedure, the interventional radiologist may examine the area to be biopsied with an ultrasound probe.
• Your child's skin is cleaned with a special iodine solution that helps prevent infection and sterile drapes are placed over the area to avoid infection.
• A local anesthetic (numbing medication) is injected into his skin.
• Once the area is numb, the radiologist passes a special type of needle through the skin into the area of abnormality. Image-guidance is used to ensure precise placement of the needle.
• When the needle is removed, it contains a small piece of tissue.
• A bandage will be placed over the area on your child's body where the biopsy was done.

What happens after the needle biopsy?

• When your child starts to wake up, a nurse takes him to the Post-Anesthesia Care Unit (PACU) or hospital room.
• A nurse watches your child closely for four to six hours. You may stay with your child.
• The radiologist or the interventional radiologist nurse practitioner will speak with you about the procedure.
• While your child is recovering from the test, he needs to stay in bed, resting quietly.
• When your child is ready, he may have clear liquids to drink like water, apple juice, or a Popsicle.
• Most of the time your child will go home the same day. Occasionally, it is necessary to admit your child.

Is a needle biopsy safe? Will it hurt?

Image-guided needle biopsy, when performed by an interventional radiologist with appropriate training and experience, is a safe technique. Like all invasive procedures, complications and side effects may occur. These will be explained to you in detail before you give your consent. The pierce of the needle through the skin may cause some discomfort but this will be minimized as much as possible by the use of local anesthetics (numbing medication) and sedation medication. If necessary, general anesthesia is available.

Your child may be exposed to ionizing radiation if x-rays or CT are used for image guidance during the procedure. We believe that the benefit to your child's health outweighs the exposure that occurs during the needle biopsy. Because children are more sensitive to radiation exposure than adults, we have been leaders in adjusting equipment and procedures to deliver the lowest possible dose to young patients.

How do I learn the results of the needle biopsy?

After the procedure, the radiologist will tell you how the procedure went and whether the biopsy was adequate. The final analysis of the biopsy by the pathologist and geneticist will require additional time and the results will be relayed to you by your physician.

How Boston Children's Hospital approaches needle biopsies

Our pediatric interventional radiologists, the doctors who do the procedure, are highly trained in the performance of invasive procedures on infants and children.

In addition to the interventional radiologist, your child will be cared for by a team of anesthesiologists, nurse practitioners, nurses, and technologists who specialize in caring for children undergoing interventional radiology procedures and treatments.

We perform needle biopsies in our suite on the second floor of the hospital, which features three procedure rooms equipped with the latest imaging technology, a recovery area for patients who have received sedation or anesthesia, and examining rooms for outpatient visits.

The hospital is capable of obtaining sophisticated pathology and genetic processing of specimens obtained during a needle biopsy.