Ultrasound-Guided Biopsy in Gomti Nagar, Lucknow

The radiologist first scans the target and plans the shortest safe path to it. The skin is cleaned and numbed with local anaesthetic, and a hollow core needle is passed along that path while the screen shows its tip. Ultrasound lets the doctor watch the needle move in real time, which is its great advantage over aiming by touch alone.

The needle is fired by a spring-loaded device. You hear a loud click as it fires, and a thin core of tissue is caught in a notch in the needle. Several cores are usually taken, each from a slightly different line.

When a vessel may lie close to the path, Colour Doppler can show blood flow on the screen first, so that the path avoids it.

The target must be clearly visible and reachable along a safe path. The common ones are:

• Liver: a mass, or the liver as a whole when tests stay abnormal. You are asked to hold your breath briefly as the needle passes.
• Thyroid: a nodule, usually after FNAC did not give a clear answer.
• Lymph node: glands in the neck, armpit, groin or abdomen. A core often gives more detail than cells alone, which helps when the exact type of the disease has to be named.
• Soft tissue: a lump in muscle, fat or under the skin, where the exact type decides the next step.
• Other organs, such as the kidney, when your doctor advises it and the target is clearly seen.

Breast tissue has its own service, breast biopsy. For the general idea of a biopsy and what happens to the sample, see biopsy.

Ultrasound cannot see through bone or gas. A target behind them, or in the lung, may need another route, and the doctor advises which.

A core needle leaves a small hole in the organ, and the organ can bleed from it. Usually this shows only as a bruise. Rarely the bleeding is deeper and needs longer observation or treatment, which may mean time in hospital. The chance is higher if your blood clots slowly, your platelet count is low or you take blood thinners.

So the team usually asks for a blood count and a clotting test before the day. Tell them about every medicine that affects clotting:

• Aspirin and clopidogrel.
• Warfarin, apixaban, rivaroxaban or dabigatran.
• Heparin injections.
• Painkillers such as ibuprofen and diclofenac, and any herbal products you use regularly.

Do not stop any of them yourself. Some people take these medicines to prevent a stroke or to protect a heart stent, so stopping can be dangerous. Tell the team and your own doctor what you take. They decide together whether a pause is safe and for how long.

Infection at the site is uncommon. Soreness for a day or two is usual. The needle can, rarely, injure a structure beside the target, which is why the path is chosen to avoid them.

Sometimes the cores come from a scar or a dead area inside the lump, and the pathologist cannot give a clear answer. A repeat sample may then be advised. The team goes through the risks that apply to your site before you sign consent.